RS SIMRS KHANZA GUWOSARI, Pajangan, Bantul Hp: 08562675039, 085296559963, E-mail : [email protected] MONITORING REAKSI TRANFUSI PERIODE 09-03-2023 s.d. 09-03-2023

No.Rawat

No.R.M.

Nama Pasien

Umur

JK

Tgl.Lahir

Tgl.Obser

Jam Obser

Produk/Jenis Darah

No.Kantong

Lokasi Insersi

TD(mmHg)

HR(x/menit)

RR(x/menit)

Suhu(°C)

Alergi

Keterangan

NIP

Nama Petugas

2023/01/27/000002

000003

HAFIZ HARIYADI

25 Th

L

1997-05-22

2023-03-09

18:16:45

12121212

2

qwqwqwq

4

5

6

7

8

9

123124

FREDIAN AHMAD