REPUBLIC OF THE PHILIPPINES

PROVINCE OF PAMPANGA
NARS SA NAYON NG PAMPANGA PROJECT
Column1
Column2
PATIENT ADMISSION REPORT
NO.

NAME OF PATIENT

Column3

Column4

Column5

Column6

Column7

ADDRESS

AGE

CONTACT NO.

DATE OF ADMISSION

CATEGORY
NHTS

Column8

Column9
DIAGNOSIS

POC

DELOS SANTOS, ARMANDO

DOLORES, BACOLOR
(ANNEX HOSP)

50

09491305613
C/O BHW

4/23/2014

HPN II, BPPV

DELOS SANTOS, LOLITA

DOLORES, BACOLOR
(ANNEX HOSP)

70

09491305613
C/O BHW

4/23/2014

HPN II, BPPV

DELOS SANTOS, MARLYN

DOLORES, BACOLOR
(ANNEX HOSP)

46

09491305613
C/O BHW

4/23/2014

ARTHRITIS

CASTILLO, CORAZON

DOLORES, BACOLOR
(ANNEX HOSP)

69

09491305613
C/O BHW

4/23/2014

COPD in AE, CAD

VENTURINA, ANTONIO

STA. INES, BACOLOR

(ANNEX HOSP)

42

09093303866

4/23/2014

HPN II

PATIENT ADMISSION REPORT

NO.

NAME OF PATIENT

ADDRESS

AGE

CONTACT NO.

DATE OF ADMISSION

RONQUILLO, KHEIL

CABAMBANGAN,
BACOLOR (ANNEX
HOSP)

09303530311

4/22/2014

TAPANG, CYRUS

MAGLIMAN,
BACOLOR (ANNEX
HOSP)

09265426148

4/22/2014

DE JESUS, RODOLFO

MAGLIMAN,
BACOLOR (ANNEX
HOSP)

59

09297353663

2/22/2014

PHYSICAL INJURY SECONDARY TO MAULING

BANDE, ABDULIA

DOLORES, BACOLOR
(ANNEX HOSP)

78

09354889873

2/24/2014

HPN.PTB

10

11

CATEGORY

DIAGNOSIS

PNEUMONIA MODERATE RISK, UTI

PNEUMONIA

PATIENT ADMISSION REPORT

NO.

12

13

14

15

17

18

19

NAME OF PATIENT

ADDRESS

AGE

CONTACT NO.

DATE OF ADMISSION

CATEGORY

DIAGNOSIS

PATIENT ADMISSION REPORT

NO.

20

21

22

23

24

25

26

NAME OF PATIENT

ADDRESS

AGE

CONTACT NO.

DATE OF ADMISSION

CATEGORY

DIAGNOSIS

PATIENT ADMISSION REPORT

NO.

27

28

29

30

NAME OF PATIENT

ADDRESS

AGE

CONTACT NO.

DATE OF ADMISSION

CATEGORY

DIAGNOSIS

Column10

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Column12

Column13

Column14

COORDINATING PHYSICIAN

NURSE IN CHARGE

DATE DISCHARGED

DIAGNOSTIC EXAM

FOLLOW UP

DRA. JINGLE MARAYMARIA PATRICIA B. MORALES

4/25/2014

ECG

5/2/2014

DRA. JINGLE MARAYMARIA PATRICIA B. MORALES

4/25/2014

ECG

5/2/2014

DRA. JINGLE MARAYMARIA PATRICIA B. MORALES

4/25/2014

NONE

5/2/2014

4/25/2014

ECG, CHEST XRAY

5/2/2014

4/24/2014

ECG, CHEST
XRAY,CBC

5/1/2014

DRA. JINGLE MARAY

MADELYN AGUIPO

DRA. JINGLE MARAYJEMIMAH A. MANGALINDAN

COORDINATING PHYSICIAN

NURSE IN CHARGE

DATE DISCHARGED

DIAGNOSTIC EXAM

FOLLOW UP

DRA. JINGLE MARAYMARIA PATRICIA B. MORALES

4/25/2014

CBC, UA

5/2/2014

DRA. JINGLE MARAYPAULYNGHEELIN L. MAGPAYO

4/25/2014

CBC, UA

5/2/2014

DRA. JINGLE MARAYPAULYNGHEELIN L. MAGPAYO

4/23/2014

CBC, X-RAY

4/30/2014

DRA. JINGLE MARAY

4/25/2014

CBC, X-RAY

5/25/2014

MADELYN AGUIPO

COORDINATING PHYSICIAN

NURSE IN CHARGE

DATE DISCHARGED

DIAGNOSTIC EXAM

FOLLOW UP

COORDINATING PHYSICIAN

NURSE IN CHARGE

DATE DISCHARGED

DIAGNOSTIC EXAM

FOLLOW UP

COORDINATING PHYSICIAN

NURSE IN CHARGE

DATE DISCHARGED

DIAGNOSTIC EXAM

FOLLOW UP