RICARDO LIMSO MEDICAL CENTER INC. RICARDO LIMSO MEDICAL CENTER INC.
V. ILUSTRE STREET, DAVAO CITY V. ILUSTRE STREET, DAVAO CITY
OPERATING ROOM SPECIAL ASSIST OPERATING ROOM SPECIAL ASSIST
Date and Time:__________________________ Date and Time:__________________________
Case: __________________________________ Case: __________________________________ Name of Surgeon: ________________________ Name of Surgeon: ________________________ Name of Patient: ________________________ Name of Patient: ________________________ Name of ROD:___________________________ Name of ROD:___________________________ Name of NOD: ___________________________ Name of NOD: ___________________________ Billing/ Cashier: __________________________ Billing/ Cashier: __________________________
RICARDO LIMSO MEDICAL CENTER INC. RICARDO LIMSO MEDICAL CENTER INC. V. ILUSTRE STREET, DAVAO CITY V. ILUSTRE STREET, DAVAO CITY
OPERATING ROOM SPECIAL ASSIST OPERATING ROOM SPECIAL ASSIST
Date and Time:__________________________ Date and Time:__________________________
Case: __________________________________ Case: __________________________________ Name of Surgeon: ________________________ Name of Surgeon: ________________________ Name of Patient: ________________________ Name of Patient: ________________________ Name of ROD:___________________________ Name of ROD:___________________________ Name of NOD: ___________________________ Name of NOD: ___________________________ Billing/ Cashier: __________________________ Billing/ Cashier: __________________________