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BALASAN RUJUKANNomor :/SM-BM//14Banyumas,.......................................2014Perihal :Balasan Rujukan Kepada Yh,............................................................................................................!i .................................................!en"an ini ami #eri$ahuan #ah%a pasien yan" saudara irim :Nama : ............................................................................................................................&lama$ : ............................................................................................................................ .............................................................................................................................!ia"nosa : ............................................................................................................................ ............................................................................................................................. .............................................................................................................................'an""al (u)uan: ............................................................................................................................'elah dilauan $indaan:.........................................................................................................................................................................................................................................................................................................................................................................................Ke$eran"an :...........................................................................................................................................................................................................................................................*orma$ Kamidr. Pan)i &n""ara