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REFERRAL AY NIHINANG UBOS NGANAK HOME BASED

PROBLEMA TANDAH EH MIDWIFE/NURSE POST PARTUM CARE


MOTHER'S CARD
DOCTOR MAKA AY BAY TAHINANG MA PIRMI SUBSY BINOWA SIDJA CARD TIYA-I TU BANG
IYA LLAW PAG-BISITA BANG/ HOME VISITS CLINIC MAG-PAKISSA NI HEALTH CENTER
BAY NA NGANAK 24 HRS 1 WEEK 2-4Wks VISIT
llaW PAG-BISITA BLOOD TYPE FAMILY SERIAL NO.
PAGPADURUH MA GATAS NAME/ON:
INAH SIDJA ADDARESS:
MIKIL BILAHI MAG- USE
FAMILY PLANNING(Y/N) LLAW BAY TABUWANAN TETANUS TOXOID
PASUH-PUHUH 39 C(Y/N) 1 2 3 4 5
NIYAH BAWWAN PA-
LUWAS MIN ALOPAN AGE: YR. BELOW 18 18-34 36+ H
DANDA (Y/N) HEIGHT CM. BELOW 145CM145CM & ABOVE
LANDOS LAHAH PALU-
WAS MIN ALOPAN (Y/N) OBSTETRICAL HISTORY
NGAMUDDAS (Y/N) HEKA BAY NI BATTONGAN 1 2 3 4+
KOWET (HAP/MBAL) BAY TA CESAREAN SECTION AHO HALAM
BAY KALABUAN MIN TALLU AHO HALAM
AY TANDAH MAKA AY BAY TAHINANG MA IYA VIT. A 200,000 IU (Y/N) BAY NIYAH MATAY MIN SIKAN AHO HALAM
MIN REFERRAL CENTER IRON/FOLATE : DATE AND NO. HEKA LAHAH BANG BAY MAG-ANAK AHO HALAM
FAMILY PLANNING PROBLEMS PROBLEMA PAMARANAN BATNAAN
DATE OF DATE OF METHOD PILA HEKA NA REMARKS TUBERCULOSIS (14 NGALLAW + KOHOL) AHO HALAM
FF.-UP VISITS PAMUWAN SAKKI MA JANTUNG AHO HALAM
HEKA SOKAL MA LAHAH AHO HALAM
BRONCHIAL ASTHMA(SANGNGOT) AHO HALAM
GOITER( BANGNGOK) AHO HALAM
BOHEH DURUH INAH YA HAP KINAKAN MA ANAK-ANAK BAHA-U KEYAT = SUBAY SINOHOH NI DR MA RHU/FF-UP
NI ANAKAN. BANG KITA MAG PALANTAH MIN 3 TUDJU 5 TAHUN GADDUNG= SUBAY PINAYANAN TOONGAN EH MW
HAP PAGBARAN TA MAKA SAGA ANAK TA SABAB MAKA ISBAT BILU= SUBAY MAG-ANAK MA HOSPITAL
KITA BARAN TA MAKA-ANAK TA PAHAP
36+ H