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PUSKESMAS PASIR PUTIH

Jl.Jend. Sudirman Km.06 Sampit,Telp / Fax. 0531-


30619
KARTU BEROBAT

NAMA KK : _________________________
U M U R : ________ Tahun
ALAMAT : _______________________________________
No K T P : _________________________
No INDEKS :
No. MR : 6202060 /________/___
Family Folder ID Pasien Kode Hub.Keluarga

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