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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="4%">
1.
</td>
<td valign="top" width="20%">
No.RM
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
000001
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Nama Pasien
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Khanza
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Alamat
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
YOGYAKARTA, -, -, -
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Umur
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
5 Bl (Laki-Laki)
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Tempat & Tanggal Lahir
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016-05-29
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Ibu Kandung
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Golongan Darah
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Status Nikah
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
MENIKAH
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Agama
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
ISLAM
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Pendidikan Terakhir
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Pertama Daftar
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016-05-29
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
Riwayat Perawatan
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
 1. No.Rawat
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016/05/29/000001
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      No.Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
001
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Tanggal Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016-05-29 09:01:01
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Unit/Poliklinik
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Unit IGD
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Dokter
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
juminten
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Cara Bayar
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Penanggung Jawab
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Alamat P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
ALAMAT, KELURAHAN, KECAMATAN, KABUPATEN
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Hubungan P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
SAUDARA
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Status
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Ralan
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Biaya & Perawatan
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr>
<td valign="top" width="89%">
Administrasi
</td>
<td valign="top" width="1%" align="right">
:
</td>
<td valign="top" width="10%" align="right">
0
</td>
</tr>
</table>
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
 2. No.Rawat
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016/05/30/000001
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      No.Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
001
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Tanggal Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016-05-30 09:04:26
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Unit/Poliklinik
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Poli Gigi
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Dokter
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
dr Dewi Ekawati
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Cara Bayar
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Penanggung Jawab
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Alamat P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
, -, -, -
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Hubungan P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
SAUDARA
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Status
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Ralan
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Pemeriksaan Rawat Jalan
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr align="center">
<td valign="top" width="5%" bgcolor="#f8fdf3">
No.
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Tanggal
</td>
<td valign="top" width="5%" bgcolor="#f8fdf3">
Suhu(C)
</td>
<td valign="top" width="5%" bgcolor="#f8fdf3">
Tensi
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Nadi(/menit)
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Respirasi(/menit)
</td>
<td valign="top" width="5%" bgcolor="#f8fdf3">
Tinggi(Cm)
</td>
<td valign="top" width="5%" bgcolor="#f8fdf3">
Berat(Kg)
</td>
<td valign="top" width="5%" bgcolor="#f8fdf3">
GCS(E,V,M)
</td>
<td valign="top" width="15%" bgcolor="#f8fdf3">
Keluhan
</td>
<td valign="top" width="15%" bgcolor="#f8fdf3">
Pemeriksaan
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Alergi
</td>
</tr>
<tr>
<td valign="top" align="center">
1
</td>
<td valign="top">
2016-05-30
</td>
<td valign="top">
37
</td>
<td valign="top">
110/90
</td>
<td valign="top">
null
</td>
<td valign="top">
null
</td>
<td valign="top">
null
</td>
<td valign="top">
null
</td>
<td valign="top">
null
</td>
<td valign="top">
Normal
</td>
<td valign="top">
Membaik
</td>
<td valign="top">
null
</td>
</tr>
</table>
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Biaya & Perawatan
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr>
<td valign="top" width="89%">
Administrasi
</td>
<td valign="top" width="1%" align="right">
:
</td>
<td valign="top" width="10%" align="right">
0
</td>
</tr>
</table>
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr>
<td valign="top" colspan="4">
Tindakan Rawat Jalan Dokter
</td>
<td valign="top" colspan="1" align="right">
:
</td>
<td valign="top">
</td>
</tr>
<tr align="center">
<td valign="top" width="5%" bgcolor="#f8fdf3">
No.
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Tanggal
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Kode
</td>
<td valign="top" width="45%" bgcolor="#f8fdf3">
Nama Tindakan/Perawatan
</td>
<td valign="top" width="20%" bgcolor="#f8fdf3">
Dokter
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Biaya
</td>
</tr>
<tr>
<td valign="top" align="center">
1
</td>
<td valign="top">
2016-05-30
</td>
<td valign="top">
J000004
</td>
<td valign="top">
Periksa Hamil
</td>
<td valign="top">
dr Dewi Ekawati
</td>
<td valign="top" align="right">
95,000
</td>
</tr>
</table>
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
 3. No.Rawat
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016/05/31/000001
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      No.Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
001
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Tanggal Registrasi
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
2016-05-31 14:49:34
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Unit/Poliklinik
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Poli Gigi
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Dokter
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
juminten
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Cara Bayar
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
-
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Penanggung Jawab
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Alamat P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Yogyakarta
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Hubungan P.J.
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
SAUDARA
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Status
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
Ranap
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Diagnosa/Penyakit/ICD 10
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr align="center">
<td valign="top" width="5%" bgcolor="#f8fdf3">
No.
</td>
<td valign="top" width="24%" bgcolor="#f8fdf3">
Kode
</td>
<td valign="top" width="50%" bgcolor="#f8fdf3">
Nama Penyakit
</td>
<td valign="top" width="23%" bgcolor="#f8fdf3">
Status
</td>
</tr>
<tr>
<td valign="top" align="center">
1
</td>
<td valign="top">
A00.0
</td>
<td valign="top">
Cholera
</td>
<td valign="top">
Ranap
</td>
</tr>
</table>
</td>
</tr>
<tr class="isi">
<td valign="top" width="4%">
</td>
<td valign="top" width="20%">
      Biaya & Perawatan
</td>
<td valign="top" width="1%" align="center">
:
</td>
<td valign="top" width="75%">
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr>
<td valign="top" width="89%">
Administrasi
</td>
<td valign="top" width="1%" align="right">
:
</td>
<td valign="top" width="10%" align="right">
0
</td>
</tr>
</table>
<table width="100%" border="0" align="center" cellpadding="3px" cellspacing="0" class="tbl_form">
<tr>
<td valign="top" colspan="4">
Tindakan Rawat Inap Dokter
</td>
<td valign="top" colspan="1" align="right">
:
</td>
<td valign="top">
</td>
</tr>
<tr align="center">
<td valign="top" width="5%" bgcolor="#f8fdf3">
No.
</td>
<td valign="top" width="15%" bgcolor="#f8fdf3">
Tanggal
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Kode
</td>
<td valign="top" width="40%" bgcolor="#f8fdf3">
Nama Tindakan/Perawatan
</td>
<td valign="top" width="20%" bgcolor="#f8fdf3">
Dokter
</td>
<td valign="top" width="10%" bgcolor="#f8fdf3">
Biaya
</td>
</tr>
<tr>
<td valign="top" align="center">
1
</td>
<td valign="top">
2016-06-08 03:48:52
</td>
<td valign="top">
J000003
</td>
<td valign="top">
Visit Dokte
</td>
<td valign="top">
juminten
</td>
<td valign="top" align="right">
60,000
</td>
</tr>
<tr>
<td valign="top" align="center">
2
</td>
<td valign="top">
2016-06-08 03:49:01
</td>
<td valign="top">
J000003
</td>
<td valign="top">
Visit Dokte
</td>
<td valign="top">
juminten
</td>
<td valign="top" align="right">
60,000
</td>
</tr>
<tr>
<td valign="top" align="center">
3
</td>
<td valign="top">
2016-06-08 03:49:11
</td>
<td valign="top">
J000003
</td>
<td valign="top">
Visit Dokte
</td>
<td valign="top">
juminten
</td>
<td valign="top" align="right">
60,000
</td>
</tr>
<tr>
<td valign="top" align="center">
4
</td>
<td valign="top">
2016-06-08 04:18:21
</td>
<td valign="top">
J000003
</td>
<td valign="top">
Visit Dokte
</td>
<td valign="top">
juminten
</td>
<td valign="top" align="right">
60,000
</td>
</tr>
<tr>
<td valign="top" align="center">
5
</td>
<td valign="top">
2016-06-08 04:18:27
</td>
<td valign="top">
J000003
</td>
<td valign="top">
Visit Dokte
</td>
<td valign="top">
juminten
</td>
<td valign="top" align="right">
60,000
</td>
</tr>
<tr>
<td valign="top" align="center">
6
</td>
<td valign="top">
2016-06-08 04:18:34
</td>
<td valign="top">
J000003
</td>
<td valign="top">