Cara Membuat Masker Wajah yang Alami

Format Dokumentasi Asuhan Keperawatan (Askep) Doc Terlengkap

<div style="text-align: justify;"> Didalam dunia keperawatan askep merupakan sebuah pegangan atau aliran seorang perawat dalam melaksanakan pelayananan berupa asuhan keperawatan untuk sanggup memecahkan problem pasien.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBQNluartBTnHXfSAVONVn7y4M4u3ft3tHGiaKwfiYHKTsk8FXx1wOhnz1wymqjg6km5BD0xb7_SQZUNx1cOclsGwFrkm6nPmpvyEhWn8fqNvhScJsIuICiTv18geP6SBLa9n0ivG-zNzx/s1600/Format+askep.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="297" data-original-width="444" height="214" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBQNluartBTnHXfSAVONVn7y4M4u3ft3tHGiaKwfiYHKTsk8FXx1wOhnz1wymqjg6km5BD0xb7_SQZUNx1cOclsGwFrkm6nPmpvyEhWn8fqNvhScJsIuICiTv18geP6SBLa9n0ivG-zNzx/s320/Format+askep.png" width="320" /></a>Dari itu sebagai seorang perawat, haruslah memliki konsep yang terang dalam menyusun sebuah askep, sebuah askep yang seyogyanya merupakan amunisi perawat dalam melaksanakan tindakannya dan sebagai benteng yang bisa membackup nya dari problem dikemudian hari.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Dari itu kita sebagai perawat diharuskan sanggup menyusun askep dengan baik dan benar sesuai dengan format yang telah ditetapkan biar perumusan problem pasien pun sanggup terkerucut dan juga sanggup dituntaskan dengan baik oleh seorang perawat.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Dalam penyusunannya, format askep harus sesuai dengan langkah-langkah asuhan keperawatan yang akan dilakuakan mulai dari pengkajian, diagnosa keperawatan, perencanaan / intervensi, pelaksanaan / implementasi, dan evaluasi.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Untuk mempermudah dalam penyusunan Asuhan keperawatan (Askep) disini kami coba share format asuhan keperawatan, silahkan lihat dibawah :<br /> <br /> <br /></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b><span style="font-family: "times new roman" , "serif"; font-size: 14pt;">ASUHAN KEPERAWATAN PADA  Tn. …… DENGAN RESIKO INFEKSI B/D ………………….DENGAN DIAGNOSA MEDIS............. DI RUANG …………… RS………. KOTA ………….</span></b> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <br /></div> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Tanggal masuk            : ……</span></div> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Jam                            : ……</span></div> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">No RM                      : ……</span></div> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Tgl pengkajian            : ………</span></div> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Jam                            : …………….</span></div> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Diagnosa medis          : ………………….</span></div> </div> <div class="MsoNormal" style="line-height: normal;"> <div style="text-align: justify;"> <br /></div> </div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; text-indent: -.25in;"> <div style="text-align: justify;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">    A.<span style="font: 7pt "Times New Roman";">    </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pengkajian</span></b></div> </div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 13.5pt; mso-add-space: auto; mso-list: l7 level1 lfo41; text-indent: -13.5pt;"> <div style="text-align: justify;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">1.<span style="font: 7pt "Times New Roman";">   </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Identitas pasien dan penanggung jawab</span></b></div> </div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 5.4pt; text-align: justify;"><tbody> <tr style="height: 20.65pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; height: 20.65pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 202.5pt;" valign="top" width="270"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Identitas pasien</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; height: 20.65pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 199.8pt;" valign="top" width="266"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Identitas penanggung jawab</span></div> </td>  </tr> <tr style="height: 163.75pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; height: 163.75pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 202.5pt;" valign="top" width="270"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Nama                 : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Umur               : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 1.0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Agama             :   </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Jenis   kelamin    : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Alamat            <span style="background-color: #e06666;"></span> : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Suku   / bangsa  : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pekerjaan           : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pendidikan        : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Status                : </span></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 163.75pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 199.8pt;" valign="top" width="266"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Nama                 : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Umur               : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: 1.0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Agama             :   </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Jenis   kelamin   : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Alamat              : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Suku   / bangsa  : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pekerjaan           : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pendidikan        : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Status                : </span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Hub   dgn klien : </span></div> </td>  </tr> </tbody></table> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 13.5pt; mso-add-space: auto; mso-list: l7 level1 lfo41; text-indent: -13.5pt;"> <div style="text-align: justify;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><br /></span></b></div> <div style="text-align: justify;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">2.<span style="font: 7pt "Times New Roman";">   </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Riwayat kesehatan </span></b></div> </div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; mso-list: l70 level1 lfo42; text-indent: -.25in;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">a.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Keluhan utama</span></div> </div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………………</span></div> </div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l70 level1 lfo42; text-indent: -.25in;"> <div style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">b.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Riwayat kesehatan sekarang</span></div> </div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.7pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-indent: -.25in;"> <div style="text-align: justify;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Waktu terjadinya sakit</span></div> </div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.7pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.7pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <br /></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Proses terjadinya sakit</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Upaya yang telah di lakukan</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; tab-stops: .75in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-indent: -.25in;"> <div style="text-align: justify;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Hasil investigasi sementara / sekarang</span></div> </div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">P     : ……………………</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Q     : ………………………</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">R     : ……………</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">S     : ……………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">T     : …………………………</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 31.5pt; margin-right: 0in; margin-top: 0in; mso-list: l70 level1 lfo42; tab-stops: .5in; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">c.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Riwayat kesehatan dahulu</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Penyakit dahulu</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Perlukaan</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Dirawat di RS</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Alergi obat / makanan</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 49.5pt; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Obat-obatan kini :</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-list: l56 level1 lfo59; text-align: justify; text-indent: -.25in;"> <span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;">·<span style="font: 7pt "Times New Roman";">         </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………….....</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 85.5pt; mso-add-space: auto; mso-list: l56 level1 lfo59; text-align: justify; text-indent: -.25in;"> <span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;">·<span style="font: 7pt "Times New Roman";">         </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; mso-list: l70 level1 lfo42; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">d.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Riwayat kesehatan keluarga</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; mso-list: l70 level1 lfo42; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">e.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Genogram</span></div> <div class="MsoListParagraphCxSpMiddle" style="text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;">           ………………………………..</span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"></span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Keterangan:               </span><br /> <br /> <ul> <li>Laki-laki (hidup)</li> <li>Laki-laki (meninggal)</li> <li>Wanita (hidup)</li> <li>Wanita (meninggal)</li> <li>Pasien</li> <li>Penderita penyakit (.....)</li> <li>Serumah dengan pasien         </li> </ul> (Note : Untuk genogram silahkan dibentuk sendiri sesuai dengan silsilah keluarga pasien dan tanda keterangan silahkan kreasi sendiri)</div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 31.5pt; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l7 level1 lfo41; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">3.<span style="font: 7pt "Times New Roman";">      </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola fungsi kesehatan</span></b></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            a.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola administrasi kesehatan – persepsi kesehatan</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Tingkat pengetahuan kesehatan / penyakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Prilaku untuk mengatasi problem kesehatan</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Factor-faktor resiko sehubungan dengan kesehatan</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           b.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola kegiatan dan latihan</span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; tab-stops: .75in; text-align: justify; text-indent: -31.5pt;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;"> Ø<span style="font: 7pt "Times New Roman";">    </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><i>Sebelum sakit<i></i></i></span></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 41.4pt; text-align: justify;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Aktifitas</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">0</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">1</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">2</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">3</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">4</span></div> </td>  </tr> <tr style="mso-yfti-irow: 1;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Makan</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 2;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Mandi </span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 3;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Berpakaian</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 4;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Eliminasi</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 5;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Mobilisasi ditempat tidur</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 6;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Berpindah </span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 7;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Ambulansi</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 8; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 3.5in;" valign="top" width="336"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Naik tangga</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 22.5pt;" valign="top" width="30"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 24.3pt;" valign="top" width="32"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>  </tr> </tbody></table> <div class="MsoListParagraph" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <br /></div> <div class="MsoListParagraph" style="line-height: 150%; margin-left: 0.75in; text-align: justify; text-indent: -0.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit</span><br /> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Tabel yang dipakai sama dengan tabel sebelum sakit .</span><br /> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><br /></span></div> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: 0in; margin-top: 0in; text-align: justify; text-indent: .5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Keterangan : </span></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.0in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l83 level1 lfo46; text-align: justify; text-indent: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">0<span style="font: 7pt "Times New Roman";">                    </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">: Mandiri</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l83 level1 lfo46; text-align: justify; text-indent: -.5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">1<span style="font: 7pt "Times New Roman";">                    </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">: Di bantu sebagian</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l83 level1 lfo46; text-align: justify; text-indent: -.5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">2<span style="font: 7pt "Times New Roman";">                    </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">: Di bantu orang lain</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l83 level1 lfo46; text-align: justify; text-indent: -.5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">3<span style="font: 7pt "Times New Roman";">                    </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">: Di bantu orang dan peralatan</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 1.5in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; mso-list: l83 level1 lfo46; text-align: justify; text-indent: -.5in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">4<span style="font: 7pt "Times New Roman";">                    </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">: Ketergantungan / tidak mampu  </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0.0001pt 1.5in; text-align: justify; text-indent: -0.5in;"> </div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           c.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola istirahat tidur</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"> ………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           d.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola nutrisi dan metabolik</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Selama sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">A: …………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">B: …………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">C:……………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">D:……………… …….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">          e.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola eliminasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           f.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola kognitif dan perceptual</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit.</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………  </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           g.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola konsep diri</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Gambaran diri</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Identitas diri</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Peran diri</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………...</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Ideal diri</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Harga diri</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           h.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola toleransi stress-koping</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">i           .<span style="font: 7pt "Times New Roman";">        </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola reproduksi-seksualitas</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….  </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           j.<span style="font: 7pt "Times New Roman";">        </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola kekerabatan peran</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l25 level1 lfo44; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           k.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pola nilai dan keyakinan</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Sebelum sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Saat sakit</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">    B.<span style="font: 7pt "Times New Roman";">     </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Pemeriksaan fisik</span></b></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l55 level1 lfo47; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">1.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Penampakan umum</span></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 23.4pt; text-align: justify;"><tbody> <tr style="height: 28.3pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; height: 28.3pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 1.25in;" valign="top" width="120"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Keadaan   umum</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; height: 28.3pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 294.3pt;" valign="top" width="392"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………..</span></div> </td>  </tr> <tr style="mso-yfti-irow: 1;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 1.25in;" valign="top" width="120"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Kesadaran</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 294.3pt;" valign="top" width="392"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">……………</span></div> </td>  </tr> <tr style="mso-yfti-irow: 2;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 1.25in;" valign="top" width="120"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">GCS</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 294.3pt;" valign="top" width="392"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Eye   : …..   Verbal:…..   Motorik :…… Total =….</span></div> </td>  </tr> <tr style="mso-yfti-irow: 3;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 1.25in;" valign="top" width="120"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">BB   </span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 294.3pt;" valign="top" width="392"><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-yfti-tbllook: 1184;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;">     <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 123.35pt;" valign="top" width="164"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"> ……… kg</span></div> </td>     <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 123.4pt;" valign="top" width="165"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">TB:     … cm</span></div> </td>    </tr> </tbody></table> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"></span></div> </td>  </tr> <tr style="mso-yfti-irow: 4;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 1.25in;" valign="top" width="120"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Skala   nyeri</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 294.3pt;" valign="top" width="392"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">   ………</span></div> </td>  </tr> <tr style="mso-yfti-irow: 5; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 1.25in;" valign="top" width="120"><div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">TD:….mmHg</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 294.3pt;" valign="top" width="392"><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: medium none; width: 337px;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0; mso-yfti-lastrow: yes;">     <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 80.75pt;" valign="top" width="108"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Suhu     : …ºC</span></div> </td>     <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 80.75pt;" valign="top" width="108"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">RR     : …x/mnt</span></div> </td>     <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 91.55pt;" valign="top" width="122"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Nadi     : ….x/mnt</span></div> </td>    </tr> </tbody></table> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"></span></div> </td>  </tr> </tbody></table> <div class="MsoNormal" style="tab-stops: 22.5pt; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l55 level1 lfo47; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">2.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Kepala dan leher</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            a.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Rambut</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            b.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Mata </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           c.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Telinga</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            d.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Hidung</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            e.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Mulut</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">             f.<span style="font: 7pt "Times New Roman";">       </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Leher</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            g.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Dada </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..<span style="color: #00b050;"></span></span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Perkusi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Auskultasi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            h.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Jantung</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Perkusi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Auskultasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; mso-list: l1 level1 lfo48; tab-stops: 27.0pt 31.5pt; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">               i.<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Abdomen</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………..</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Auskultasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">            …………………………………………………………………….......</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Perkusi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; text-align: justify; text-indent: .25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">           ………………………………………………………………………........</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………………………………………………………………………….</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 27.0pt; margin-right: 0in; margin-top: 0in; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -9.0pt;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">j.<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inguinal dan genetalia</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inpeksi </span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………..</span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi </span></div> <div class="MsoListParagraph" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .75in; margin-right: 0in; margin-top: 0in; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">................................................................................................................</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 27.0pt; mso-add-space: auto; mso-list: l1 level1 lfo48; text-align: justify; text-indent: -9.0pt;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">k.</span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Ekstrimitas</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Inspeksi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l34 level1 lfo43; text-align: justify; text-indent: -.25in;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Palpasi </span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">…………………………………………………………………………</span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 45.0pt; mso-add-space: auto; mso-list: l34 level1 lfo43; text-indent: -.25in;"> <div style="text-align: justify;"> <span style="font-family: "wingdings"; font-size: 12pt; line-height: 150%;">Ø<span style="font: 7pt "Times New Roman";">  </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Kekuatan otot</span></div> </div> <table border="0" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt; text-align: left;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-bottom-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-bottom-themecolor: text1; mso-border-right-alt: solid black .5pt; mso-border-right-themecolor: text1; mso-border-right-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 36.45pt;" valign="top" width="49"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: page; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 212.9pt; mso-element-top: 8.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">….</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border: none; mso-border-bottom-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-left-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 35.55pt;" valign="top" width="47"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: page; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 212.9pt; mso-element-top: 8.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">..</span></div> </td>  </tr> <tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;">   <td style="border-right: solid black 1.0pt; border: none; mso-border-right-alt: solid black .5pt; mso-border-right-themecolor: text1; mso-border-right-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 36.45pt;" valign="top" width="49"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: page; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 212.9pt; mso-element-top: 8.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">….</span></div> </td>   <td style="border: none; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 35.55pt;" valign="top" width="47"><div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in; mso-element-anchor-horizontal: page; mso-element-anchor-vertical: paragraph; mso-element-frame-hspace: 9.0pt; mso-element-left: 212.9pt; mso-element-top: 8.85pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">….</span></div> </td>  </tr> </tbody></table> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; text-align: justify;"> <br /></div> <div class="MsoNormal" style="text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">     C.<span style="font: 7pt "Times New Roman";">    </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Data penunjang</span></b><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"> </span></div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Tanggal ………… (kimia klinik)</span><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"></span></b></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 18.9pt; text-align: justify;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Pemeriksaan </span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 85.5pt;" valign="top" width="114"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Hasil</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 84.0pt;" valign="top" width="112"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Satuan</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 73.5pt;" valign="top" width="98"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Nilai normal</span></div> </td>  </tr> <tr style="mso-yfti-irow: 1;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Gula darah sewaktu</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 85.5pt;" valign="top" width="114"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">………</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 84.0pt;" valign="top" width="112"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">……..</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 73.5pt;" valign="top" width="98"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">…………..</span></div> </td>  </tr> <tr style="mso-yfti-irow: 2;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Ureum</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 85.5pt;" valign="top" width="114"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">………..</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 84.0pt;" valign="top" width="112"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">……..</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 73.5pt;" valign="top" width="98"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">……….</span></div> </td>  </tr> <tr style="mso-yfti-irow: 3;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Creatinin</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 85.5pt;" valign="top" width="114"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">……….. </span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 84.0pt;" valign="top" width="112"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">………..</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 73.5pt;" valign="top" width="98"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;"> ………..</span></div> </td>  </tr> <tr style="height: 11.4pt; mso-yfti-irow: 4; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; height: 11.4pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">SGOT</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 11.4pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 85.5pt;" valign="top" width="114"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">………</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 11.4pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 84.0pt;" valign="top" width="112"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">………</span></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 11.4pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 73.5pt;" valign="top" width="98"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">…………</span></div> </td>  </tr> </tbody></table> <div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 4.5pt; mso-add-space: auto; mso-list: l0 level1 lfo40; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">   D.<span style="font: 7pt "Times New Roman";">    </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Data fokus</span></b></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 0.25in; text-align: justify;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 185.4pt;" valign="top" width="247"><div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Data   subyektif</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 204.3pt;" valign="top" width="272"><div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Data   obyektif</span></div> </td>  </tr> <tr style="height: 49.0pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; height: 49.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 185.4pt;" valign="top" width="247"><div class="MsoNoSpacing" style="margin-left: .25in; text-align: justify;"> <br /></div> <div class="MsoNoSpacing" style="margin-left: .25in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 49.0pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 204.3pt;" valign="top" width="272"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> </td>  </tr> </tbody></table> <div class="MsoNormal" style="text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">   E.<span style="font: 7pt "Times New Roman";">     </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Analisa data</span></b></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 5.4pt; text-align: justify;"><tbody> <tr style="height: 16.15pt; mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; height: 16.15pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 142.6pt;" valign="top" width="190"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Symtom</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; height: 16.15pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 129.35pt;" valign="top" width="172"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Etiologi</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; height: 16.15pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.35pt;" valign="top" width="174"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Problem</span></div> </td>  </tr> <tr style="height: 16.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; height: 16.15pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 142.6pt;" valign="top" width="190"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 12.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 16.15pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 129.35pt;" valign="top" width="172"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 16.15pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.35pt;" valign="top" width="174"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <br /></div> </td>  </tr> </tbody></table> <div class="MsoListParagraphCxSpFirst" style="margin-left: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="margin-left: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">     F.<span style="font: 7pt "Times New Roman";">     </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Diagnosa keperawatan dan prioritas masalah</span></b></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: .25in; mso-add-space: auto; mso-list: l66 level1 lfo49; tab-stops: 4.5pt; text-align: justify; text-indent: -.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">1.<span style="font: 7pt "Times New Roman";">      </span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">………..........................................................................................................</span></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">2.   ......................................................................................................................</span><br /> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0.25in; text-align: justify; text-indent: -0.25in;"> </div> <div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; tab-stops: 4.5pt; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">    G.<span style="font: 7pt "Times New Roman";">    </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Perencanaan NIC dan NOC</span></b></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: medium none; margin-left: 5.4pt; text-align: justify; width: 559px;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 36.05pt;" width="48"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Hr</span></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Tgl</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 37.7pt;" width="50"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Jam</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 20.75pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -2.65pt; margin-right: 0in; margin-top: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">no</span></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -2.65pt; margin-right: 0in; margin-top: 0in;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">dx</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 157.5pt;" width="210"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">NOC / tujuan</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 139.5pt;" width="186"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">NIC / intervensi</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 27.45pt;" width="37"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -.9pt; margin-right: 0in; margin-top: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Ttd</span></div> </td>  </tr> <tr style="mso-yfti-irow: 1;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 36.05pt;" valign="top" width="48"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -5.45pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 20.75pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 157.5pt;" valign="top" width="210"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list 81.0pt 99.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list 81.0pt 99.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list 81.0pt 99.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list 81.0pt 99.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; tab-stops: list 81.0pt 99.0pt; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 139.5pt;" valign="top" width="186"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .3in; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 27.45pt;" valign="top" width="37"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -5.4pt; margin-right: 0in; margin-top: 0in; text-align: center;"> <br /></div> </td>  </tr> <tr style="mso-yfti-irow: 2; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 36.05pt;" valign="top" width="48"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 37.7pt;" valign="top" width="50"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -5.45pt; margin-right: 0in; margin-top: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 20.75pt;" valign="top" width="28"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 157.5pt;" valign="top" width="210"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 139.5pt;" valign="top" width="186"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 12.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 12.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: 12.6pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 27.45pt;" valign="top" width="37"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -5.4pt; margin-right: 0in; margin-top: 0in;"> <br /></div> </td>  </tr> </tbody></table> <div class="MsoListParagraphCxSpFirst" style="margin-left: 0in; mso-add-space: auto; tab-stops: 4.5pt; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="margin-left: 0in; mso-add-space: auto; tab-stops: 4.5pt; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="margin-left: 0in; mso-add-space: auto; tab-stops: 4.5pt; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="margin-left: 0in; mso-add-space: auto; tab-stops: 4.5pt; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; tab-stops: 4.5pt; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">     H.<span style="font: 7pt "Times New Roman";">    </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Implementasi </span></b></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 5.4pt; text-align: justify;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: .5in;" width="48"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Hari/tgl</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 40.5pt;" width="54"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">jam</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 27.0pt;" width="36"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">No Dx</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" width="174"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; mso-add-space: auto;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Tindakan</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 148.5pt;" width="198"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Respon</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: .5in;" width="48"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -5.4pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Paraf</span></div> </td>  </tr> <tr style="height: 31.45pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; height: 31.45pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: .5in;" valign="top" width="48"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; margin-left: -5.4pt; margin-right: 0in; margin-top: 0in; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 31.45pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 40.5pt;" valign="top" width="54"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 31.45pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 27.0pt;" valign="top" width="36"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 31.45pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 130.5pt;" valign="top" width="174"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: 10.0pt; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: 10.0pt; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: 10.0pt; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: 10.0pt; margin-left: 8.1pt; margin-right: 0in; margin-top: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 31.45pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 148.5pt;" valign="top" width="198"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 31.45pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: .5in;" valign="top" width="48"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: justify;"> <br /></div> </td>  </tr> </tbody></table> <div class="MsoListParagraphCxSpFirst" style="margin-left: 0in; mso-add-space: auto; tab-stops: 0in; text-align: justify;"> <br /> <br /></div> <div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin-left: 0in; mso-add-space: auto; mso-list: l0 level1 lfo40; tab-stops: 0in; text-align: justify; text-indent: -.25in;"> <b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">     I.<span style="font: 7pt "Times New Roman";">       </span></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Evaluasi</span></b></div> <table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: medium none; margin-left: 5.4pt; text-align: justify; width: 534px;"><tbody> <tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;">   <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 67.5pt;" width="90"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Tgl / hari</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 49.5pt;" width="66"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Jam</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 31.5pt;" width="42"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">No dx</span></div> </td>   <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 211.5pt;" width="282"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">Catatan   perkembangan</span></div> </td>   <td style="border-left: none; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-left-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 40.5pt;" width="54"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in; text-align: center;"> <span style="font-family: "times new roman" , "serif"; font-size: 12pt;">TTD</span></div> </td>  </tr> <tr style="height: 35.5pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes;">   <td style="border-top: none; border: solid black 1.0pt; height: 35.5pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 67.5pt;" valign="top" width="90"><div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 35.5pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 49.5pt;" valign="top" width="66"><div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 35.5pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 31.5pt;" valign="top" width="42"><div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin: 0in; mso-add-space: auto; text-align: center;"> <br /></div> </td>   <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; height: 35.5pt; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0in 5.4pt 0in 5.4pt; width: 211.5pt;" valign="top" width="282"><div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> <div class="MsoNormal" style="line-height: normal; margin-bottom: 10.0pt; text-align: justify;"> <br /></div> </td>   <td style="border-bottom: solid windowtext 1.0pt; border-left: none; border-right: solid windowtext 1.0pt; border-top: none; height: 35.5pt; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-left-themecolor: text1; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt; width: 40.5pt;" valign="top" width="54"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"> <br /></div> </td>  </tr> </tbody></table> <div class="MsoNormal" style="line-height: 150%; tab-stops: 4.5pt; text-align: justify;"> <br /> Untuk mendownload Format asuhan keperawatan dalam format doc, silahkan dibawah :<br /> <ul> <li><b><span style="background-color: cyan;">File format asuhan keperawatan (Askep) doc</span>, <a href="https://drive.google.com/file/d/1LxeEeHqeoq-TJyZlmT_n7e265ZpUosdW/view?usp=sharing" target="_blank">(Ambil file)</a></b></li> </ul> <div> Atau</div> <div> <ul> <li><b><a href="https://drive.google.com/file/d/1LxeEeHqeoq-TJyZlmT_n7e265ZpUosdW/view?usp=sharing" target="_blank">Link Alternatif Format askep 1</a></b></li> <li><b><a href="https://drive.google.com/file/d/1LxeEeHqeoq-TJyZlmT_n7e265ZpUosdW/view?usp=sharing" target="_blank">Link Alternatif Format askep 2</a></b></li> </ul> <div> Demikian Format Dokumentasi Asuhan Keperawatan (Askep) doc, kami bagikan semoga bisa membantu dan bermanfaat.</div> </div> </div> <div style="clear: both;"> </div>

Format Dokumentasi Asuhan Keperawatan (Askep) Doc Terlengkap

Didalam dunia keperawatan askep merupakan sebuah pegangan atau aliran seorang perawat dalam melaksanakan pelayananan berupa asuhan keperawa...

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Laporan Pendahuluan Tonslitis Kronis Lengkap, Donwload Pdf Dan Doc

<div style="text-align: justify;"> Kami bagikan laporan pendahuluan tonsilitis kronis pdf dan doc.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Kalau sebelumnya telah kami bagikan laporan pendahuluan dengan aneka macam judul, pada postingan kali ini kami akan bagikan laporan pendahuluan tonsilitis kronis.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Laporan pendahuluan tonsilitis kronis biasanya menjadi kiprah yang dibentuk seorang perawat yang sedang menjalani parktek keprofesian stage medical bedah, untuk membantu hal tersebut disini kami sajikan laporan pendahuluan tonsilitis kronis yang telah kami susun selengkap mungkin dan juga kami sediakan dalam dua format yaitu pdf dan doc sehingga memudahkan teman-teman perawat dalam pemgeditan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Untuk mendownload laporan pendahuluan tonsilitis kronis pdf dan doc ini, telah kami sediakan link tautan untuk mengunduh file diakhir artikel ini.</div> <div style="text-align: justify;"> <br /></div> <h3 style="text-align: justify;"> <b>Laporan Pendahuluan Tonsilitis Kronis</b></h3> <div style="text-align: justify;"> <b><br /></b></div> <div style="text-align: justify;"> <b>Pengertian</b></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tonsilitis kronis ialah tonsil yang sanggup mengalami peradangan menahun. (M.A. Handerson, Ilmu Bedah untuk Perawat, 1989)</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tonsilitis Kronis ialah tonsilitis jawaban dari peradangan, faktor predisposisi ; rangsangan kronik (rokok dan makanan), efek cuaca, pengobatan radang akut yang tidak adekuat dan hygien verbal yang tidak baik/buruk.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b>Etiologi</b></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Penyebab tonsillitis kronik sama dengan tonsillitis akut yaitu kuman golongan atreptococcus hemolyticus viridans dan streptococcus pyogenes, tetapi kadang kala kuman bermetamorfosis kuman golongan gram negatif.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Faktor predisposisi timbulnya radang kronik ini ialah yang menahun (misalnya : makanan), efek cuaca, pengobatan radang akut yang tidak adekuat, serta hygiene yang buruk.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b>Patofisiologi</b></div> <div style="text-align: justify;"> <span style="white-space: pre;"> </span></div> <div style="text-align: justify;"> Pada tonsilitis kronik terdapat dua bentuk yaitu hipertroil dan aerotnsil alasannya proses berulang, maka selain epitel mukosa terkikis, jaringan limfoik diganti oleh jaringan parut. Jaringan parut ini sesuai dengan sifatnya akan mengalami pengerutan. Kelompok jaringan limfoid mengerut, sehingga ruang antara kelompok melebar. Hal ini secara klinik tampak sebagai pelebaran kriptus dan kriptus ini diisi oleh defritus. Proses berjalan terus, sehingga menembus kapsul dan balasannya timbul perlekatan dengan jaringan disekitar fosa tonsillitis. Pada bawah umur proses ini disertai dengan pembesaran kelenjar limfe sub mandibula.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b>Pathway tonsilitis kronis</b></div> <div class="separator" style="clear: both; text-align: justify;"> <img border="0" data-original-height="555" data-original-width="553" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzG6i7rIKQwWL4WkbJb6PTIoqreateeSJa3hphCqo-lqruuPf0ULSCD9bwtMRdPkeNmznM0IoxMk1zkMSFQlNj2VhizEH9LsxnIcNetGc15u6Oh8kYMVrN53c4js6vIWFgqSWAmCs7-4SM/s640/Pathway+Tonsilitis+kronis.png" width="636" /></div> <h3 style="text-align: justify;"> <b>Untuk mendownload Pathway Tonsilitis Kronis format doc, <span style="background-color: cyan;"><a href="https://drive.google.com/file/d/1Zwa53jgRltL4CrXcBqMwdtVRb5kEqM4Q/view?usp=sharing" target="_blank">DISINI</a></span></b></h3> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b>Gambaran Klinis</b></div> <ul> <li style="text-align: justify;">Gambaran klinis dari tonsillitis yaitu tonsil membesar dengan adanya hipertropi dan jaringan parut.</li> <li style="text-align: justify;">Sebagian kripta tampak mengalami stenosis, tapi eksudat yang sering kali purulen.</li> <li style="text-align: justify;">Gambaran klinis lain yang sering ialah dari tonsil yang kecil biasanya menciptakan lekukan.</li> <li style="text-align: justify;">Biakan tonsilia dengan penyakit kronis biasanya membuktikan beberapa organisme yang virulensinya relatif rendah.</li> </ul> <br /> <div style="text-align: justify;"> Gejala tonsillitis kronik sebagai brikut</div> <ol style="-webkit-text-stroke-width: 0px; color: black; font-family: "Times New Roman"; font-size: medium; font-style: normal; font-variant-caps: normal; font-variant-ligatures: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-decoration-color: initial; text-decoration-style: initial; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;"> <li style="text-align: justify;">Keluhan sakit menelan, liur banyak.</li> <li style="text-align: justify;">Panas, sakit kepala, rasa sakit ditelinga</li> <li style="text-align: justify;">Tonsil warna merah dan membengkak.</li> <li style="text-align: justify;">Tonsil tampak bercak kecil dan sumbatan pada kripta (angila lakrimalis) pada tonsillitis folio kuralis bercaknya besar.</li> <li style="text-align: justify;">Bercak tampak bergabung menjadi satu meluas hingga ke arkus varing.</li> <li style="text-align: justify;">Oedem pada arkus varing dan mungkin hingga palatum mole.</li> <li style="text-align: justify;">Sakit tekan pada limforadi.</li> <li style="text-align: justify;">Bercak sanggup meluas keseluruh jaringan limfe dilingkaran welldeyer.</li> </ol> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b>Komplikasi</b></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tonsillitis yang tidak segera ditangani/diterapi sanggup berkembang menjadi penyakit yang berbahaya.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Komplikasi ke tempat sekitar tonsil berupa</div> <ul> <li style="text-align: justify;">Rinitis kronis</li> <li style="text-align: justify;">Sirositis</li> </ul> <div style="text-align: justify;"> Komplikasi ke organ yang jauh dari tonsil seperti</div> <ul> <li style="text-align: justify;">Indokarditis<span style="white-space: pre;">     </span></li> <li style="text-align: justify;">Artritis</li> <li style="text-align: justify;">Miositis<span style="white-space: pre;">     </span></li> <li style="text-align: justify;">Nefritis, ufeisis</li> <li style="text-align: justify;">Iridoksitis<span style="white-space: pre;">     </span></li> <li style="text-align: justify;">Dermatitis</li> <li style="text-align: justify;">Pruritis<span style="white-space: pre;">      </span></li> <li style="text-align: justify;">Utikaria</li> <li style="text-align: justify;">Furun kilosis</li> </ul> <div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b>Pemeriksaan penunjang</b></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Pemeriksaan Penunjang berdasarkan Firman S (2006), yaitu :</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> 1. Tes Laboratorium</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tes laboratorium ini dipakai untuk memilih apakah basil yang ada dalam tubuh pasien merupkan akteri gru A, alasannya grup ini disertai dengan demam renmatik, glomerulnefritis, dan demam jengkering.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> 2. Pemeriksaan penunjang</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Kultur dan uji resistensi bila diperlukan</div> </div> <div style="text-align: justify;"> <br /> <br /></div> <div style="text-align: justify;"> <b>Penatalaksanaan</b></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Pengobatan dan perawatan yang diberikan pada pasien tonsillitis kronik adalah:</div> <div style="text-align: justify;"> a. Tonsilektomi</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Indikasi tonsilektomi yang penting sanggup diterima bawah umur ialah sebagai berikut :</div> <ul> <li style="text-align: justify;">Serangan tonsillitis berulang yang tercatat (walaupun telah diberikan penatalaksanaan medis yang adekuat)</li> <li style="text-align: justify;">Tonsilitis bekerjasama dengan streptococcus menetap dan patogenik (keadaan karier)</li> <li style="text-align: justify;">Hiperplasia dan obstruksi yang menetap 6 bulan sesudah infeksi mononucleosis (biasanya pada cukup umur muda) </li> <li style="text-align: justify;">Hiperplasia tonsil yang obstruksi</li> </ul> <div style="text-align: justify;"> Kontra indikasi</div> <ul> <li style="text-align: justify;">Infeksi pernafasan penggalan atas yang berulang</li> <li style="text-align: justify;">Infeksi sistemik</li> <li style="text-align: justify;">Asma</li> <li style="text-align: justify;">Tonus otot yang melemah</li> <li style="text-align: justify;">sinositus</li> </ul> <div style="text-align: justify;"> b. Antibiotika, analgetika/anti panas</div> <div style="text-align: justify;"> c. Makan-makanan yang lembut</div> <div style="text-align: justify;"> d. Makanan yang pedas dan panas dilarang</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> <b>Konsep Asuhan Keperawatan</b></div> <div style="text-align: justify;"> <b><br /></b></div> <div style="text-align: justify;"> <b>Pengkajian</b></div> <div style="text-align: justify;"> <b>      </b></div> <div style="text-align: justify;"> Pengkajian merupakan tahap awal dan landasan proses keperawatan. Diperlukan pengkajian yang cermat untuk mengenali dilema klien, biar sanggup menawarkan arah pada tindakan keperawatan.</div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Pengkajian data merupakan kegiatan dalam menghimpun info data-data dari klien yang mencakup biopsikososial spiritual yang komprehensif. Data sanggup dikumpulkan dari aneka macam sumber.</div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Data utama ialah pasien. Data-data perhiasan yang dibutuhkan sanggup diperoleh dari sumber lain, missal : keluarga, tenaga kesehatan lain, catatan-catatan oleh tenaga kesehatan yang tercatat dalam dokumentasi medis pasien dan hasil investigasi penunjang.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Adapun data yang diperoleh dari pasien tonsillitis :</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> 1. Data Subyektif</div> <ul> <li style="text-align: justify;">Keluhan sakit menelan</li> <li style="text-align: justify;">Sakit kepala</li> <li style="text-align: justify;">Pasien sakit di telinga</li> <li style="text-align: justify;">Pasien sakit tekan di limfoid</li> </ul> <div style="text-align: justify;"> 2. Data Obyektif</div> <ul> <li style="text-align: justify;">Panas</li> <li style="text-align: justify;">Liur banyak</li> <li style="text-align: justify;">Tonsil tampak memerah</li> <li style="text-align: justify;">Tonsil bengkak</li> <li style="text-align: justify;">Oedema pada arkus faring</li> </ul> <br /> <div style="text-align: justify;"> <b>Diagnosa Keperawatan</b></div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Beberapa diagnosa keperawatan yang sanggup ditemukan pada klien dengan pre atau post operasi tonsillitis antara lain :</div> <ol> <li style="text-align: justify;">Resiko terhadap kekurangan volume cairan yang bekerjasama dengan penurunan masukan cairan sekunder terhadap nyeri ketika menelan.</li> <li style="text-align: justify;">Resiko terhadap perubahan nutrisi kurang dari kebutuhan tubuh yang bekerjasama dengan penurunan masukan sekunder terhadap nyeri ketika menelan.</li> <li style="text-align: justify;">Resiko terhadap ketidakefektifan penatalaksanaan hukum terapeutik yang bekerjasama dengan ketidakcukupan pengetahuan wacana komplikasi, penatalaksanaan nyeri, pengaturan posisi dan pembatasan aktivitas.</li> <li style="text-align: justify;">Nyeri bekerjasama dengan pembedahan</li> <li style="text-align: justify;">Kurang perawatan diri bekerjasama dengan keterbatasan mobilitas fisik terhadap pembedahan.</li> <li style="text-align: justify;">Resiko tinggi terhadap kerusakan penatalaksanaan pemeliharaan dirumah bekerjasama dengan kurangya pengetahuan wacana perawatan diri ketika pasien pulang.</li> <li style="text-align: justify;">Ansietas bekerjasama dengan kurang pengetahuan wacana insiden pra operasi dan post operasi takut wacana beberapa aspek pembedahan.</li> <li style="text-align: justify;">Resiko tinggi terhadap komplikasi, infeksi bekerjasama dengan factor pembedahan</li> </ol> <br /> <div style="text-align: justify;"> <b>Perencanaan / Intervensi Keperawatan</b></div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Merupakan prioritas, hasil yang diharapkan dari pasien dengan kegiatan keperawatan yang spesifik.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Beberapa diagnosa yang menjadi focus intervensinya ialah :</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Diagnosa Keperawatan. 1</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Resiko terhadap kekurangan volume cairan yang bekerjasama dengan penurunan masukan cairan sekunder terhadap nyeri ketika menelan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tujuan : Klien sanggup meningkatkan masukan cairan minimal 2000 ml</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Rencana tindakan</div> <ul> <li style="text-align: justify;">Kaji perubahan tanda vital, referensi peningkatan suhu tubuh</li> <li style="text-align: justify;">Kaji turgor kulit, kelembaban membran mukosa.</li> </ul> <div style="text-align: justify;"> Diagnosa. 2</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Resiko terhadap perubahan nutrisi kurang dari kebutuhan tubuh yang bekerjasama dengan penurunan masukan sekunder nyeri ketika menelan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tujuan : Klien membuktikan nafsu makan</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Rencana tindakan</div> <ul> <li style="text-align: justify;">Beri masakan porsi kecil dan sering atau masakan yang menarik untuk pasien.</li> </ul> <div style="text-align: justify;"> Diagnosa. 3</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Resiko terhadap ketidakefektifan penatalaksanaan hukum terapeutik yang bekerjasama dengan ketidakcukupan pengetahuan wacana komplikasi, penatalaksanaan nyeri, pengaturan posisi dan pembatasan aktivitas.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> tujuan : Klien sanggup menggambarkan proses penyakit, penyebab-penyebab dan factor penunjang pada tanda-tanda dan hukum untuk penyakit atau kontrol gejala.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Rencana tindakan</div> <ul> <li style="text-align: justify;">Diskusikan aspek ketidalmampuan dari penyakit, lamanya penyembuhan dan impian kesembuhan.</li> </ul> <div style="text-align: justify;"> Diagnosa. 4</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Nyeri bekerjasama dengan pembedahan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tujuan : Klien menyatakan nyeri hilang/terkontrol</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Rencana tindakan</div> <ul> <li style="text-align: justify;">Pantau tanda-tanda vital</li> <li style="text-align: justify;">Berikan tindakan nyaman missal perubahan posisi, musik, relaksasi.</li> </ul> <div style="text-align: justify;"> Diagnosa. 5</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Kurang perawatan diri bekerjasama dengan keterbatasan mobilitas fisik terhadap pembedahan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Tujuan : Klien berpartisipasi secara fisik dan atau verbal dalam aktivitas.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Rencana Tindakan</div> <ul> <li style="text-align: justify;">tentukan tingkat derma yang diperlukan.</li> </ul> <div style="text-align: justify;"> Diagnosa. 6</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Resiko tinggi terhadap kerusakan penatalaksanaan pemeliharaan dirumah bekerjasama dengan kurangnya pengetahuan wacana perawatan diri ketika pasien pulang.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> tujuan : Klien menyatakan mrngerti wacana instruksi, melaksanakan dengan sempurna ketrampilan perawatan diri yang diperlukan, mengidentifikasi bagian-bagian yang memerlukan perawatan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Rencana tindakan</div> <ul> <li style="text-align: justify;">Ajarkan dan biarkan pasien merawat luka jikalau penggantian perlu dilakukan di rumah.</li> </ul> <div style="text-align: justify;"> Diagnosa. 7</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Ansietas bekerjasama dengan kurang pengetahuan wacana insiden pra operasi dan post operasi, takut wacana beberapa aspek pembedahan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> tujuan : Mengungkapkan pemahaman wacana insiden pra operasi dan pasca operasi, melaporkan berkurangnya perasaan cemas atau gugup, ekspresi wajah rileks, kurang bicara.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Rencana tindakan</div> <ul> <li style="text-align: justify;">Jelaskan apa yang terjadi selama periode pra operasi dan pasca operasi termasuk tes laboratorium pra operasi, ganjal an status puasa.</li> </ul> <div style="text-align: justify;"> Diagnosa. 8</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Resiko tinggi terhadap komplikasi, infeksi bekerjasama dengan factor pembedahan.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> tujuan</div> <ul> <li style="text-align: justify;">Tidak ada infeksi</li> <li style="text-align: justify;">Tidak ada komplikasi</li> </ul> <div style="text-align: justify;"> Rencana tindakan</div> <ul> <li style="text-align: justify;">Pantau suhu tubuh tiap 4 jam, keadaan luka ketika melaksanakan perawatan.</li> </ul> <br /> <div style="text-align: justify;"> <b>Implementasi</b></div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Merupakan pelaksanaan perencanaan keperawatan oleh perawat terhadap pasien.</div> <div style="text-align: justify;"> Beberapa petunjuk pada implementasi ialah sebagai berikut :</div> <ol> <li style="text-align: justify;">Implementasi dilakukan sesuai dengan planning sesudah dilakukan validasi.</li> <li style="text-align: justify;">Dokumentasi intervensi dan respon klien.</li> </ol> <div style="text-align: justify;"> <b>Evaluasi</b></div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Merupakan tahap simpulan dalam proses keperawatan dan memilih sejauh mana tujuan sanggup dicapai.</div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Evaluasi dilakukan dengan menggunakan criteria evaluasi, dengan melibatkan klien, keluarga dan anggota tim kesehatan lain.</div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> Evaluasi dikatakan berhasil apabila dilema sudah sanggup diatasi dengan kata lain tujuan sudah tercapai sesuai dengan planning tujuan yang telah ditetapkan.</div> <div style="text-align: justify;">       </div> <div style="text-align: justify;">       </div> <div style="text-align: justify;"> <b>Kesimpulan</b></div> <ol> <li style="text-align: justify;">Tonsilitis kronik ialah tonsil yang sanggup mengalami peradangan menahun.</li> <li style="text-align: justify;">Kasus tonsillitis kronik tanpa diragukan merupakan penyakit yang paling sering dari srmua penyakit tenggorokan berulang. </li> <li style="text-align: justify;">Tonsiliyis kronik sering ditemukan pada anak-anak.</li> <li style="text-align: justify;">Pengobatan pada klien tonsillitis kronik ialah berupa tindakan tonsilektomi dan pemberian antibiotik serta anti piretik.</li> </ol> <div style="text-align: justify;"> Untuk mendownload laporan pendahuluan tonsilitis kronis pdf dan doc, dibawah :</div> <div> <ul> <li style="text-align: justify;"><b><span style="background-color: cyan;">Laporan pendahuluan tonsilitis kronis pdf</span>, <i><a href="https://drive.google.com/file/d/1W6-uMvb1K8_LQsIrouyYFvaKpCXBP8c7/view?usp=sharing" target="_blank">(Ambil File)</a></i></b></li> <li style="text-align: justify;"><b><span style="background-color: lime;">Laporan pendahuluan tonilitis kronis doc</span>, <i><a href="https://drive.google.com/file/d/1InMYQYDc8Yn2XJ-ezHnX2h6Q9R5ujNRC/view?usp=sharing" target="_blank">(Ambil File)</a></i></b></li> </ul> <div style="text-align: justify;"> Link Alternatif</div> </div> <div> <ul> <li style="text-align: justify;"><b><a href="https://drive.google.com/file/d/1W6-uMvb1K8_LQsIrouyYFvaKpCXBP8c7/view?usp=sharing" target="_blank">Alternatif LP tonsilitis kronis pdf 1</a></b></li> <li style="text-align: justify;"><b><a href="https://drive.google.com/file/d/1InMYQYDc8Yn2XJ-ezHnX2h6Q9R5ujNRC/view?usp=sharing" target="_blank">Alternatif LP tonsilitis kronis doc 1</a></b></li> </ul> <ul> <li style="text-align: justify;"><b><a href="https://drive.google.com/file/d/1W6-uMvb1K8_LQsIrouyYFvaKpCXBP8c7/view?usp=sharing" target="_blank">Alternatif LP tonsilitis kronis pdf 2</a></b></li> <li style="text-align: justify;"><b><a href="https://drive.google.com/file/d/1InMYQYDc8Yn2XJ-ezHnX2h6Q9R5ujNRC/view?usp=sharing" target="_blank">Alternatif LP tonsilitis kronis doc 2</a></b></li> </ul> <div style="text-align: justify;"> Demikian Laporan pendahuluan tonsilitis kronis, download pdf dan doc ini kami bagikan, semoga bisa membantu sahabat sejawat sekalian dalam menuntaskan kiprah keperawatan, askep, makalah, ataupun laporan pendahuluan itu sendiri, terima kasih.</div> </div>

Laporan Pendahuluan Tonslitis Kronis Lengkap, Donwload Pdf Dan Doc

Kami bagikan laporan pendahuluan tonsilitis kronis pdf dan doc. Kalau sebelumnya telah kami bagikan laporan pendahuluan dengan aneka ma...

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