Edit Laporan

Nama

Tgl Lahir

Jenis Kelamin

NO RM

Tgl

Jam

ALERGI

Sumber Data :

Judul Penilaian Nyeri

SKALA NYERI

Nyeri Hilang Dengan

Nyeri

Karakteristik

Lokasi

Durasi

Frekuensii

Judul Anamnesa

Keluhan Utama

RIWAYAT PENYAKIT DAHULU DAN RIWAYAT PENGOBATAN

Riwayat penyakit keluarga

Riwayat Pekerjaan, Sosial, ekonomi, psikologi dan kebiasaan

Tanda-Tanda Vital

Keadaan Umum

BB

TB

Tensi

Suhu

Nadi :

Respirasi

PEMERIKSAAN FISIK.

<table class="MsoNormalTable" border="1" cellspacing="0" cellpadding="0" width="709" style="margin-left: 13.85pt; border: none;">
 <tbody><tr style="mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes;
 height:3.5pt">
 <td width="709" valign="top" style="width:531.55pt;border:solid black 1.0pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:3.5pt">
  
 PEMERIKSAAN FISIK<o:p></o:p>
 <table class="MsoNormalTable" border="1" cellspacing="0" cellpadding="0" width="684" style="border: none;">
 <tbody><tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 No<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border:solid black 1.0pt;
 border-left:none;mso-border-left-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 Anggota Tubuh<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border:solid black 1.0pt;
 border-left:none;mso-border-left-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 Normal<o:p></o:p>
 <w:sdt sdttag="goog_rdk_0" id="1497998614">( beri tanda √ )</w:sdt><o:p></o:p>
 </td>
 <td width="398" valign="top" style="width:298.85pt;border:solid black 1.0pt;
 border-left:none;mso-border-left-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 Abnormal ( jelaskan )<o:p></o:p>
 </td>
 </tr>
 <tr style="mso-yfti-irow:1;height:19.5pt">
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt;height:19.5pt">
 1<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:19.5pt">
 Kepala<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:19.5pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:19.5pt">
  
 </td>
 </tr>
 <tr style="mso-yfti-irow:2;height:14.0pt">
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt;height:14.0pt">
 2<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:14.0pt">
 Mata<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:14.0pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:14.0pt">
  
 </td>
 </tr>
 <tr style="mso-yfti-irow:3;height:16.45pt">
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt;height:16.45pt">
 3<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:16.45pt">
 Leher<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:16.45pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt;height:16.45pt">
  
 </td>
 </tr>
 <tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 4<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 THT<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 </tr>
 <tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 5<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 Mulut<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 </tr>
 <tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 6<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 Jantung<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 </tr>
 <tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 7<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 Paru<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 </tr>
 <tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 8<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 Abdomen<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 </tr>
 <tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 9<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 Genitalia<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 </tr>
 <tr>
 <td width="40" valign="top" style="width:29.8pt;border:solid black 1.0pt;
 border-top:none;mso-border-top-alt:solid black .5pt;mso-border-alt:solid black .5pt;
 padding:0cm 5.4pt 0cm 5.4pt">
 10<o:p></o:p>
 </td>
 <td width="142" valign="top" style="width:106.3pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
 Extremitas<o:p></o:p>
 </td>
 <td width="104" valign="top" style="width:77.95pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 <td width="398" valign="top" style="width:298.85pt;border-top:none;border-left:
 none;border-bottom:solid black 1.0pt;border-right:solid black 1.0pt;
 mso-border-top-alt:solid black .5pt;mso-border-left-alt:solid black .5pt;
 mso-border-alt:solid black .5pt;padding:0cm 5.4pt 0cm 5.4pt">
  
 </td>
 </tr>
 </tbody></table>
 <o:p></o:p>
 </td>
 </tr>
</tbody></table>

DIAGNOSA KERJA

Diagnosa Utama

Diagnosa Tambahan

DIAGNOSA BANDING

Diagnosa kerja

<table class="MsoNormalTable" border="0" cellspacing="0" cellpadding="0" width="514" style="width: 385.8pt;">
 <tbody><tr style="mso-yfti-irow:0;mso-yfti-firstrow:yes;height:14.4pt;mso-row-margin-right:
 1.8pt">
 <td width="256" nowrap="" colspan="2" valign="bottom" style="width:192.0pt;border:
 solid windowtext 1.0pt;mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">RENCANA TATALAKSANA<o:p></o:p>
 </td>
 <td width="256" nowrap="" valign="bottom" style="width:192.0pt;border:solid windowtext 1.0pt;
 border-left:none;mso-border-top-alt:solid windowtext .5pt;mso-border-bottom-alt:
 solid windowtext .5pt;mso-border-right-alt:solid windowtext .5pt;padding:
 .75pt 5.4pt 0cm 5.4pt;height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">INTRUKSI (DENGAN TARGET TERUKUR)<o:p></o:p>
 </td>
 <td style="mso-cell-special:placeholder;border:none;padding:0cm 0cm 0cm 0cm" width="2"> </td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:1;height:20.4pt;mso-row-margin-right:1.8pt">
 <td width="256" nowrap="" colspan="2" rowspan="2" valign="bottom" style="width:192.0pt;
 border:solid windowtext 1.0pt;border-top:none;mso-border-top-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:20.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">1. Edukasi<o:p></o:p>
 </td>
 <td width="256" rowspan="2" style="width:192.0pt;border-top:none;border-left:
 none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:20.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">□Ya (isi edukasiterlampir)    
 □Tidak<o:p></o:p>
 </td>
 <td style="mso-cell-special:placeholder;border:none;padding:0cm 0cm 0cm 0cm" width="2"> </td>
 
 <td style="height:20.4pt;border:none" width="0" height="34"></td>
 
 </tr>
 <tr style="mso-yfti-irow:2;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:3;height:14.4pt">
 <td width="256" colspan="2" rowspan="2" style="width:192.0pt;border:solid windowtext 1.0pt;
 border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
 padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">2. Pemeriksaan Penunjang 
 (Diagnostik) Lanjutan<o:p></o:p>
 </td>
 <td width="256" nowrap="" rowspan="2" valign="bottom" style="width:192.0pt;border-top:
 none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID"> <o:p></o:p>
 </td>
 <td width="2" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:4;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:5;height:14.4pt">
 <td width="256" colspan="2" rowspan="2" style="width:192.0pt;border:solid windowtext 1.0pt;
 border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
 padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">3. Diet<o:p></o:p>
 </td>
 <td width="256" nowrap="" rowspan="2" valign="bottom" style="width:192.0pt;border-top:
 none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID"> <o:p></o:p>
 </td>
 <td width="2" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:6;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:7;height:14.4pt">
 <td width="256" colspan="2" rowspan="2" style="width:192.0pt;border:solid windowtext 1.0pt;
 border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
 padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">4. Nyeri (Khusus nyeri sedang-berat<o:p></o:p>
 </td>
 <td width="256" nowrap="" rowspan="2" valign="bottom" style="width:192.0pt;border-top:
 none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID"> <o:p></o:p>
 </td>
 <td width="2" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:8;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:9;height:14.4pt">
 <td width="87" nowrap="" rowspan="5" style="width:65.5pt;border:solid windowtext 1.0pt;
 border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
 padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">5. Terapi<o:p></o:p>
 </td>
 <td width="169" rowspan="3" style="width:126.5pt;border-top:none;border-left:
 none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">Non farmakologis<o:p></o:p>
 </td>
 <td width="256" nowrap="" rowspan="3" valign="bottom" style="width:192.0pt;border-top:
 none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID"> <o:p></o:p>
 </td>
 <td width="2" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:10;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:11;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:12;height:14.4pt">
 <td width="169" nowrap="" rowspan="2" style="width:126.5pt;border-top:none;
 border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID">Farmakologis<o:p></o:p>
 </td>
 <td width="256" nowrap="" rowspan="2" valign="bottom" style="width:192.0pt;border-top:
 none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID"> <o:p></o:p>
 </td>
 <td width="2" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:13;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:14;height:14.4pt">
 <td width="256" nowrap="" colspan="2" rowspan="3" style="width:192.0pt;border:solid windowtext 1.0pt;
 border-top:none;mso-border-top-alt:solid windowtext .5pt;mso-border-alt:solid windowtext .5pt;
 padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:"Times New Roman";
 mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;color:black;
 mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:EN-ID">6.
 Tindakan<o:p></o:p>
 </td>
 <td width="256" nowrap="" rowspan="3" valign="bottom" style="width:192.0pt;border-top:
 none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;
 mso-border-top-alt:solid windowtext .5pt;mso-border-left-alt:solid windowtext .5pt;
 mso-border-alt:solid windowtext .5pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt">
 <span style="mso-ascii-font-family:Calibri;mso-fareast-font-family:
 "Times New Roman";mso-hansi-font-family:Calibri;mso-bidi-font-family:Calibri;
 color:black;mso-font-kerning:0pt;mso-ligatures:none;mso-fareast-language:
 EN-ID"> <o:p></o:p>
 </td>
 <td width="2" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:15;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
 <tr style="mso-yfti-irow:16;mso-yfti-lastrow:yes;height:14.4pt">
 <td width="2" nowrap="" valign="bottom" style="width:1.8pt;padding:.75pt 5.4pt 0cm 5.4pt;
 height:14.4pt"></td>
 
 <td style="height:14.4pt;border:none" width="0" height="24"></td>
 
 </tr>
</tbody></table>

<o:p> </o:p>

PENGKAJIAN AWAL MEDIS RAWAT JALAN