ALAGANG PINOY TAGUBILIN

Pangalan Edad Ward Hospital Number

(Name) (Age)
Toni, Ann Te 20 Y.O Med 2 1234502019
Petsa ng Pagpasok Petsa ng Paglabas
(Date of Admission) (Date of Discharge)

Nov. 24, 2019 Nov. 27,2019

Diagnosis/Sakit
Diabetes Mellitus Type II

Major Diagnostic Results / Pangunahing Resulta ng Pagsusuri (Resulta sa Eksaminasyon

Laboratory CBC, HgAIC, CBS
Xray _________________________________________________________________________
CT Scan _______________________________________________________________________
MRI _________________________________________________________________________
Others _______________________________________________________________________
Home Medication/ Gamot
(Pangalan ng Gamot) (Dosage) (Oras ng Pag inom)
Melformin 500mg Once a day with meals
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Health Teachings / Pagunahing Paalalang Pangkalusugan

(Mga Pahinumdum unsa buhaton sa balay)
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Other instructions / Karagdagang Paalala

(Uban pang Pahimangno)
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Follow-up Check-up / ( Petsa sa pagbalik ug pakonsulta sa Hospital

December 2, 2019 8:00am TAGUBILIN

Date of Follow-up Time Need to Bring
Prepared by: Noted by:

Shandy B. Pansa Dr. Raphael Recamadas

Nurse on Duty