<band height="895">
<textField>
<reportElement mode="Opaque" x="138" y="161" width="323" height="13"/>
<textElement verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="10" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$F{nm_pasien}]]></textFieldExpression>
</textField>
<staticText>
<reportElement x="165" y="85" width="269" height="16"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="12"/>
</textElement>
<text><![CDATA[PENGANTAR PERMINTAAN]]></text>
</staticText>
<line>
<reportElement x="41" y="70" width="510" height="1"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</line>
<staticText>
<reportElement x="48" y="161" width="80" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Nama]]></text>
</staticText>
<staticText>
<reportElement x="130" y="161" width="6" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<image scaleImage="FillFrame" onErrorType="Blank">
<reportElement x="89" y="18" width="51" height="51"/>
<imageExpression class="java.io.InputStream"><![CDATA[$P{logo}]]></imageExpression>
</image>
<textField>
<reportElement x="142" y="56" width="319" height="14"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA["E-mail : "+$P{emailrs}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="142" y="45" width="319" height="14"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{kontakrs}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="142" y="18" width="319" height="17"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="14"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{namars}]]></textFieldExpression>
</textField>
<textField>
<reportElement x="142" y="34" width="319" height="14"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$P{alamatrs}+", "+$P{kotars}+", "+$P{propinsirs}]]></textFieldExpression>
</textField>
<staticText>
<reportElement x="165" y="101" width="269" height="16"/>
<textElement textAlignment="Center" lineSpacing="Single">
<font fontName="Tahoma" size="12"/>
</textElement>
<text><![CDATA[TINDAKAN HEMODIALISA]]></text>
</staticText>
<staticText>
<reportElement x="48" y="146" width="413" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Mohon dilakukan tindakan hemodialisa terhadap :]]></text>
</staticText>
<staticText>
<reportElement x="130" y="177" width="6" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="48" y="177" width="80" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[No.RM]]></text>
</staticText>
<textField>
<reportElement mode="Opaque" x="138" y="177" width="323" height="13"/>
<textElement verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="10" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$F{no_rkm_medis}]]></textFieldExpression>
</textField>
<textField>
<reportElement mode="Opaque" x="138" y="193" width="90" height="13"/>
<textElement verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="10" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$F{umur}]]></textFieldExpression>
</textField>
<staticText>
<reportElement x="48" y="193" width="80" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Umur]]></text>
</staticText>
<staticText>
<reportElement x="130" y="193" width="6" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<textField>
<reportElement mode="Opaque" x="229" y="193" width="90" height="13"/>
<textElement verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="10" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[", "+$F{jk}]]></textFieldExpression>
</textField>
<textField>
<reportElement mode="Opaque" x="138" y="209" width="323" height="13"/>
<textElement verticalAlignment="Middle" lineSpacing="Single">
<font fontName="Tahoma" size="10" isBold="false"/>
</textElement>
<textFieldExpression class="java.lang.String"><![CDATA[$F{alamat}]]></textFieldExpression>
</textField>
<staticText>
<reportElement x="48" y="209" width="80" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Alamat]]></text>
</staticText>
<staticText>
<reportElement x="130" y="209" width="6" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="130" y="225" width="331" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ...................................................................]]></text>
</staticText>
<staticText>
<reportElement x="48" y="225" width="80" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Diagnosa]]></text>
</staticText>
<staticText>
<reportElement x="48" y="241" width="180" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Instruksi program hemodialisa :]]></text>
</staticText>
<staticText>
<reportElement x="48" y="257" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[1. Lama Hemodialisa]]></text>
</staticText>
<staticText>
<reportElement x="188" y="257" width="273" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................... Jam]]></text>
</staticText>
<staticText>
<reportElement x="48" y="273" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[2. Dialisat]]></text>
</staticText>
<staticText>
<reportElement x="188" y="273" width="273" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: Bicarbonat]]></text>
</staticText>
<staticText>
<reportElement x="48" y="289" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[3. Penarikan Cairan]]></text>
</staticText>
<staticText>
<reportElement x="188" y="289" width="273" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................... ml]]></text>
</staticText>
<staticText>
<reportElement x="48" y="305" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[4. Akses]]></text>
</staticText>
<staticText>
<reportElement x="188" y="305" width="273" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: Femoral / Cimino]]></text>
</staticText>
<staticText>
<reportElement x="48" y="321" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[5. Tranfusi]]></text>
</staticText>
<staticText>
<reportElement x="188" y="321" width="273" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................... Kalf / Durante HD]]></text>
</staticText>
<staticText>
<reportElement x="48" y="337" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[6. Hasil Laborat]]></text>
</staticText>
<staticText>
<reportElement x="188" y="337" width="11" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[:]]></text>
</staticText>
<staticText>
<reportElement x="198" y="337" width="46" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Ureum]]></text>
</staticText>
<staticText>
<reportElement x="198" y="353" width="46" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Hb]]></text>
</staticText>
<staticText>
<reportElement x="198" y="369" width="46" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[HsbAg]]></text>
</staticText>
<staticText>
<reportElement x="248" y="337" width="71" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................]]></text>
</staticText>
<staticText>
<reportElement x="248" y="353" width="71" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................]]></text>
</staticText>
<staticText>
<reportElement x="248" y="369" width="71" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................]]></text>
</staticText>
<staticText>
<reportElement x="328" y="369" width="46" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[CT / BT]]></text>
</staticText>
<staticText>
<reportElement x="378" y="369" width="71" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................]]></text>
</staticText>
<staticText>
<reportElement x="328" y="337" width="46" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Creatinin]]></text>
</staticText>
<staticText>
<reportElement x="328" y="353" width="46" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[GDS]]></text>
</staticText>
<staticText>
<reportElement x="378" y="353" width="71" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................]]></text>
</staticText>
<staticText>
<reportElement x="378" y="337" width="71" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: ..................]]></text>
</staticText>
<staticText>
<reportElement x="48" y="385" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[7. Lain]]></text>
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<staticText>
<reportElement x="188" y="385" width="324" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[: .........................................................................................]]></text>
</staticText>
<staticText>
<reportElement x="188" y="401" width="324" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[ .........................................................................................]]></text>
</staticText>
<staticText>
<reportElement x="188" y="417" width="324" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[ .........................................................................................]]></text>
</staticText>
<staticText>
<reportElement x="48" y="493" width="140" height="13"/>
<textElement textAlignment="Left" lineSpacing="Single">
<font fontName="Tahoma"/>
</textElement>
<text><![CDATA[Terimakasih,]]></text>
</staticText>
<staticText>
<reportElement x="48" y="525" width="210" height="13"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
</textElement>
<text><![CDATA[Penanggungjawab Unit Hemodialisa]]></text>
</staticText>
<textField>
<reportElement x="48" y="509" width="110" height="13"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
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<textFieldExpression class="java.lang.String"><![CDATA[$P{kotars}+","]]></textFieldExpression>
</textField>
<textField pattern="dd/MM/yyyy">
<reportElement x="158" y="509" width="100" height="13"/>
<textElement textAlignment="Right" lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
</textElement>
<textFieldExpression class="java.util.Date"><![CDATA[new java.util.Date()]]></textFieldExpression>
</textField>
<line direction="BottomUp">
<reportElement x="48" y="628" width="271" height="1"/>
<graphicElement>
<pen lineWidth="0.5"/>
</graphicElement>
</line>
<textField>
<reportElement x="48" y="613" width="271" height="13"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
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<textFieldExpression class="java.lang.String"><![CDATA[$P{dokter}]]></textFieldExpression>
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<textField>
<reportElement x="48" y="631" width="271" height="13"/>
<textElement lineSpacing="Single">
<font fontName="Tahoma" size="10"/>
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<textFieldExpression class="java.lang.String"><![CDATA[$P{nipdokter}]]></textFieldExpression>
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