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resumemedis.html
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<html>
<head><link href="file.css" rel="stylesheet" type="text/css" />
</head>
<body>
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr class="isi">
<td valign="top" width="20%">
No.RM
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
020313
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Nama Pasien
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
BAMBANG SURYANTO
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Alamat
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
, -, -, -
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Umur
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
22 Th 6 Bl 0 Hr (Laki-Laki)
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Tempat & Tanggal Lahir
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
Balikpapan 1997-05-26
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Ibu Kandung
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Golongan Darah
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Status Nikah
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
MENIKAH
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Agama
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
ISLAM
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Pendidikan Terakhir
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Pertama Daftar
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
2019-11-26
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
Riwayat Perawatan
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
 1. No.Rawat
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
2019/11/26/000001
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      No.Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
001
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Tanggal Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
2019-11-26 08:29:46
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Unit/Poliklinik
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
IGD
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Dokter
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
dr. ADHARI AJI PURNOMO
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Cara Bayar
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
BPJS
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Penanggung Jawab
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Alamat P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
ALAMAT, KELURAHAN, KECAMATAN, KABUPATEN
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Hubungan P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
SAUDARA
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Status
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
Ranap
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Asuhan Gizi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr align="center">
<td valign="top" width="5%" bgcolor="#FFFAF8">
No.
</td>
<td valign="top" width="95%" bgcolor="#FFFAF8">
Penilaian Gizi
</td>
</tr>
<tr>
<td valign="top" align="center">
1
</td>
<td valign="top">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0px" class="tbl_form">
<tr>
<td width="20%" border="0">
Tanggal
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
2020-01-04
</td>
</tr>
<tr>
<td width="20%" border="0">
Antropometri
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
BB : - (Kg), TB : - (Cm), IMT : - (Kg/Cm), LiLA : -
(Cm), TL : - (Cm), ULNA : - (Cm), BB Ideal : - (Kg),
BB/U : -- (%), TB/U : - (%), BB/TB : - (%), LiLA/U : --
(%)
</td>
</tr>
<tr>
<td width="20%" border="0">
Biokimia
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
-
</td>
</tr>
<tr>
<td width="20%" border="0">
Fisik/Klinis
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
-
</td>
</tr>
<tr>
<td width="20%" border="0">
Riwayat Gizi
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
<br>
Alergi Makanan :<br>
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0px" class="tbl_form">
<tr>
<td width="70%" border="0">
  Telur
</td>
<td border="0">
: Tidak
</td>
</tr>
<tr>
<td width="70%" border="0">
  Susu sapi dan produk olahannya
</td>
<td border="0">
: Tidak
</td>
</tr>
<tr>
<td width="70%" border="0">
  Kacang kedelai / tanah
</td>
<td border="0">
: Tidak
</td>
</tr>
<tr>
<td width="70%" border="0">
  Gluten / gandum
</td>
<td border="0">
: Tidak
</td>
</tr>
<tr>
<td width="70%" border="0">
  Udang
</td>
<td border="0">
: Tidak
</td>
</tr>
<tr>
<td width="70%" border="0">
  Ikan
</td>
<td border="0">
: Tidak
</td>
</tr>
<tr>
<td width="70%" border="0">
  Hazelnut / almont
</td>
<td border="0">
: Tidak
</td>
</tr>
</table>
<br>
Pola Makan : -
</td>
</tr>
<tr>
<td width="20%" border="0">
Riwayat Personal
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
-
</td>
</tr>
<tr>
<td width="20%" border="0">
Diagnosis Gizi
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
-
</td>
</tr>
<tr>
<td width="20%" border="0">
Intervensi Gizi
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
-
</td>
</tr>
<tr>
<td width="20%" border="0">
Monitoring & Evaluasi
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
-
</td>
</tr>
<tr>
<td width="20%" border="0">
Petugas
</td>
<td border="0">
:
</td>
<td width="79%" border="0">
101010101 Syarifah Aisyiah
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
<tr class="isi">
<td valign="top" width="20%">
      Monitoring & Evaluasi Asuhan Gizi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="79%">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr align="center">
<td valign="top" width="5%" bgcolor="#FFFAF8">
No.
</td>
<td valign="top" width="15%" bgcolor="#FFFAF8">
Tanggal
</td>
<td valign="top" width="30%" bgcolor="#FFFAF8">
Monitoring
</td>
<td valign="top" width="30%" bgcolor="#FFFAF8">
Evaluasi
</td>
<td valign="top" width="20%" bgcolor="#FFFAF8">
Petugas
</td>
</tr>
<tr>
<td valign="top" align="center">
1
</td>
<td valign="top">
2020-01-11 17:35:13.0
</td>
<td valign="top">
monitoring
</td>
<td valign="top">
evaluasi as a sa s as a sa s as a s as a s as a s as a s as as
as a s as a s as a s as a sa s
</td>
<td valign="top">
Syarifah Aisyiah
</td>
</tr>
</table>
</td>
</tr>
<tr class="isi">
<td colspan="3">
 
</td>
</tr>
</table>
</body>
</html>