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Klinik Abah Medical Check-Up Resume

This document is a medical check-up report from Klinik Abah clinic in Aceh Tamiang, Indonesia. It contains sections for the patient's identity, medical history, physical examination findings, and results of any medical tests. The physical examination includes measurements of vital signs, general health status, and system-specific exams of the eyes, ears/throat/nose, mouth, neck, chest, abdomen, extremities, and neurological system. Any laboratory tests, chest x-rays, or electrocardiograms ordered are also documented. The report is signed by the examining physician, Dr. Nuansa Chalid Awaluddin, and dated for 2019 from Aceh Tamiang.

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Nuansa Chalid Awaluddin
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49 views2 pages

Klinik Abah Medical Check-Up Resume

This document is a medical check-up report from Klinik Abah clinic in Aceh Tamiang, Indonesia. It contains sections for the patient's identity, medical history, physical examination findings, and results of any medical tests. The physical examination includes measurements of vital signs, general health status, and system-specific exams of the eyes, ears/throat/nose, mouth, neck, chest, abdomen, extremities, and neurological system. Any laboratory tests, chest x-rays, or electrocardiograms ordered are also documented. The report is signed by the examining physician, Dr. Nuansa Chalid Awaluddin, and dated for 2019 from Aceh Tamiang.

Uploaded by

Nuansa Chalid Awaluddin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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KLINIK ABAH NOMOR IZIN : 441 / DPMTSP – KL / 129 / 2017

Jl. Medan ˗ Banda Aceh, Bukit Rata, Kejuruan Muda, Aceh Tamiang
Kode Pos 24477, HP 081360208556, Email: klinikabah@[Link]

RESUME MEDICAL CHECK UP


NOMOR : 445 / / 418.67 / 2015

I. IDENTITAS
 Nama : ……………………………………………………………………………………….
 Umur : ………………… Tahun
 No Registrasi : ……………………………………………………………………………………….
 Alamat : ……………………………………………………………………………………….
………………………………………………………………………………………

II. ANAMNESE
1. Keluhan Sekarang : ………………………………………………………………………...
2. Penyakit Riwayat Dahulu : ………………………………………………………………………...
………………………………………………………………………...
3. Riwayat Penyakit Keluarga : ………………………………………………………………………..
………………………………………………………………………...
4. Kebiasaan Sehari – hari : ………………………………………………………………………...
 Aktivitas : ……………………………………………………………………………….
 Olahraga : ……………………………………………………………………………….
 Merokok : ……………………………………………………………………………….
 Minum Alkohol : ……………………………………………………………………………….

III. PEMERIKSAAN FISIK


1. Keadaan Umum : ……………………………………………………………………………….
2. Berat Badan : ……….. kg
3. Tinggi Badan : ……….. cm
4. Vital Sign
 Tekanan Darah : ……….. mmHg
 Nadi : ……….. x/m
 Pernafasan : ……….. x/m
 Suhu Tubuh : ……….. °C
KLINIK ABAH NOMOR IZIN : 441 / DPMTSP – KL / 129 / 2017
Jl. Medan ˗ Banda Aceh, Bukit Rata, Kejuruan Muda, Aceh Tamiang
Kode Pos 24477, HP 081360208556, Email: klinikabah@[Link]

5. Pemeriksaan
 Mata : ……………………………………………………………………………….
 THT : ……………………………………………………………………………….
 Mulut : ……………………………………………………………………………….
 Leher : ……………………………………………………………………………….
 Thorax : ……………………………………………………………………………….
 Abdomen : ……………………………………………………………………………….
 Extrimitas : ……………………………………………………………………………….
 Pemeriksaan Neurologis : …………………………………………………………………….

IV. PEMERIKSAAN PENUNJANG


1. Laboratorium : ……………………………………………………………………………….
2. Foto Thorax PA : ……………………………………………………………………………….
3. Elektrokardiografi : ……………………………………………………………………………….

Aceh Tamiang, 2019


Dokter Pemeriksa

dr. Nuansa Chalid Awaluddin

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