Patient Information

: : : :
: : : :
: : : :
: :

Diagnosis Information

Diagnosis : Category : Location:                              Delete
Diagnosis : Category : Location:                              Delete
Diagnosis : Category : Location:                              Delete
Diagnosis : Category : Location:                              Delete
Diagnosis : Category : Location:                              Delete
Diagnosis : Category : Location:                              Delete
Diagnosis : Category : Location:                              Delete

Contact Information

: : : :

Document Information

Photo: Delete
Photo Labo Imagine Anapath Other

Patient IPD

Date In:                      Date Out:                      Remark:   Delete

Surgery Information

       2008-06-09   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         
       2012-03-12   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         
       2017-01-18   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         
       2019-09-11   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         
       2020-10-22   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         

Follow Up

       0000-00-00   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2017-01-12   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2017-01-18   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2018-10-30   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2019-09-11   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2019-11-03   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2019-11-04   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2020-10-22   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2020-11-05   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2023-09-02   Delete
Date :       BP : /       Puls :         T° :       RR :      
       2023-09-04   Delete
Date :       BP : /       Puls :         T° :       RR :