Saya yang bertanda-tangan dibawah ini :
Nama	:	{{ $data['CBDokter'] }}
Spesialis	:	{{ $data['spesialisBertandaTangan'] }}
Jabatan	:	{{ $data['jabatanBertandaTangan'] }}
Memang Benar Telah Memberikan Pelayanan Canggih HEMODIALISA Kepada :
Nomor Rekam Medis:	:	{{ $data['norm'] }}
Nama Pasien:	:	{{ $data['namaPasien'] }}
Tanggal Lahir/Umur	:	Warning: Undefined variable $data in /var/www/html/simrs/backend/resources/views/report/emr/formulir-bukti-pelayanan-canggih.blade.php on line 172 Warning: Trying to access array offset on value of type null in /var/www/html/simrs/backend/resources/views/report/emr/formulir-bukti-pelayanan-canggih.blade.php on line 172 Warning: Trying to access array offset on value of type null in /var/www/html/simrs/backend/resources/views/report/emr/formulir-bukti-pelayanan-canggih.blade.php on line 172 Warning: Undefined variable $data in /var/www/html/simrs/backend/resources/views/report/emr/formulir-bukti-pelayanan-canggih.blade.php on line 172 Warning: Trying to access array offset on value of type null in /var/www/html/simrs/backend/resources/views/report/emr/formulir-bukti-pelayanan-canggih.blade.php on line 172 Warning: Trying to access array offset on value of type null in /var/www/html/simrs/backend/resources/views/report/emr/formulir-bukti-pelayanan-canggih.blade.php on line 172 / 0 tahun, 0 bulan
Jenis Kelamin	:	{{ $data['pasien']['jeniskelamin'] }}
Alamat	:	{{ $data['pasien']['alamatlengkap'] }}
Diagnosa	:	{{ $data['diagnosa'] }}