132 lines
2.8 KiB
HTML
132 lines
2.8 KiB
HTML
<html>
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<head>
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<meta charset="UTF-8" />
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<style>
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table {
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width: 100%;
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border-collapse: collapse
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}
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.border-table,
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.border-table td,
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.border-table th {
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border: 1px solid black;
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}
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.section-title {
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margin-top: 1rem;
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margin-bottom: 0rem;
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}
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</style>
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</head>
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<body style="font-family: Arial, sans-serif; line-height: 1.4">
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<table style="margin-top: 1rem;">
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<tr>
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<td>
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<img src="logo-1.png" alt="logo" style="height: 70px" />
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</td>
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<td>
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<div>
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SURAT RENCANA KONTROL
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</div>
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<div>
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RSUD dr. Saiful Anwar
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</div>
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</td>
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<td>
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<div>
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No. : {{ .Number }}
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</div>
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</td>
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</tr>
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<tr>
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<td style="height: 0.5rem;"></td>
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</tr>
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<tr>
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<td>
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<div>
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Kepada Yth
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</div>
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</td>
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<td>
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<div>
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{{ .Doctor_Name }}
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</div>
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<div>
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Sp./Sub. {{ .DstUnit_Name }}
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</div>
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</td>
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</tr>
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</table>
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<div style="margin-top: 1rem;">
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Mohon Pemeriksaan dan Penanganan Lebih Lanjut:
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</div>
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<table style="margin-top: 1rem;">
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<tr>
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<td style="width: 9rem;">
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No.Kartu
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</td>
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<td>
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: {{ .CardNumber }}
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</td>
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</tr>
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<tr>
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<td>
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Nama Peserta
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</td>
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<td>
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: {{ .Name }}
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</td>
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</tr>
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<tr>
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<td>
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Tgl.Lahir
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</td>
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<td>
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: {{ .BirthDate }}
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</td>
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</tr>
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<tr>
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<td>
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Diagnosa
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</td>
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<td>
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: {{ .Diagnose }}
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</td>
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</tr>
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<tr>
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<td>
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Rencana Kontrol
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</td>
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<td>
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: {{ .PlanDate }}
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</td>
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</tr>
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</table>
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<div style="margin: 1rem 0;">
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Demikian atas bantuannya, diucapkan banyak terima kasih.
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</div>
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<table>
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<tr>
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<td></td>
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<td style="width: 15rem;">
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Mengetahui, DPJP : {{ .ResponsibleDoctor_Name }}
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</td>
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</tr>
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</table>
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<div style="margin-top: 6rem;">
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Tgl. Cetak : {{ .PrintDate }}
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</div>
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<div style="height: 3rem;"></div>
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</body>
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</html> |