Abstract - Information technology is rapidly developed in this
century that impact to various aspects of the organization really
need information technology to support the performance and
everyday business processes. In health services, information
technology is required to process and storage the patient medical
records, so that the patient's medical record is well preserved, and
competitive advantage can be obtained between patient and
polyclinic. The application of Customer Relationship Management
(CRM) approach can be developed by implementing information
system of medical record history to get new patient and retain
existing patient, improving relationship with patient and
maintaining patient loyalty as well as supporting the
company/organization to provide excellent service to customers in
real time through the advantage of information technology. The
aims of this research are to understand patient medical record by
CRM approach and Unified Modeling Language (UML) for system
design, system validation using Forum Group Discussion (FGD),
and using software testing Model ISO 9126. The result of this
research are Medical Record History Information System and the
result of system validation with FGD is 100% accepted, the result of
system test using Model ISO 9126 is good with success rate 82,86%,
so it can give contribution to polyclinic.