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Republic of the Philippines

City Of Laoag
Laoag City General Hospital

#46 Nalbo, Laoag City, 2900 Telephone Numbers: 772-88-26
July 18, 2014


Edna Orcino
Administrator
Ilocos Norte Chapter-Philippine Red Cross


Madam,

Greetings!

Patient Antonieta G. Amian is 57 years old, single and bonifide resident of Barangay 60-A
Caaoacan Laoag City. She was examined and confined in this hospital last May 31,2014 and
diagnosed with SQUAMOUS CELL CARCINOMA NON-KERATENIZING LARGE TUMOR STAGE III-B
STATUS POST CHEMOTHERAPY 2 times. Her niece came personally in our office seeking for
possible enrollment in your Blood Samaritan Program for them to settle their unsettled fees
incurred.

During her confinement patient undergo on series of laboratory examination and family
advised that the patient must undergo on blood transfusion which is she used 18 bags of blood.
Family provided the blood for the patient but they were suffering from financial crisis due to the
medication of the patient. They solicit money from their relatives but this is not enough. Family was
hoping that the patient will survive on her condition so they sacrifice all their resources.

But suddenly on the 25
th
day of June 2014 patient was died. Family is now suffering from
emotional and financial problem and worried on how to provide the fees of blood they
borrowed.All resources was exhausted during his medication hence this referral on your good
office.

We anticipate with gratitude for your utmost assistance to our patient.


Respectfully yours,


Remy Ann T.Tango, RSW
Social Welfare Aide

Recommending Approval:


Imelda P. Malto
Administrative Officer V

Noted:

Francis Manolito B. Dacuycuy,MD,FPSMS,DPAMS
Hospital Administrator

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Republic of the Philippines
City Of Laoag
Laoag City General Hospital

#46 Nalbo, Laoag City, 2900 Telephone Numbers: 772-88-26