1506 lines
73 KiB
PHP
1506 lines
73 KiB
PHP
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.xl109
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{mso-style-parent:style0;
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font-size:8.0pt;
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font-family:"Aptos Narrow";
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text-align:center;
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vertical-align:top;
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border-bottom:none;
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{mso-style-parent:style0;
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font-size:8.0pt;
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text-align:center;
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vertical-align:top;
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border-top:.5pt solid windowtext;
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border-right:none;
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border-bottom:none;
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border-left:none;}
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.xl111
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{mso-style-parent:style0;
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text-align:left;
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border-top:none;
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border-right:.5pt solid windowtext;
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border-bottom:.5pt solid windowtext;
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border-left:none;}
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{mso-style-parent:style0;
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text-align:left;
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border-top:none;
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border-bottom:none;
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border-left:none;}
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{mso-style-parent:style0;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:center;
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border-top:none;
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border-right:none;
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border-bottom:none;
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border-left:.5pt solid windowtext;}
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.xl114
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{mso-style-parent:style0;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:center;}
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.xl115
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{mso-style-parent:style0;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:center;
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border-top:none;
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border-right:.5pt solid windowtext;
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border-bottom:none;
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border-left:none;}
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.xl116
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{mso-style-parent:style0;
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font-weight:700;
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font-family:"Aptos Narrow";
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mso-font-charset:0;
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text-align:center;
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border-top:.5pt solid windowtext;
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border-right:none;
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border-bottom:none;
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border-left:.5pt solid windowtext;}
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.xl117
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{mso-style-parent:style0;
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font-weight:700;
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font-family:"Aptos Narrow";
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mso-font-charset:0;
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text-align:center;
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border-top:.5pt solid windowtext;
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border-right:none;
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border-bottom:none;
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border-left:none;}
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.xl118
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{mso-style-parent:style0;
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font-weight:700;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:center;
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border-top:.5pt solid windowtext;
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border-right:.5pt solid windowtext;
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border-bottom:none;
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border-left:none;}
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.xl119
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{mso-style-parent:style0;
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font-weight:700;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:left;
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border-top:.5pt solid windowtext;
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border-right:none;
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border-bottom:none;
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border-left:.5pt solid windowtext;}
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.xl120
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{mso-style-parent:style0;
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font-weight:700;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:left;
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border-top:.5pt solid windowtext;
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border-right:none;
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border-bottom:none;
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border-left:none;}
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.xl121
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{mso-style-parent:style0;
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font-weight:700;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:left;
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border-top:.5pt solid windowtext;
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border-right:.5pt solid windowtext;
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border-bottom:none;
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border-left:none;}
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.xl122
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{mso-style-parent:style0;
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text-align:left;
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border-top:.5pt solid windowtext;
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border-right:none;
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border-bottom:none;
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border-left:none;}
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.xl123
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{mso-style-parent:style0;
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font-weight:700;
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font-family:"Aptos Narrow";
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mso-generic-font-family:auto;
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mso-font-charset:0;
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text-align:left;}
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.xl124
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{mso-style-parent:style0;
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text-align:left;
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border-top:.5pt solid windowtext;
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border-right:none;
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border-bottom:.5pt solid windowtext;
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border-left:none;}
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</style>
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</head>
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<body link="#467886" vlink="#96607D">
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<div id="tes_10102" align=center x:publishsource="Excel">
|
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@php
|
|
$data = [];
|
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$data['keterangan'] = $periksa->keterangan;
|
|
if (!empty($komponens)) {
|
|
foreach ($komponens as $rows) {
|
|
$key = trim($rows->komponen);
|
|
if (!empty($key)) {
|
|
if ($key == 'keterangan') {
|
|
$data['keterangan'] .= $rows->isidata;
|
|
} else {
|
|
$data[$key] = $rows->isidata;
|
|
}
|
|
}
|
|
}
|
|
}
|
|
@endphp
|
|
<table border=0 cellpadding=2 cellspacing=2 width=1054 style='border-collapse: collapse;table-layout:fixed;width:789pt'>
|
|
<col width=31 style='mso-width-source:userset;mso-width-alt:981;width:23pt'>
|
|
<col width=45 style='mso-width-source:userset;mso-width-alt:1450;width:34pt'>
|
|
<col width=168 style='mso-width-source:userset;mso-width-alt:5376;width:126pt'>
|
|
<col width=23 style='mso-width-source:userset;mso-width-alt:725;width:17pt'>
|
|
<col width=39 style='mso-width-source:userset;mso-width-alt:1237;width:29pt'>
|
|
<col width=20 style='mso-width-source:userset;mso-width-alt:640;width:15pt'>
|
|
<col width=23 style='mso-width-source:userset;mso-width-alt:725;width:17pt'>
|
|
<col width=33 style='mso-width-source:userset;mso-width-alt:1066;width:25pt'>
|
|
<col width=39 style='mso-width-source:userset;mso-width-alt:1237;width:29pt'>
|
|
<col width=87 style='width:65pt'>
|
|
<col width=17 style='mso-width-source:userset;mso-width-alt:554;width:13pt'>
|
|
<col width=37 style='mso-width-source:userset;mso-width-alt:1194;width:28pt'>
|
|
<col width=39 style='mso-width-source:userset;mso-width-alt:1237;width:29pt'>
|
|
<col width=79 style='mso-width-source:userset;mso-width-alt:2517;width:59pt'>
|
|
<col width=57 style='mso-width-source:userset;mso-width-alt:1834;width:43pt'>
|
|
<col width=61 style='mso-width-source:userset;mso-width-alt:1962;width:46pt'>
|
|
<col width=39 style='mso-width-source:userset;mso-width-alt:1237;width:29pt'>
|
|
<col width=52 style='mso-width-source:userset;mso-width-alt:1664;width:39pt'>
|
|
<col width=39 style='mso-width-source:userset;mso-width-alt:1237;width:29pt'>
|
|
<col width=47 style='mso-width-source:userset;mso-width-alt:1493;width:35pt'>
|
|
<col width=39 style='mso-width-source:userset;mso-width-alt:1237;width:29pt'>
|
|
<col width=40 style='mso-width-source:userset;mso-width-alt:1280;width:30pt'>
|
|
<col width=31 style='mso-width-source:userset;mso-width-alt:981;width:23pt'>
|
|
<tr style='height:16.0pt'>
|
|
<td width=31 style='height:16.0pt;width:23pt'></td>
|
|
<td colspan=5 class=xl67 width=295 style='width:221pt'>Barcode NIK</td>
|
|
<td width=23 style='width:17pt'></td>
|
|
<td width=33 style='width:25pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=87 style='width:65pt'></td>
|
|
<td width=17 style='width:13pt'></td>
|
|
<td width=37 style='width:28pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=79 style='width:59pt'></td>
|
|
<td width=57 style='width:43pt'></td>
|
|
<td width=61 style='width:46pt'></td>
|
|
<td colspan=6 class=xl67 width=256 style='width:191pt'>Barcode TBC.05</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=5 class=xl67><img src="{!! route('generate.barcode', ['data' => $nik ?? $periksa->nofoto]) !!}" alt="Barcode" style="max-width: 100%; height: auto;"></td>
|
|
<td colspan=10 style='mso-ignore:colspan'></td>
|
|
<td colspan=6 class=xl67><img src="{!! route('generate.barcode', ['data' => '2416199639']) !!}" alt="Barcode" style="max-width: 100%; height: auto;"></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=5 class=xl106 style='border-right:.5pt solid black'>PENANGGULANGAN TBC NASIONAL</td>
|
|
<td colspan=10 style='mso-ignore:colspan'></td>
|
|
<td colspan=6 class=xl106 style='border-right:.5pt solid black'>TBC.05</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl67></td>
|
|
<td class=xl67></td>
|
|
<td class=xl67></td>
|
|
<td class=xl67></td>
|
|
<td class=xl67></td>
|
|
<td colspan=10 style='mso-ignore:colspan'></td>
|
|
<td colspan=6 class=xl109>INDONESIA 2020/EDISI 3</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=21 class=xl67>FORMULIR PERMOHONAN PEMERIKSAAN BAKTERIOLOGIS TBC</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=22 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>Nama Fasyankes</td>
|
|
<td>:</td>
|
|
<td colspan=6 class=xl65>{!! $periksa->nmrs !!}</td>
|
|
<td> </td>
|
|
<td colspan=3 class=xl65>Nama Dokter Pengirim</td>
|
|
<td class=xl63>:</td>
|
|
<td colspan=7 class=xl105>{!! $periksa->klinisi !!}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>Kode Fasyankes</td>
|
|
<td>:</td>
|
|
<td colspan=6 class=xl65>{!! $periksa->ruangan_id !!}</td>
|
|
<td colspan=4 style='mso-ignore:colspan'></td>
|
|
<td class=xl63></td>
|
|
<td colspan=7 style='mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>No. Rekam Medis</td>
|
|
<td>:</td>
|
|
<td colspan=6 class=xl65>{!! $periksa->noregister !!}</td>
|
|
<td colspan=4 style='mso-ignore:colspan'></td>
|
|
<td class=xl63></td>
|
|
<td colspan=7 style='mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>Nama Terduga</td>
|
|
<td>:</td>
|
|
<td colspan=6 class=xl65>{!! $periksa->nmpasien !!}</td>
|
|
<td> </td>
|
|
<td colspan=3 class=xl65>No. Telp. Pasien</td>
|
|
<td class=xl63>:</td>
|
|
<td colspan=7 class=xl105>{!! $periksa->tlppasien !!}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>No. Induk Kependudukan</td>
|
|
<td>:</td>
|
|
<td colspan=6 class=xl105>{{$nik}}</td>
|
|
<td> </td>
|
|
<td colspan=3 class=xl65>No. BPJS</td>
|
|
<td class=xl63>:</td>
|
|
<td colspan=7 class=xl124>{{$bpjs}}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>Jenis Kelamin</td>
|
|
<td>:</td>
|
|
<td class=xl66>
|
|
@if ($periksa->jkpasien == 'L')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td colspan=3 class=xl97 style='border-right:.5pt solid black;border-left: none'>Laki - Laki</td>
|
|
<td class=xl66 style='border-left:none'>
|
|
@if ($periksa->jkpasien != 'L')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td>Perempuan</td>
|
|
<td> </td>
|
|
<td colspan=3 class=xl65>Umur</td>
|
|
<td class=xl63>:</td>
|
|
<td colspan=7 class=xl124>{!! $periksa->usia !!}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>Alamat Lengkap</td>
|
|
<td>:</td>
|
|
<td colspan=18 class=xl65>{!! $periksa->alamatpasien !!}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=4 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
<td colspan=18 class=xl65> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>Kabupaten / Kota</td>
|
|
<td>:</td>
|
|
<td colspan=2 style='mso-ignore:colspan'>{!! $periksa->getPasien->kota ?? '-' !!}</td>
|
|
<td colspan=5 style='mso-ignore:colspan'></td>
|
|
<td colspan=11 class=xl63>Jenis Terduga / Pasien TBC</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl65>Provinsi</td>
|
|
<td>:</td>
|
|
<td colspan=3 style='mso-ignore:colspan'>{!! $periksa->getPasien->keterangan ?? '-' !!}</td>
|
|
<td colspan=5 style='mso-ignore:colspan'></td>
|
|
<td class=xl64>
|
|
@if (isset($data['inlineCheckbox1']) && $data['inlineCheckbox1'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl63>TBC SO</td>
|
|
<td class=xl64>
|
|
@if (isset($data['inlineCheckbox2']) && $data['inlineCheckbox2'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl63>TBC RO</td>
|
|
<td class=xl64>
|
|
@if (isset($data['inlineCheckbox3']) && $data['inlineCheckbox3'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl63>Anak</td>
|
|
<td class=xl64>
|
|
@if (isset($data['inlineCheckbox4']) && $data['inlineCheckbox4'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl63>HIV</td>
|
|
<td class=xl64>
|
|
@if (isset($data['inlineCheckbox5']) && $data['inlineCheckbox5'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl63>DM</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=22 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=9 class=xl116 style='border-right:.5pt solid black'>No. Identitas Sediaan</td>
|
|
<td> </td>
|
|
<td colspan=11 class=xl123>Lama Riwayat Pengobatan Terduga / Pasien TBC</td>
|
|
</tr>
|
|
@php
|
|
if (isset($data['id_lamariwayatpengobatantb']) && $data['id_lamariwayatpengobatantb'] == 'Riwayat Pengobatan < 5 tahun'){
|
|
$rw1 = ' ';
|
|
$rw2 = '√';
|
|
} else {
|
|
$rw2 = ' ';
|
|
$rw1 = '√';
|
|
}
|
|
@endphp
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=9 class=xl113 style='border-right:.5pt solid black'>{{$data['id_noidsediaan'] ?? ''}}</td>
|
|
<td> </td>
|
|
<td class=xl64>{!! $rw1 !!}</td>
|
|
<td> </td>
|
|
<td colspan=9 class=xl65>Riwayat Pengobatan >= 5 tahun</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl68 colspan=2 style='mso-ignore:colspan'>Tanggal pengambilan contoh uji</td>
|
|
<td class=xl65> </td>
|
|
<td class=xl65> </td>
|
|
<td>:</td>
|
|
<td colspan=4 class=xl65 style='border-right:.5pt solid black'>{{$data['id_tanggalpengambilancontohuji'] ?? ''}}</td>
|
|
<td> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $rw2 !!}</td>
|
|
<td> </td>
|
|
<td colspan=9 class=xl65>Riwayat Pengobatan < 5 tahun</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl68 colspan=2 style='mso-ignore:colspan'>Tanggal pengiriman contoh uji</td>
|
|
<td class=xl65> </td>
|
|
<td class=xl65> </td>
|
|
<td>:</td>
|
|
<td colspan=4 class=xl65 style='border-right:.5pt solid black'>{{$data['id_tanggalpengirimancontohuji'] ?? ''}}</td>
|
|
<td colspan=12 style='mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl68 colspan=4 style='mso-ignore:colspan'>Tanda tangan pengambilan contoh uji</td>
|
|
<td>:</td>
|
|
<td colspan=4 class=xl65 style='border-right:.5pt solid black'> </td>
|
|
<td> </td>
|
|
<td colspan=10 class=xl75>Alasan Pemeriksaan :</td>
|
|
<td class=xl72> </td>
|
|
</tr>
|
|
@php
|
|
if (isset($data['id_alasanpemeriksaan']) && $data['id_alasanpemeriksaan'] == 'Diagnosis TBS'){
|
|
$d2 = ' ';
|
|
$d1 = '√';
|
|
$d3 = ' ';
|
|
} else if (isset($data['id_alasanpemeriksaan']) && $data['id_alasanpemeriksaan'] == 'Diagnosis Baseline TBC'){
|
|
$d1 = ' ';
|
|
$d2 = '√';
|
|
$d3 = ' ';
|
|
} else {
|
|
$d1 = ' ';
|
|
$d3 = '√';
|
|
$d2 = ' ';
|
|
}
|
|
@endphp
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=9 class=xl88 style='border-right:.5pt solid black'> </td>
|
|
<td> </td>
|
|
<td class=xl64>{!! $d1 !!}</td>
|
|
<td> </td>
|
|
<td colspan=8 class=xl65>Diagnosis TBC</td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=11 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
<td class=xl64 style='border-top:none'>{!! $d2 !!}</td>
|
|
<td> </td>
|
|
<td colspan=8 class=xl65>Diagnosis Baseline TBC</td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl119>Jenis Pemeriksaan</td>
|
|
<td class=xl72> </td>
|
|
<td colspan=6 class=xl119 style='border-right:.5pt solid black;border-left: none'>Lokasi Anatomi</td>
|
|
<td> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $d3 !!}</td>
|
|
<td> </td>
|
|
<td colspan=8 class=xl65>Akhir Pengobatan</td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
@php
|
|
if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'Mikroskopis'){
|
|
$j1 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM MTB Rif (Xpert)'){
|
|
$j2 = '√';
|
|
$j1 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM XDR (Xpert)'){
|
|
$j3 = '√';
|
|
$j2 = ' ';
|
|
$j1 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM MTB Rif (Truenat)'){
|
|
$j4 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j1 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'TCM MTB Rif INH (BDMAX)'){
|
|
$j5 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j1 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'PCR Open System'){
|
|
$j6 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j1 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'LPA lini 1'){
|
|
$j7 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j1 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'LPA lini 2'){
|
|
$j8 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j1 = ' ';
|
|
$j9 = ' ';
|
|
$j10 = ' ';
|
|
} else if (isset($data['id_jenispemeriksaantb']) && $data['id_jenispemeriksaantb'] == 'Biakan'){
|
|
$j9 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j1 = ' ';
|
|
$j10 = ' ';
|
|
} else {
|
|
$j10 = '√';
|
|
$j2 = ' ';
|
|
$j3 = ' ';
|
|
$j4 = ' ';
|
|
$j5 = ' ';
|
|
$j6 = ' ';
|
|
$j7 = ' ';
|
|
$j8 = ' ';
|
|
$j9 = ' ';
|
|
$j1 = ' ';
|
|
}
|
|
if (isset($data['tekslokasianatomi']) && $data['tekslokasianatomi'] != ''){
|
|
$p2 = '√';
|
|
$p1 = ' ';
|
|
} else {
|
|
$p1 = '√';
|
|
$p2 = ' ';
|
|
}
|
|
@endphp
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64>{!! $j1 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>Mikroskopis</td>
|
|
<td class=xl64 style='border-left:none'>{!! $p1 !!}</td>
|
|
<td> </td>
|
|
<td colspan=4 class=xl65 style='border-right:.5pt solid black'>Paru</td>
|
|
<td> </td>
|
|
<td colspan=10 class=xl68>Pemantauan kemajuan pengobatan (Follow up)</td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j2 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>TCM MTB Rif (Xpert)</td>
|
|
<td class=xl64 style='border-top:none;border-left:none'>{!! $p2 !!}</td>
|
|
<td> </td>
|
|
<td colspan=4 class=xl65 style='border-right:.5pt solid black'>Ekstraparu</td>
|
|
<td> </td>
|
|
<td class=xl74> </td>
|
|
<td colspan=2 class=xl65 style='border-right:.5pt solid black'>Bulan ke :</td>
|
|
<td class=xl64 style='border-left:none'>{!! $data['id_bulankemajuantbfollow'] ?? '' !!}</td>
|
|
<td colspan=6 style='mso-ignore:colspan'></td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j3 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>TCM XDR (Xpert)</td>
|
|
<td class=xl74 style='border-left:none'> </td>
|
|
<td> </td>
|
|
<td colspan=2 style='mso-ignore:colspan'>Lokasi :</td>
|
|
<td colspan=2 class=xl105 style='border-right:.5pt solid black'>{!! $data['id_ekstraparu'] ?? '' !!}</td>
|
|
<td> </td>
|
|
<td colspan=10 class=xl68>Pemeriksaan ulang ke- :</td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j4 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>TCM MTB Rif (Truenant)</td>
|
|
<td class=xl69 style='border-left:none'> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl71> </td>
|
|
<td> </td>
|
|
<td class=xl74> </td>
|
|
<td colspan=2 class=xl65 style='border-right:.5pt solid black'>Bulan ke :</td>
|
|
<td class=xl64 style='border-left:none'>{!! $data['id_bulanpemeriksaanulang'] ?? '' !!}</td>
|
|
<td colspan=6 style='mso-ignore:colspan'></td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j5 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>TCM (MTB (Rif INH (BDMAX)</td>
|
|
<td colspan=7 style='mso-ignore:colspan'></td>
|
|
<td colspan=10 class=xl68>Pemeriksaan setelah selesai pengobatan :</td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j6 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>PCR Open System</td>
|
|
<td colspan=7 style='mso-ignore:colspan'></td>
|
|
<td class=xl74> </td>
|
|
<td colspan=2 class=xl65 style='border-right:.5pt solid black'>Bulan ke :</td>
|
|
<td class=xl64 style='border-left:none'>{!! $data['id_bulanpemeriksaansetelahselesai'] ?? '' !!}</td>
|
|
<td colspan=6 style='mso-ignore:colspan'></td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j7 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>LPA lini 1</td>
|
|
<td colspan=7 style='mso-ignore:colspan'></td>
|
|
<td colspan=5 class=xl68>No. Reg. TBC/TBC RO Fasyankes</td>
|
|
<td>:</td>
|
|
<td colspan=4 class=xl65>{!! $data['id_noregfasyankes'] ?? '' !!}</td>
|
|
<td class=xl73> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j8 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>LPA lini 2</td>
|
|
<td colspan=7 style='mso-ignore:colspan'></td>
|
|
<td colspan=5 class=xl104>No. Reg. TBC/TBC RO Kota</td>
|
|
<td class=xl70>:</td>
|
|
<td colspan=4 class=xl105>{!! $data['id_noregkota'] ?? '' !!}</td>
|
|
<td class=xl71> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j9 !!}</td>
|
|
<td colspan=2 class=xl68 style='border-right:.5pt solid black;border-left: none'>Biakan</td>
|
|
<td colspan=18 style='mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>{!! $j10 !!}</td>
|
|
<td colspan=2 class=xl104 style='border-right:.5pt solid black;border-left: none'>Paket standar uji kepekaan</td>
|
|
<td colspan=18 style='mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=22 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=4 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
<td colspan=18 class=xl102>Secara visual dahak tampak (berilah tanda V pada kotak)</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl75 colspan=2 style='mso-ignore:colspan;border-right:.5pt solid black'>Contoh Uji</td>
|
|
<td> </td>
|
|
<td class=xl76 style='border-top:none'> </td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td colspan=3 class=xl103>Nanah lendir</td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td colspan=3 class=xl103>Bercak darah</td>
|
|
<td class=xl77 style='border-top:none'> </td>
|
|
<td colspan=3 class=xl103 style='border-right:.5pt solid black'>Air Liur</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64>
|
|
@if (isset($data['id_contohuji']) && $data['id_contohuji'] == 'Dahak')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl73>Dahak</td>
|
|
<td> </td>
|
|
<td colspan=5 class=xl68>Sewaktu / Pagi</td>
|
|
<td colspan=2 style='mso-ignore:colspan'> </td>
|
|
<td colspan=3 class=xl99 style='border-right:.5pt solid black'>
|
|
@if (isset($data['inlineCheckbox6']) && $data['inlineCheckbox6'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td> </td>
|
|
<td colspan=3 class=xl99 style='border-right:.5pt solid black'>
|
|
@if (isset($data['inlineCheckbox7']) && $data['inlineCheckbox7'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td> </td>
|
|
<td colspan=3 class=xl99 style='border-right:.5pt solid black'>
|
|
@if (isset($data['inlineCheckbox8']) && $data['inlineCheckbox8'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64 style='border-top:none'>
|
|
@if (isset($data['id_contohuji']) && $data['id_contohuji'] != 'Dahak')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl71>Lainnya : {!! $data['id_contohujilainnya'] ?? '' !!}</td>
|
|
<td> </td>
|
|
<td colspan=5 class=xl104>Sewaktu / Pagi</td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td colspan=3 class=xl99 style='border-right:.5pt solid black'>
|
|
@if (isset($data['inlineCheckbox9']) && $data['inlineCheckbox9'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl70> </td>
|
|
<td colspan=3 class=xl99 style='border-right:.5pt solid black'>
|
|
@if (isset($data['inlineCheckbox10']) && $data['inlineCheckbox10'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl70> </td>
|
|
<td colspan=3 class=xl99 style='border-right:.5pt solid black'>
|
|
@if (isset($data['inlineCheckbox11']) && $data['inlineCheckbox11'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=4 style='height:16.0pt;mso-ignore:colspan'> </td>
|
|
<td class=xl78 colspan=4 style='mso-ignore:colspan'>* Lingkari yang sesuai</td>
|
|
<td colspan=14 style='mso-ignore:colspan'> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=15 style='height:16.0pt;mso-ignore:colspan'> </td>
|
|
<td colspan=7 class=xl63>Malang, {{$tanggal}}</td>
|
|
</tr>
|
|
<tr height=42 style='height:32.0pt;mso-xlrowspan:2'>
|
|
<td height=42 colspan=22 style='height:32.0pt;mso-ignore:colspan'> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=15 style='height:16.0pt;mso-ignore:colspan'> </td>
|
|
<td colspan=7 class=xl63>{{$periksa->klinisi}}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=22 style='height:16.0pt;mso-ignore:colspan'> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=21 class=xl67>HASIL PEMERIKSAAN BAKTERIOLOGIS TBC</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=22 style='height:16.0pt;mso-ignore:colspan'> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=8 style='mso-ignore:colspan'>No. Register Lab. (sesuai Buku Register Lab TBC.04) :</td>
|
|
<td colspan=13 style='mso-ignore:colspan'> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=22 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 rowspan=2 class=xl91 style='border-right:.5pt solid black; border-bottom:.5pt solid black'>Contoh uji *)</td>
|
|
<td colspan=5 class=xl97 style='border-right:.5pt solid black;border-left: none'>Tanggal Hasil</td>
|
|
<td colspan=4 rowspan=2 class=xl91 style='border-right:.5pt solid black; border-bottom:.5pt solid black'>Kode Unik TCM XDR (Xpert)</td>
|
|
<td colspan=10 rowspan=2 class=xl91 style='border-right:.5pt solid black; border-bottom:.5pt solid black'>Hasil Pemeriksaan TCM XDR (Xpert) ***</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=5 class=xl88 style='border-right:.5pt solid black;border-left: none'>Dilaporkan</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl97 style='border-right:.5pt solid black'> </td>
|
|
<td colspan=5 rowspan=4 class=xl91 style='border-right:.5pt solid black'>{{$data['hasilpemeriksaanttcmmtbxdrxpert_tglpagi'] ?? ''}}</td>
|
|
<td colspan=4 rowspan=4 class=xl91 style='border-right:.5pt solid black'><img src="{!! route('generate.barcode', ['data' => $data['hasilpemeriksaanttcmmtbxdrxpert_kodeunikpagi'] ?? $periksa->nofoto]) !!}" alt="Barcode" style="max-width: 100%; height: auto;"</td>
|
|
<td> </td>
|
|
<td class=xl80>Neg</td>
|
|
<td class=xl80>H Low</td>
|
|
<td class=xl80>H</td>
|
|
<td colspan=2 class=xl80>FQ Low</td>
|
|
<td colspan=2 class=xl80>FQ</td>
|
|
<td colspan=2 class=xl80 style='border-right:.5pt solid black'>Invalid</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64>{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagi'] ?? ''!!}</td>
|
|
<td class=xl73>Pagi</td>
|
|
<td> </td>
|
|
<td class=xl79>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagineg'] ?? ' '!!}
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagih'] ?? ' '!!}
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagifqlow'] ?? ' '!!}
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagifq'] ?? ' '!!}
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagiinvalid'] ?? ' '!!}
|
|
</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 rowspan=2 class=xl85 style='border-right:.5pt solid black'> </td>
|
|
<td> </td>
|
|
<td class=xl80>Amk</td>
|
|
<td class=xl80>Km</td>
|
|
<td class=xl80>Cm</td>
|
|
<td colspan=2 class=xl80>Eto</td>
|
|
<td colspan=2 class=xl80>Error</td>
|
|
<td colspan=2 class=xl80 style='border-right:.5pt solid black'>No Result</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td> </td>
|
|
<td class=xl79>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagiamk'] ?? ' '!!}
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagikm'] ?? ' '!!}
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagicm'] ?? ' '!!}
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagieto'] ?? ' '!!}
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_pagierror'] ?? ' '!!}
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
{!! $data['hasilpemeriksaanttcmmtbxdrxpert_paginoresult'] ?? ' '!!}
|
|
</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl69> </td>
|
|
<td class=xl71> </td>
|
|
<td class=xl69 style='border-left:none'> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl71> </td>
|
|
<td class=xl69 style='border-left:none'> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl71> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl71> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 class=xl85 style='border-right:.5pt solid black'> </td>
|
|
<td colspan=5 rowspan=4 class=xl87 style='border-right:.5pt solid black'>{!! $data['hasilpemeriksaanttcmmtbxdrxpert_tglsewaktu'] ?? '' !!}</td>
|
|
<td colspan=4 rowspan=4 class=xl87 style='border-right:.5pt solid black'><img src="{!! route('generate.barcode', ['data' => $data['hasilpemeriksaanttcmmtbxdrxpert_kodeunik'] ?? $periksa->nofoto]) !!}" alt="Barcode" style="max-width: 100%; height: auto;"</td>
|
|
<td> </td>
|
|
<td class=xl80>Neg</td>
|
|
<td class=xl80>H Low</td>
|
|
<td class=xl80>H</td>
|
|
<td colspan=2 class=xl80>FQ Low</td>
|
|
<td colspan=2 class=xl80>FQ</td>
|
|
<td colspan=2 class=xl80 style='border-right:.5pt solid black'>Invalid</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl64>{!! $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktu'] ?? '' !!}</td>
|
|
<td class=xl73>Sewaktu / Pagi</td>
|
|
<td> </td>
|
|
<td class=xl79>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuneg']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuneg'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktunhlow']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktunhlow'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuh']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuh'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktufqlow']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktufqlow'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktufq']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktufq'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuinvalid']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuinvalid'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td colspan=2 rowspan=2 class=xl85 style='border-right:.5pt solid black'> </td>
|
|
<td> </td>
|
|
<td class=xl80>Amk</td>
|
|
<td class=xl80>Km</td>
|
|
<td class=xl80>Cm</td>
|
|
<td colspan=2 class=xl80>Eto</td>
|
|
<td colspan=2 class=xl80>Error</td>
|
|
<td colspan=2 class=xl80 style='border-right:.5pt solid black'>No Result</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td> </td>
|
|
<td class=xl79>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuamk']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuamk'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktukm']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktukm'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktucm']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktucm'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktueto']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktueto'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuerror']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktuerror'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
<td colspan=2 class=xl79 style='border-left:none'>
|
|
@if (isset($data['hasilpemeriksaanttcmmtbxdrxpert_sewaktunoresult']) && $data['hasilpemeriksaanttcmmtbxdrxpert_sewaktunoresult'] != '')
|
|
√
|
|
@else
|
|
|
|
@endif
|
|
</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td class=xl69> </td>
|
|
<td class=xl71> </td>
|
|
<td class=xl69 style='border-left:none'> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl71> </td>
|
|
<td class=xl69 style='border-left:none'> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl71> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl70> </td>
|
|
<td class=xl71> </td>
|
|
</tr>
|
|
<tr style='height:16.0pt'><td style='height:16.0pt'> </td><td colspan=21 class=xl67></td></tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=15 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
<td colspan=7 class=xl65>Mengetahui</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=2 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
<td colspan=13 class=xl65>Tanda tangan pemeriksa</td>
|
|
<td colspan=7 class=xl65>Dokter PJ pemeriksaan Lab</td>
|
|
</tr>
|
|
<tr style='mso-height-source:userset;height:40.0pt'>
|
|
<td colspan=2 style='height:40.0pt;mso-ignore:colspan'></td>
|
|
<td colspan=13 class=xl83><!-- $ttdexecutor --></td>
|
|
<td colspan=7 class=xl83>{!! $tandatangan !!}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'>
|
|
<td colspan=2 style='height:16.0pt;mso-ignore:colspan'></td>
|
|
<td colspan=13 class=xl65>{!! $periksa->nmexcutor !!}</td>
|
|
<td colspan=7 class=xl65>{!! $periksa->nmdokter !!}</td>
|
|
</tr>
|
|
<tr style='height:16.0pt'><td style='height:16.0pt'> </td><td colspan=21 class=xl67></td></tr>
|
|
<tr style='height:16.0pt'>
|
|
<td style='height:16.0pt'> </td>
|
|
<td>*)</td>
|
|
<td colspan=20 class=xl65>Diisi sesuai dengan kode huruf sesuai identitas sediaan/waktu pengambilan dahak</td>
|
|
</tr>
|
|
<tr height=88 style='mso-height-source:userset;height:66.0pt'>
|
|
<td height=88 style='height:66.0pt'></td>
|
|
<td class=xl81>****)</td>
|
|
<td colspan=20 class=xl82 width=978 style='width:732pt'>Beri tanda rumput sesuai hasil pemeriksaan TCM untuk kolom neg/invalid/no result/error Kolom FQ/Amk/Km/Cm/Eto isi sesuai hasil dengan pilihan R jika resisten, S jika sensitif, dan IDT untuk indeterminate. Khusus untuk isian H dan FQ terdapat 2 hasil pemeriksaan yaitu dosis standar dan dosis rendah (H low dan FQ low), diisi dengan R jika terjadi resistan, S jika sensitive, dan IDT untuk indeterminate</td>
|
|
</tr>
|
|
<![if supportMisalignedColumns]>
|
|
<tr height=0 style='display:none'>
|
|
<td width=31 style='width:23pt'></td>
|
|
<td width=45 style='width:34pt'></td>
|
|
<td width=168 style='width:126pt'></td>
|
|
<td width=23 style='width:17pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=20 style='width:15pt'></td>
|
|
<td width=23 style='width:17pt'></td>
|
|
<td width=33 style='width:25pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=87 style='width:65pt'></td>
|
|
<td width=17 style='width:13pt'></td>
|
|
<td width=37 style='width:28pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=79 style='width:59pt'></td>
|
|
<td width=57 style='width:43pt'></td>
|
|
<td width=61 style='width:46pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=52 style='width:39pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=47 style='width:35pt'></td>
|
|
<td width=39 style='width:29pt'></td>
|
|
<td width=40 style='width:30pt'></td>
|
|
</tr>
|
|
<![endif]>
|
|
</table>
|
|
</div>
|
|
</body>
|
|
</html>
|