diff --git a/app/components/app/sep/entry-form.vue b/app/components/app/sep/entry-form.vue
index d1848e6c..ae82c741 100644
--- a/app/components/app/sep/entry-form.vue
+++ b/app/components/app/sep/entry-form.vue
@@ -33,6 +33,8 @@ const schema = z.object({
   diagnosaAwal: z.string().min(1, 'Diagnosa awal wajib diisi'),
   cob: z.string().min(1, 'COB wajib diisi'),
   katarak: z.string().min(1, 'Katarak wajib diisi'),
+  jenisProsedur: z.string().min(1, 'Jenis prosedur wajib diisi'),
+  kodePenunjang: z.string().min(1, 'Kode penunjang wajib diisi'),
 })
 
 const { handleSubmit, errors, defineField } = useForm({
@@ -54,6 +56,8 @@ const [dpjp] = defineField('dpjp')
 const [diagnosaAwal] = defineField('diagnosaAwal')
 const [cob] = defineField('cob')
 const [katarak] = defineField('katarak')
+const [jenisProsedur] = defineField('jenisProsedur')
+const [kodePenunjang] = defineField('kodePenunjang')
 
 // Submit handler
 const onSubmit = handleSubmit((values) => {
@@ -162,7 +166,11 @@ const onSubmit = handleSubmit((values) => {
         </div>
       </div>
 
-      <hr />
+      <!-- Catatan -->
+      <div>
+        <Label>Catatan</Label>
+        <Textarea placeholder="Masukkan catatan opsional" />
+      </div>
 
       <div class="flex items-center gap-4">
         <div>
@@ -193,10 +201,33 @@ const onSubmit = handleSubmit((values) => {
         </div>
       </div>
 
-      <!-- Catatan -->
-      <div>
-        <Label>Catatan</Label>
-        <Textarea placeholder="Masukkan catatan opsional" />
+      <div class="grid gap-4 md:grid-cols-3">
+        <div class="flex flex-col gap-2">
+          <Label class="mb-2 block">Jenis Prosedur<span class="text-red-500">*</span></Label>
+          <RadioGroup v-model="jenisProsedur" class="flex items-center gap-2">
+            <div class="flex items-center space-x-2">
+              <RadioGroupItem value="procedure-one" id="procedure-one" />
+              <Label for="procedure-one">Prosedur tidak berkelanjutan</Label>
+            </div>
+            <div class="flex items-center space-x-2">
+              <RadioGroupItem value="procedure-two" id="procedure-two" />
+              <Label for="procedure-two">Prosedur dan terapi berkelanjutan</Label>
+            </div>
+          </RadioGroup>
+        </div>
+      </div>
+
+      <div class="grid gap-4 md:grid-cols-3">
+        <div class="flex flex-col gap-2">
+          <Label>Kode Penunjang<span class="text-red-500">*</span></Label>
+          <Select
+            icon-name="i-lucide-chevron-down"
+            v-model="kodePenunjang"
+            :items="items"
+            placeholder="Pilih Kode Penunjang"
+          ></Select>
+          <p v-if="errors.kodePenunjang" class="text-sm text-red-500">{{ errors.kodePenunjang }}</p>
+        </div>
       </div>
 
       <!-- Actions -->