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  • Barangay Singko ITR

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    Feb
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    This document appears to be a health record form for a local health center in Barangay 5, Pioduran, Albay, Philippines. The form collects personal information like name, birthdate, age, gender, address, marital status, religion, and contact details. It also tracks vital signs, chief complaints, diagnoses, and treatments on different dates of visits. The purpose is to document a patient's health information and history of care at the community health center.

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    This document appears to be a health record form for a local health center in Barangay 5, Pioduran, Albay, Philippines. The form collects personal information like name, birthdate, age, gender, address, marital status, religion, and contact details. It also tracks vital signs, chief complaints, diagnoses, and treatments on different dates of visits. The purpose is to document a patient's health information and history of care at the community health center.

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    © All Rights Reserved
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    8 views1 page

    Barangay Singko ITR

    Uploaded by

    Feb
    This document appears to be a health record form for a local health center in Barangay 5, Pioduran, Albay, Philippines. The form collects personal information like name, birthdate, age, gender, address, marital status, religion, and contact details. It also tracks vital signs, chief complaints, diagnoses, and treatments on different dates of visits. The purpose is to document a patient's health information and history of care at the community health center.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    BARANGAY 5 HEALTH CENTER

    Purok 6, Barangay 5, Pioduran, Albay


    Name: ____________________________________________________________ Birthdate: ___________________ Age: _________Gender: (F) (M)
    Address: ________________________________________________________ Status: (S) (M) (W) (Sep)(Child) Religion: _________________
    Spouse/Parents: ________________________________________PhilHealth Status_________ Philhealth No:_ ____________________________
    DATE VITAL SIGNS CHIEF COMPLAINT/ DIAGNOSIS TREATMENT/ MANAGEMENT

    Contact No.: ___________________________________

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