ee 7 ———— DATE: October 31, 2022 PATIENT 1.D. NO. - | IENT LD. NO. 832806 wu ce or | EMERGENCY URGENT ELECTIVE Name of Patient JADION, ALEXIE LAINE Gh 0 GEX'F | tars wanton Adoress 14 DE BORJA GOMPOUND, STA. ANA, PATEROS-MANILA Nationality Filipino Religion Name of Spouse Place of Birth PASIG CITY Date of Birth October 31,2022 ContactNo. — Ome sae ane Name of Father Name of Mother LALAINE JADION To be admitted under the department of Newborn Gagrting LIVE: TERM: SINGLETON: FEMALE; DELIVERED VIA CESAREAN SECTION SECONDARY TO MULTIPLE diagnosis 3 | > -CONGENFALH ta e- Blicdum Consultant Briefed as to Admission Policies and may therefore be admit V SS pr Lerrocked administrate Adel bate: pet 2g FLOREMAE GARCIA sy Admitting Staff FI CLASSIFICATION, Ce Remarks _/ tb adnuten ta ice + Ee Ling POE DISPOSITION Daye. wae: fecovered ‘Transferred ! | [1morovea | | pischarae | | Autoosied 11 he [| unimoroved L | dia [| Not Autonsied |_| absconded Final Diagnosis OPERATIONS DONE Ieo10 Yy 4\oh Consultant/Resident-In-Charge HARMAC) EDIGA RECORDS COMPLETE " LABORATO: HOSPITAL CASHIER ‘Supervising Nurse-In-Charge 1s The information provided bythe paint? EEE oom pepo oy as 7 INO prorat 001 | Reveed Ne 40 1 Novenber 2019 — Scanned with CamScannerSample 10 ooz083613 PateniD no, gags OR Ne, Semple Tye aoa Source] Seriat No. [81204] Component ‘bare’ | chtte, [>sanathesPate ana bp teeny ‘ont - I: - [Thermo / AHG|Reteased} Name} i Je _pozorroe Psmuebroczece [nano peeve fovwwnne Ye hin 7p : fe _fpozzsreose Posmnac ace fanaare owwaace i fc foro. Posmyepeczace hananor counansce Patient's Blood Group: A Rh (0) Group: ‘Positive O Negative a MOA. EDICAL CON FN So onearnany Patient Nome IM 1 AnexIe oie Minter B39, | e292 Pad =a rt | Sooiel Ossie it "ey | ‘eomptbi | i 20 toy Ars yee vec Ue 9 ' sp EXAMINED BY: es5¥ BUCO, nf REVIEWED BY: JoxQUIN axTontO sata HO, 0 DATE EXAMINED 3 137262022 o7h3:31 DATE RELEASED 11/26/2022 07:59:00 Every blood transfusions unt must Bea ‘These two persons must sign the form a 1 The patients idenety has bee 2. The compatability label snd t 3. The expty dat of he blood by 8 trined nurse and must be checked by a physician, st the relevant blood bog number erered above and thereby declared the: heed agaist the compactle abel an thi form, {Gm show the Blood and te blood bag label be compile with tat of the paint. BB-Form Wo. O18 Revision No. 029 August 2013, Scanned with CamScannerf . . b ag 7 6 OV 22 > Iau a yp 2 [ep Cp at yet » teak ate ; ; ow on vg yer a pyle Be Tao » on palate vaeeys 4519 gue 2 met uk- a8 ae ‘ 7 nee He 790) te eallntent beats pe A dat fee I aria era we 2.47 b ancest . pepe 44 7 wt wl rate nt ea BO rd De gp “tt Fey uw” a uh wv webb! peat ame # pe ee : t ra , wy, c atest ant je ! tose ager weet am “een tmta decd on sh Soa a a r Scanned with CamScanner‘Name of Patient No: “1Goq Ward/Rm.. tA 209, CONSUL ae Tamara [oa Hea He32 NES ey + a > thay We won Tol ro Dab ae Byep mah Ste Me ia Noo PAM i egy eT (MP-Form No. 005 Revision No.0 December 2013, Scanned with CamScanner