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DAILY TIME RECORD

NAME SSS #

DESIGNATION NURSE TIN #

CLIENT NAME UNILAB INC. PHIC #

PERIOD COVERED SEPT 16-30, 2020 _

SHIFT SCHEDULE A SHIFT B SHIFT C SHIFT TOTAL


DATE REMARKS*
(eg. 8am - 5:00pm)
IN OUT IN OUT IN OUT HOURS

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

RH - Reg. 0
I hereby certify thatHoliday Meetingindicated above are TRUE and CORRECT.
ALL information and remarks
*Remarks:
SH - Spec. Holiday On Leave
OT- Overtime RD - Restday
On Training (A1/BOSH/BLS) Events

Validated by:

0 ___________________________

SIGNATURE OVER PRINTED NAME CLINIC COORDINATOR


DAILY TIME RECORD

NAME ROSSELINI DERYL ESPINEDA SSS # 04-4019525-8

DESIGNATION NURSE TIN # 719-383-648

CLIENT NAME UNILAB INC. PHIC # 04-4019525-8

PERIOD COVERED JAN 16-31, 2021 _ 1212-1940-3011 / BPI: 3919-2376-42

SHIFT SCHEDULE A SHIFT B SHIFT C SHIFT TOTAL


DATE REMARKS*
(eg. 8am - 5:00pm)
IN OUT IN OUT IN OUT HOURS

16 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 RDOT

17

18 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

19 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

20 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

21 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

22 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

23 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 RDOT

24

25 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

26 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

27 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

28 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

29 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

30 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 RDOT

RH - Reg. 156
I hereby certify thatHoliday Meetingindicated above are TRUE and CORRECT.
ALL information and remarks
*Remarks:
SH - Spec. Holiday On Leave
OT- Overtime RD - Restday
On Training (A1/BOSH/BLS) Events

Validated by:

ROSSELINI DERYL ESPINEDA ___________________________

SIGNATURE OVER PRINTED NAME CLINIC COORDINATOR


DAILY TIME RECORD

NAME NILDA QUANICO SSS # 33-1791173-7

DESIGNATION NURSE TIN # 463-141-821-00

CLIENT NAME UNILAB INC. PHIC # 19-000713206-2

PERIOD COVERED JAN 16-31, 2021 _HDMF # 1210-1309-7619

SHIFT SCHEDULE A SHIFT B SHIFT C SHIFT TOTAL


DATE REMARKS*
(eg. 8am - 5:00pm)
IN OUT IN OUT IN OUT HOURS

16 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 RDOT

17

18 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

19 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

20 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

21 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

22 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

23 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 RDOT

24

25 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

26 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

27 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

28 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

29 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 4HRS OT'

30 6:00AM-3:00PM 6:00AM 3:00PM 3:00PM 6:00PM 12 RDOT

31
RH - Reg. 156
I hereby certify thatHoliday Meetingindicated above are TRUE and CORRECT.
ALL information and remarks
*Remarks:
SH - Spec. Holiday On Leave
OT- Overtime RD - Restday
On Training (A1/BOSH/BLS) Events

Validated by:

NILDA QUANICO ___________________________

SIGNATURE OVER PRINTED NAME CLINIC COORDINATOR


DAILY TIME RECORD

NAME Anica Paulina San Diego SSS #

DESIGNATION OH Physician TIN #

CLIENT NAME UNILAB INC. PHIC #

PERIOD COVERED JAN 16-31, 2021 _ BPI:009739-0176-18

SHIFT SCHEDULE A SHIFT B SHIFT C SHIFT TOTAL


DATE REMARKS*
(eg. 8am - 5:00pm)
IN OUT IN OUT IN OUT HOURS

16

17

18 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

19

20 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

21

22 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

23

24

25 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

26

27

28

29 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

30

RH - Reg. 40
I hereby certify thatHoliday Meetingindicated above are TRUE and CORRECT.
ALL information and remarks
*Remarks:
SH - Spec. Holiday On Leave
OT- Overtime RD - Restday
On Training (A1/BOSH/BLS) Events

Validated by:

Anica Paulina San Diego ___________________________

SIGNATURE OVER PRINTED NAME CLINIC COORDINATOR


DAILY TIME RECORD

NAME Arion Andronicus Avila SSS #

DESIGNATION OH Physician TIN #

CLIENT NAME UNILAB INC. PHIC #

PERIOD COVERED JAN 16-31, 2021 _ BPI:3859 2796 85

SHIFT SCHEDULE A SHIFT B SHIFT C SHIFT TOTAL


DATE REMARKS*
(eg. 8am - 5:00pm)
IN OUT IN OUT IN OUT HOURS

16

17

18

19 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

20

21 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

22

23

24

25

26 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

27 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

28 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

29 8:00 AM - 5:00 PM 8:00 AM 5:00 PM 8

30

31
RH - Reg. 48
I hereby certify thatHoliday Meetingindicated above are TRUE and CORRECT.
ALL information and remarks
*Remarks:
SH - Spec. Holiday On Leave
OT- Overtime RD - Restday
On Training (A1/BOSH/BLS) Events

Validated by:

Arion Andronicus Avila ___________________________

SIGNATURE OVER PRINTED NAME CLINIC COORDINATOR

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