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  • Consent For Surgical Operation: Republic of The Philippines Province of Antique Sibalom, Antique

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    Buffy Gordon-Villasor
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    The document is a consent form for a surgical operation from the Ramon Maza Sr. Memorial District Hospital in Sibalom, Antique, Philippines. It states that the patient gives the surgeon or physician full discretion to perform whatever operation they deem best, based on their knowledge, and that the patient will not hold them responsible for any unforeseen outcomes. The patient, their nearest kin or relative, and a witness must all sign to consent to these terms.

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    Consent for Surgical Operation

    Original Title

    Consent for Surgical Operation

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    The document is a consent form for a surgical operation from the Ramon Maza Sr. Memorial District Hospital in Sibalom, Antique, Philippines. It states that the patient gives the surgeon or physician full discretion to perform whatever operation they deem best, based on their knowledge, and that the patient will not hold them responsible for any unforeseen outcomes. The patient, their nearest kin or relative, and a witness must all sign to consent to these terms.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views2 pages

    Consent For Surgical Operation: Republic of The Philippines Province of Antique Sibalom, Antique

    Uploaded by

    Buffy Gordon-Villasor
    The document is a consent form for a surgical operation from the Ramon Maza Sr. Memorial District Hospital in Sibalom, Antique, Philippines. It states that the patient gives the surgeon or physician full discretion to perform whatever operation they deem best, based on their knowledge, and that the patient will not hold them responsible for any unforeseen outcomes. The patient, their nearest kin or relative, and a witness must all sign to consent to these terms.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Republic of the Philippines

    PROVINCE OF ANTIQUE
    RAMON MAZA SR. MEMORIAL DISTRICT HOSPITAL
    Sibalom, Antique

    CONSENT FOR SURGICAL OPERATION

    Date: _________________________

    I, ___________________________________________, of legal age, do hereby declare that the surgeon or physician is


    given a free hand on whatever choice of operation to perform on me/my patient to the best of his knowledge, and
    therefore, I shall not hold him/her responsible for any untoward result.

    ______________________________________ __________________________________
    Patient Name and Signature Date

    _______________________________________ ___________________________________
    Nearest of Kin or Relative Witness

    Republic of the Philippines


    PROVINCE OF ANTIQUE
    RAMON MAZA SR. MEMORIAL DISTRICT HOSPITAL
    Sibalom, Antique

    CONSENT FOR SURGICAL OPERATION

    Date: _________________________

    I, ___________________________________________, of legal age, do hereby declare that the surgeon or physician is


    given a free hand on whatever choice of operation to perform on me/my patient to the best of his knowledge, and
    therefore, I shall not hold him/her responsible for any untoward result.

    ______________________________________ __________________________________
    Patient Name and Signature Date

    _______________________________________ ___________________________________
    Nearest of Kin or Relative Witness

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