Format Pengkajian Remaja 2

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FORMAT PENGKAJIAN REMAJA I.

Identitas Klien A. Identitas Diri

1. Nama/Nama panggilan

:

2. Tempat tgl lahir/usia

:

3. Jenis kelamin

:

4. A g a m a

:

5. Kelas

:

6. Suku

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8. Alamat

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B. Identitas Orang tua 1. Ayah

a. N a m a

:

 . ! s i a

:

". #en$i$ikan : $. #eker%aan

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e. A g a m a

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)u!ungan

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12. Apakah rema%a mengetahui "ara pen"egahan #S( a. a  . Ti$ak 

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13. 1*. D. Ri+ayat Kesehatan

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Askep Ganggun Perkembangan

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rema%a untuk mer0k0k atau menggunakan NA#=A 68. 4. Apa alasan rema%a mer0k0k  . ,uung an S0sial

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