| Nama Pasien |
: SUKARMIN |
No.RM |
: 004607 |
| NIK |
: 1219050607540001 |
Pekerjaan |
: PILIH |
| Tgl.Lahir |
: 1954-07-06 Usia : 70 tahun 2 bulan 17 hari |
Warga Negara |
: WNI |
| Jenis Kelamin |
: Laki Laki |
Agama |
: Islam |
| No.Handphone |
: - |
Status Pernikahan |
: Kawin |
| No.Telepon |
: |
Nama Dokter |
: dr .DEDE GUNAWAN M.Ked(Paru), Sp.P, FISR |
| Jaminan |
: BPJS Kesehatan |
Tanggal Kunjungan |
: 2024-09-23 09:30 |
| TD |
: mmHg |
| Nadi |
: x/menit |
RR |
: x/menit |
| Suhu |
: oC |
Spo |
: % |
| TB |
: cm |
BB |
: Kg |
| Rujukan Dari |
:
- |
| Anamnesa |
: |
| Pemeriksaan Fisik |
: Kepala (), Gigi & Mulut (), THT (), Thoraks (), Abdomen (), Genital & Anus (), Ekstremitas (), Kulit (). Catatan : |
| Laboratorium |
:
(1) HIV (2) lft ,rft |
| Radiologi |
: |
| USG |
: |
| EKG |
: |
| Diagnosa |
:
ICD 10 :
K30 | Dyspepsia |
| Tindakan Medis |
:
ICD 09 :
A15.3 | Tuberculosis of lung, confirmed by unspecified means |
| Therapy / Resep |
:
Cetirizine 10mg (2x1 11 tablet)
,
Cetirizine 10mg (1 x 1 2 tablet)
,
Levofloxacin Hemihydrate 500 mg (1 x 1 1 tablet)
,
Aqua pro injection (per 12 jam 11 Vial)
,
Aqua pro injection (k/p 1 Vial)
,
Ceftiaxiason inj (per 12 jam 12 Vial)
,
Ceftiaxiason inj (1gr/12jam 2 Vial)
,
Omeprazole inj (per 12 jam 11 Ampul)
,
Omeprazole inj (40mg/12j 1 Ampul)
,
Ranitidin inj (per 12 jam 3 Ampul)
,
NAC/ N-Acetylcystyne/ Acetylcysteine (3x200mg 17 Tablet)
,
NAC/ N-Acetylcystyne/ Acetylcysteine (3x 200mg 2 Tablet)
,
Azitromycin Tab (1x500mg 5 tablet)
,
Bfluid / Aminofluid (per 24 jam 2 fls)
,
Cairan KN-3B/ kaen 3b/ ka-en 3b (per 8 jam 11 fls)
,
Cairan KN-3B/ kaen 3b/ ka-en 3b (20gtt/i 6 fls)
,
Methylprednisolone 125 mg injeksi (per 12 jam 12 ampul)
,
Ventolin nebul (per 8 jam 20 ampul)
,
Sucralfate 500 mg / SUKRALFAT (3xc1 2 tablet)
,
Pulmicort 0,25 mg/ml (Budesma) (per 8 jam 17 Ampul)
,
Pulmicort 0,25 mg/ml (Budesma) (per 12 jam 2 Ampul)
|
| Instruksi |
: |
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