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<text><![CDATA[Tanggal]]></text>
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<staticText>
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<text><![CDATA[No RM]]></text>
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<staticText>
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<text><![CDATA[Ruang/Kamar]]></text>
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<font fontName="Tahoma" size="8"/>
<paragraph lineSpacing="Single"/>
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<text><![CDATA[Kelas]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Nama Pasien]]></text>
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<staticText>
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<text><![CDATA[Perawatan yang ke :]]></text>
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<text><![CDATA[Tgl. Lahir]]></text>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Jam ]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Datang dengan]]></text>
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<staticText>
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<text><![CDATA[Penanggung jawab dalam kondisi darurat :]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Pasien masuk dari]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Agama]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Status Perkawinan]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Nomor Telpon/HP]]></text>
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<staticText>
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<text><![CDATA[Perawat Penanggung Jawab :]]></text>
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<staticText>
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<text><![CDATA[(]]></text>
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<staticText>
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<text><![CDATA[)]]></text>
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<textField>
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<textElement>
<font fontName="Tahoma" size="10"/>
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<textFieldExpression><![CDATA[$P{namars}]]></textFieldExpression>
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<textField>
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<textFieldExpression><![CDATA[$P{kontakrs}]]></textFieldExpression>
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<image scaleImage="FillFrame" onErrorType="Blank">
<reportElement x="0" y="4" width="49" height="49" uuid="248f4566-0563-40d2-8cb5-61ad8439f441"/>
<imageExpression><![CDATA[$P{logo}]]></imageExpression>
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<textFieldExpression><![CDATA[$P{alamatrs}+", "+$P{kotars}+", "+$P{propinsirs}]]></textFieldExpression>
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<textField>
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<textElement>
<font fontName="Tahoma" size="8"/>
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<textFieldExpression><![CDATA["E-mail : "+$P{emailrs}]]></textFieldExpression>
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<text><![CDATA[Pertama]]></text>
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<staticText>
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<text><![CDATA[Alamat]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Kasus Kepolisian]]></text>
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<staticText>
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<text><![CDATA[Dirawat terakhir Tanggal :]]></text>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[Pembiyayaan]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[WIB]]></text>
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<staticText>
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<text><![CDATA[SMF]]></text>
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<staticText>
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<text><![CDATA[:]]></text>
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<staticText>
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<text><![CDATA[* Nama]]></text>
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<text><![CDATA[Lama]]></text>
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<rectangle>
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<rectangle>
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<text><![CDATA[MASUK RAWAT INAP]]></text>
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<text><![CDATA[RINGKASAN MASUK KELUAR]]></text>
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<line>
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<text><![CDATA[DOKTER YANG MERAWAT :]]></text>
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<text><![CDATA[DIAGNOSA AWAL MASUK]]></text>
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<text><![CDATA[DIAGNOSA AKHIR]]></text>
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<text><![CDATA[Diagnosa Utama :]]></text>
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<text><![CDATA[ TINDAKAN]]></text>
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<rectangle>
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<text><![CDATA[Cara keluar :]]></text>
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<rectangle>
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<rectangle>
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<rectangle>
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<text><![CDATA[Dipulangkan]]></text>
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<paragraph lineSpacing="Single"/>
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<text><![CDATA[Baik]]></text>
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<staticText>
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<paragraph lineSpacing="Single"/>
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<text><![CDATA[Saat masuk :]]></text>
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<staticText>
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<text><![CDATA[Saat keluar :]]></text>
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<text><![CDATA[Penyakit :]]></text>
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<staticText>
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<paragraph lineSpacing="Single"/>
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<text><![CDATA[Sebab :]]></text>
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<staticText>
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<text><![CDATA[Pasien meninggal :]]></text>
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<staticText>
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<text><![CDATA[Cukup]]></text>
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<staticText>
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<paragraph lineSpacing="Single"/>
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<text><![CDATA[Penampilan]]></text>
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<text><![CDATA[Atas Permintaan (APS)]]></text>
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<text><![CDATA[Lemah]]></text>
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<text><![CDATA[Kecelakaan / KTD]]></text>
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<text><![CDATA[Lari]]></text>
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<text><![CDATA[Bunuh diri]]></text>
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<text><![CDATA[Maninggal]]></text>
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<text><![CDATA[Jelek]]></text>
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<text><![CDATA[Usia / senesens]]></text>
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<textFieldExpression><![CDATA[$F{no_rkm_medis}]]></textFieldExpression>
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<textFieldExpression><![CDATA[$F{nm_pasien}]]></textFieldExpression>
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<textField pattern="dd/MM/yyyy">
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<textFieldExpression><![CDATA[$F{tgl_lahir}]]></textFieldExpression>
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<textField>
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<textFieldExpression><![CDATA[$F{umur}]]></textFieldExpression>
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<textField>
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<textField>
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<textFieldExpression><![CDATA[$F{no_tlp}]]></textFieldExpression>
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<textFieldExpression><![CDATA[$P{ruang}]]></textFieldExpression>
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<textFieldExpression><![CDATA[$F{no_peserta}]]></textFieldExpression>
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<textField>
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<text><![CDATA[ICD-X :]]></text>
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<staticText>
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<text><![CDATA[ICD-9CM]]></text>
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<text><![CDATA[Ya]]></text>
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<text><![CDATA[Tidak]]></text>
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<text><![CDATA[Umur :]]></text>
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<text><![CDATA[Kedua]]></text>
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<text><![CDATA[Ketiga]]></text>
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<text><![CDATA[.........................]]></text>
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<text><![CDATA[* Telpon]]></text>
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<text><![CDATA[RAWAT BERSAMA DENGAN :]]></text>
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<text><![CDATA[DOKTER ANESTESI :]]></text>
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<text><![CDATA[OPERASI OLEH :]]></text>
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<text><![CDATA[Et Causa :]]></text>
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<text><![CDATA[Diagnosa Sekunder :]]></text>
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<text><![CDATA[DPJP AKhir :]]></text>
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