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<text><![CDATA[1. Nama Pasien]]></text>
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<text><![CDATA[2. No. Rekam Medis]]></text>
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<textElement verticalAlignment="Middle" lineSpacing="Single">
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<text><![CDATA[4. Jenis Kelamin]]></text>
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<text><![CDATA[:]]></text>
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<text><![CDATA[:]]></text>
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<text><![CDATA[:]]></text>
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<textFieldExpression class="java.lang.String"><![CDATA[$F{no_rkm_medis}]]></textFieldExpression>
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<textFieldExpression class="java.lang.String"><![CDATA[$F{jk}]]></textFieldExpression>
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<text><![CDATA[3. Tanggal Lahir]]></text>
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<text><![CDATA[:]]></text>
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<textFieldExpression class="java.lang.String"><![CDATA[$F{nm_dokter}]]></textFieldExpression>
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<font fontName="Tahoma" size="9"/>
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<text><![CDATA[Kunjungan Awal]]></text>
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<text><![CDATA[Kontrol Lanjutan]]></text>
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<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
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<text><![CDATA[DPJP/Dokter Pemeriksa]]></text>
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<font fontName="Tahoma" size="12" isBold="true"/>
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<text><![CDATA[SURAT BUKTI PELAYANAN KESEHATAN RAWAT JALAN]]></text>
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<textFieldExpression class="java.lang.String"><![CDATA[$P{namars}]]></textFieldExpression>
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<font fontName="Tahoma" size="10"/>
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<textFieldExpression class="java.lang.String"><![CDATA[$P{alamatrs}+", Telp : "+$P{kontakrs}+" E-mail : "+$P{emailrs}]]></textFieldExpression>
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<image scaleImage="FillFrame" onErrorType="Blank">
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<imageExpression class="java.io.InputStream"><![CDATA[$P{logo}]]></imageExpression>
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<textFieldExpression class="java.lang.String"><![CDATA[$P{kotars}+", "+$P{propinsirs}]]></textFieldExpression>
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<text><![CDATA[:]]></text>
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<text><![CDATA[5. Tanggal Kunjungan RS]]></text>
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<text><![CDATA[6. Jam Masuk]]></text>
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<text><![CDATA[:]]></text>
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<text><![CDATA[Observasi]]></text>
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<text><![CDATA[Post Operasi]]></text>
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<text><![CDATA[Cara Pulang :]]></text>
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<text><![CDATA[Berat Lahir : grams]]></text>
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<textElement textAlignment="Left" verticalAlignment="Middle" lineSpacing="Single">
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<text><![CDATA[POLIKLINIK/ PENUNJANG]]></text>
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<text><![CDATA[ICD IX]]></text>
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<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
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<text><![CDATA[PROSEDUR]]></text>
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<text><![CDATA[PARAF]]></text>
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<text><![CDATA[DIAGNOSA]]></text>
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<text><![CDATA[NO]]></text>
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<text><![CDATA[ICD X]]></text>
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<text><![CDATA[7. Poliklinik]]></text>
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<text><![CDATA[:]]></text>
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<text><![CDATA[Atas Persetujuan Dokter]]></text>
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<textElement verticalAlignment="Middle" lineSpacing="Single">
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<text><![CDATA[Rujuk]]></text>
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<font fontName="Tahoma" size="9"/>
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<text><![CDATA[MRS]]></text>
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<font fontName="Tahoma" size="9"/>
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<text><![CDATA[8. Umur]]></text>
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<text><![CDATA[9. Alamat]]></text>
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<text><![CDATA[:]]></text>
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<text><![CDATA[:]]></text>
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<textFieldExpression class="java.lang.String"><![CDATA[$F{almt_pj}]]></textFieldExpression>
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<textElement textAlignment="Center" verticalAlignment="Middle" lineSpacing="Single">
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<text><![CDATA[Petugas/Perawat]]></text>
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<text><![CDATA[10. Status Pasien]]></text>
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<text><![CDATA[:]]></text>
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<textFieldExpression class="java.lang.String"><![CDATA[$F{png_jawab}]]></textFieldExpression>
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