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DATA UNTUK SARINGAN TB
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- Unit Kesihatan Awam, Hospital Ampang
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NAMA KAKITANGAN (HURUF BESAR & NAMA PENUH SEPERTI DALAM K/P)
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NO KAD PENGENALAN (TANPA -)
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NO TELEFON
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JANTINA
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LELAKI
PEREMPUAN
BANGSA
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MELAYU
CINA
INDIA
LAIN-LAIN
UMUR
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JAWATAN
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UNIT/JABATAN
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TAHUN MULA BEKERJA DIBAWAH KKM
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TEMPOH BEKERJA DI JABATAN SEKARANG
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SEJARAH PERUBATAN (COMORBID)
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SEJARAH TIBI (YA/TIDAK) NYATAKAN TARIKH DIAGNOSA JIKA YA
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HASIL RAWATAN (JIKA DIJANGKITI TIBI)
SEMBUH
TERHENTI RAWATAN
SEMPURNA RAWATAN
GAGAL RAWATAN
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UJIAN MANTOUX (TARIKH CUCUK/TARIKH BACA/BACAAN mm)
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UJIAN IGRA, JIKA ADA (TARIKH UJIAN/KEPUTUSAN)
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