api_user_11797_sandro_redoble2000
REDOBLE MEDICAL CLINIC CONSENT / TO WHOM THIS MAY CONCERN: SA KINAUKULAN / I the undersigned of legal
REDOBLE MEDICAL CLINIC Temperature and Pulse Respiration record Family name / Day of month Day of hosp
REDOBLE MEDICAL CLINIC / POBLACION BUUG, ZAMBOANGA SIBUGAY / REFERRAL SLIP / DATE:___________________ / NA
Redoble Medical Clinic Case No
REDOBLE MEDICAL CLINIC BUUG ZAMBOANGA SIBUGAY PATIENT CLINICAL RECORDS / CASE NO.____________________
Name: Address: Date: Temp: B/P: Weight: Chief Complaint: / Age: Treatment: / Sex: / Status: / Diagnosis:
REDOBLE MEDICAL CLINIC Medication Record Family name Day of month Day of hospital Medication A.M P.M
REDOBLE MEDICAL CLINIC Buug, Zamboanga Sibugay / KARDEX / Name of patient: _________________________ ___
REDOBLE MEDICAL CLINIC NAME OF HOSPITAL 082 NATIONAL HIGHWAY BUUG, ZAMBOANGA SIBUGAY ADDRESS / SURNAM
SURNAME: _________________________ _________AGE__________HOS PITAL NO._________________ GIVEN NAME.___
This form may be reproduced and is NOT FOR SALE / PHILHEALTH / CLAIM FORM 1 / Revised May 2000 / Note: This
WAIVER / (Hospital Charges) / ___________________ Date To Whom It May Concern: / This is to certify that
Statistical Report 1st Quarter 08
Republic of the Philippines Department of Health Bureau of Licensing and Regulation Manila / STATISTI
TRL and A CTRL and C CTRL and F CTRL and G CTRL and N CTRL and O CTRL and P CTRL and S CTRL and V CT
REGISTER ADMISSION DATE CASE NO. TIME NAME AGE SEX HOME ADDRESS MEDICARE MEMBER GM-GSIS MEMBER GD- G
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