<band height="804">
<textField>
<reportElement x="0" y="44" width="555" height="14"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA["E-mail : "+$P{emailrs}]]></textFieldExpression>
</textField>
<rectangle>
<reportElement x="0" y="85" width="557" height="603"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</rectangle>
<textField>
<reportElement x="164" y="87" width="207" height="14"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="11" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{nama}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="164" y="101" width="207" height="14"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="11" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{jkel}]]></textFieldExpression>
</textField>
<textField pattern="">
<reportElement x="164" y="115" width="207" height="14"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="11" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{lahir}]]></textFieldExpression>
</textField>
<textField>
<reportElement mode="Transparent" x="423" y="87" width="133" height="14"/>
<textElement verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{norm}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="423" y="101" width="133" height="14"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="11" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{ruang}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="423" y="115" width="133" height="14"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="11" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{kelas}]]></textFieldExpression>
</textField>
<rectangle>
<reportElement x="519" y="60" width="38" height="20"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</rectangle>
<staticText>
<reportElement x="521" y="61" width="34" height="17"/>
<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[RM 8B]]></text>
</staticText>
<staticText>
<reportElement x="378" y="87" width="40" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[No RM]]></text>
</staticText>
<staticText>
<reportElement x="378" y="101" width="40" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[Ruang]]></text>
</staticText>
<staticText>
<reportElement x="378" y="115" width="40" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[Kelas]]></text>
</staticText>
<staticText>
<reportElement x="416" y="87" width="7" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="416" y="101" width="7" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="416" y="115" width="7" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<line>
<reportElement x="0" y="132" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<line>
<reportElement x="372" y="85" width="1" height="47"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="157" y="87" width="7" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="88" y="87" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[Nama Pasien]]></text>
</staticText>
<staticText>
<reportElement x="0" y="94" width="80" height="14"/>
<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[FORMULIR]]></text>
</staticText>
<staticText>
<reportElement x="0" y="108" width="80" height="14"/>
<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[ASUHAN GIZI]]></text>
</staticText>
<line>
<reportElement x="80" y="85" width="1" height="47"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="88" y="101" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[Jenis Kelamin]]></text>
</staticText>
<staticText>
<reportElement x="88" y="115" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[Tanggal Lahir]]></text>
</staticText>
<staticText>
<reportElement x="157" y="101" width="7" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="157" y="115" width="7" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<line>
<reportElement x="0" y="738" width="557" height="1"/>
<graphicElement>
<pen lineWidth="2.0" lineStyle="Solid"/>
</graphicElement>
</line>
<staticText>
<reportElement x="0" y="739" width="230" height="20"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[REKAM MEDIK PELAYANAN GIZI]]></text>
</staticText>
<staticText>
<reportElement x="6" y="134" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[TANGGAL]]></text>
</staticText>
<staticText>
<reportElement x="6" y="148" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[DIAGNOSA]]></text>
</staticText>
<staticText>
<reportElement x="76" y="134" width="5" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="76" y="148" width="5" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<line>
<reportElement x="0" y="163" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="0" y="165" width="555" height="14"/>
<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="11"/>
</textElement>
<text><![CDATA[ASSESMENT GIZI]]></text>
</staticText>
<staticText>
<reportElement x="6" y="179" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[ANTROPOMERI]]></text>
</staticText>
<staticText>
<reportElement x="6" y="192" width="17" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[BB]]></text>
</staticText>
<staticText>
<reportElement x="23" y="192" width="56" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[: Kg]]></text>
</staticText>
<staticText>
<reportElement x="6" y="205" width="17" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[TB]]></text>
</staticText>
<staticText>
<reportElement x="23" y="205" width="56" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[: Cm]]></text>
</staticText>
<staticText>
<reportElement x="23" y="218" width="56" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[: Kg/Cm]]></text>
</staticText>
<staticText>
<reportElement x="6" y="218" width="17" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[IMT]]></text>
</staticText>
<staticText>
<reportElement x="84" y="192" width="84" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Lingkar Lengan atas]]></text>
</staticText>
<staticText>
<reportElement x="168" y="192" width="56" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[: ]]></text>
</staticText>
<staticText>
<reportElement x="84" y="205" width="84" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Tinggi Lutut]]></text>
</staticText>
<staticText>
<reportElement x="168" y="205" width="56" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[: ]]></text>
</staticText>
<line>
<reportElement x="0" y="234" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="235" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[BIOKIMIA]]></text>
</staticText>
<line>
<reportElement x="0" y="289" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="290" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[FISIK / KLINIS]]></text>
</staticText>
<line>
<reportElement x="0" y="341" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="342" width="70" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[RIWAYAT GIZI]]></text>
</staticText>
<line>
<reportElement x="0" y="357" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="358" width="97" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[ALERGI MAKANAN]]></text>
</staticText>
<staticText>
<reportElement x="206" y="371" width="42" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[YA]]></text>
</staticText>
<staticText>
<reportElement x="248" y="371" width="42" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[TIDAK]]></text>
</staticText>
<staticText>
<reportElement x="6" y="386" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Telur]]></text>
</staticText>
<staticText>
<reportElement x="6" y="399" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Susu sapi dan produk olahannya]]></text>
</staticText>
<staticText>
<reportElement x="6" y="412" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Kacang kedelai / tanah]]></text>
</staticText>
<staticText>
<reportElement x="6" y="425" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Gluten / gandum]]></text>
</staticText>
<staticText>
<reportElement x="6" y="438" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Udang]]></text>
</staticText>
<staticText>
<reportElement x="6" y="451" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Ikan]]></text>
</staticText>
<staticText>
<reportElement x="6" y="464" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[Hazelnut / almont]]></text>
</staticText>
<staticText>
<reportElement x="6" y="484" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[POLA MAKAN]]></text>
</staticText>
<rectangle>
<reportElement x="207" y="389" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="207" y="402" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="207" y="415" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="207" y="428" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="207" y="441" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="207" y="454" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="207" y="467" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="257" y="467" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="257" y="389" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="257" y="441" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="257" y="428" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="257" y="454" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="257" y="415" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<rectangle>
<reportElement x="257" y="402" width="9" height="9"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</rectangle>
<line>
<reportElement x="0" y="527" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="528" width="97" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[RIWAYAT PESONAL]]></text>
</staticText>
<line>
<reportElement x="0" y="567" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="568" width="97" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[DIAGNOSIS]]></text>
</staticText>
<line>
<reportElement x="0" y="606" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="608" width="97" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[INTERVENSI GIZI]]></text>
</staticText>
<line>
<reportElement x="0" y="646" width="557" height="1"/>
<graphicElement>
<pen lineWidth="0.75"/>
</graphicElement>
</line>
<staticText>
<reportElement x="6" y="648" width="139" height="14"/>
<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<text><![CDATA[MONOTORING DAN EVALUASI]]></text>
</staticText>
<textField pattern="dd/MM/yyyy" isBlankWhenNull="true">
<reportElement x="83" y="134" width="207" height="14"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="11" isBold="false"/>
</textElement>
<textFieldExpression class="java.util.Date"><![CDATA[$F{tanggal}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="0" y="34" width="555" height="14"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{kontakrs}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="0" y="9" width="555" height="17"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="13"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{namars}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="0" y="23" width="555" height="14"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="9"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{alamatrs}+", "+$P{kotars}+", "+$P{propinsirs}]]></textFieldExpression>
</textField>
<image scaleImage="FillFrame" isUsingCache="true" onErrorType="Blank">
<reportElement x="1" y="10" width="45" height="45"/>
<imageExpression class="java.io.InputStream"><![CDATA[$P{logo}]]></imageExpression>
</image>
<line>
<reportElement x="0" y="56" width="557" height="1"/>
<graphicElement>
<pen lineWidth="2.0" lineStyle="Double"/>
</graphicElement>
</line>
</band>