Patient Information

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: : : :
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: :

Diagnosis Information

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

Contact Information

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Document Information

Photo: Delete
Photo Labo Imagine Anapath Other

Patient IPD

       Date in: 2013-07-01 -- Date out: 2013-07-10   Delete
Date In:                      Date Out:                      Remark:
       Date in: 2013-07-13 -- Date out: 2013-07-13   Delete
Date In:                      Date Out:                      Remark:

Surgery Information

       2013-03-12   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         
       2013-03-12   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         
       2013-07-13   Delete
Surgery Procedure:       Paraclinic Confirmed: Date:        
Medicine:        
Protocol:         

Follow Up

       2013-06-01   Delete
Date :       BP : /       Puls :         T° :       RR :