HEALTH INFORMATION SYSTEM

foR MeDicAl LABORAtORY Science

FINAL LABORATORY REQUIREMENT

Institutions visited:
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Submitted by:
BSMT -1B-SET A- GROUP#2
[Year-Section-Set-Group #]
 INSTITUTIONAL VISIT FORM #2:

SECONDARY HEALTH CARE PROVIDER (DISTRICT HOSPITAL)

COURSE & YR.: BSMT SECTION & SET: 1B-SET A [RATING]
November 00,
GROUP NUMBER: 2 DATE SUBMITTED: 2021

GROUP MEMBERS: 1. Angelica Dela cruz 5. Mike Ibay

2. Allaisa Eugenio 6. Rica Javier
3. Darlene Gerardo 7. Zeanji Gacus
4. Lyka Javier

INSTRUCTION:
Coordinate a visit to a district hospital. Complete the form below by conducting an interview
with the officials of the institution.

1. Date of interview:
2. Name of District Hospital Official:
3. Location of District Hospital:
4. Contact Details of the District Hospital:

Name:

Address:

Contact Person:

Telephone/Fax/Email:

5. General Information:

Achievements/Success Stories of the District Hospital:

Issues:

© 2019 by C&E Pblishing, Inc. This form is created from a template of the book Health Information
System for Medical Laboratory Science.
1
 Number of Personnel:

Total number of personnel

Total number of permanent (w/ regular) item personnel

Total number of casual item personnel

Total number of contractual item personnel

Total number of doctors

Total number of dentist

Total number of medical technologist

Total number of medical laboratory technicians

Total number of nurses

Total number of nutritionist/dieticians

Total number of midwives

Total number of barangay health workers

Total population of barangay

Health personnel versus total population ratio

District Hospital Administrative Setup.

Illustrate the administrative set up by using a schematic diagram. Show the line of responsibility per
job category:

© 2019 by C&E Pblishing, Inc. This form is created from a template of the book Health Information
System for Medical Laboratory Science.
2
6. Immunization Program:

Number of women attending routine child immunization services:

Number of children receiving immunization:

Infant Mortality Rate:

Child Mortality Rate:

7. Identify the different jobs/work at the District Hospital. Write the job description for each position in
the District Hospital.

8. Are there job items for medical technologists or medical laboratory technicians? If
yes, what are the tasks of medical technologists in a District Hospital?

© 2019 by C&E Pblishing, Inc. This form is created from a template of the book Health Information
System for Medical Laboratory Science.
 LABORATORY
PURPOSE
EXAMINATION

Hematology:
1.
2.
3.
9. Complete
4. the table by supplying all the necessary information needed in a clinical laboratory in the
5.
3
Clinical Chemistry:
1.
2.
3.
4.
5.

District Hospital

Clinical Microscopy:
1.
2.
3.
4.
5.

Other Tests:
1.
2.
10. SWOT
3.
4.
5.
4
Analysis

© 2019 by C&E Pblishing, Inc. This form is created from a template of the book Health Information
System for Medical Laboratory Science.
 STRENGHTS WEAKNESSES
11.

OPPORTUNITIES THREATS

Compare a primary from a secondary laboratory.

PRIMARY SECONDARY
CATEGORY
LABORATORY LABORATORY
Laboratory Size
Number of Personnel
Number of Laboratory Tests
Number of Laboratory Sections
Number of Patients on a Daily
Basis

© 2019 by C&E Pblishing, Inc. This form is created from a template of the book Health Information
System for Medical Laboratory Science. 5