ARMED FORCES OF THE PHILIPPINES HEALTH SERVICE COMMAND

VICTORIANO LUNA MEDICAL CENTER

DEPARTMENT OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY
Camp Colonel Victoriano K. Luna, V. Luna Ave., Quezon City

05 Jan 2023
Date

REQUEST FOR SURGERY

TO: HEAD, DEPT OF ANESTHESIA

Request that Del Prado, Zenaida Rank: ODM AFPSN: -

Br of Svc: PN Age: 73/F Ward: 3A Reg Nr: 50009

Be scheduled for surgery

Diagnosis: Fracture, Closed, Comminuted, Humeral Neck, Right (OTA 11B1) Neer 3-Part) sec to Fall

Operation: For ORIF (Plate) Proximal Humerus Right under GA

Anesthesia: GA
Prepared date: 05 Jan 2023 Time: Emergency
Surgeon: MAJ DELOS REYES Assist: CPT JUSTO
CPT GARROTE CPT YAP/ CPT GERONIMO
CPT CAUILAN/DE GUZMAN
CPT MEJIA M/ P2LT TACLIBON
Birthday: 04/21/1949 P2LT MALICSE/CPT ZAMORA
Address: Quezon City Approved:
DOA: 14 Dec 2022
Swab: 03 Jan 2022 Negative MAJ DENNIS PAOLO H ABADILLA MC
Weight: 65 kg Department Head

ARMED FORCES OF THE PHILIPPINES HEALTH SERVICE COMMAND

VICTORIANO LUNA MEDICAL CENTER
DEPARTMENT OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY
Camp Colonel Victoriano K. Luna, V. Luna Ave., Quezon City
05 Jan 2023
Date

REQUEST FOR SURGERY

TO: HEAD, DEPT OF ANESTHESIA

Request that Del Prado, Zenaida Rank: ODM AFPSN: -

Br of Svc: PN Age: 73/F Ward: 3A Reg Nr: 50009

Be scheduled for surgery

Diagnosis: Fracture, Closed, Comminuted, Humeral Neck, Right (OTA 11B1) Neer 3-Part) sec to Fall

Operation: For ORIF (Plate) Proximal Humerus Right under GA

Anesthesia: GA
Prepared date: 05 Jan 2023 Time: Emergency
Surgeon: MAJ DELOS REYES Assist: CPT JUSTO
CPT GARROTE CPT YAP/ CPT GERONIMO
CPT CAUILAN/DE GUZMAN
CPT MEJIA M/ P2LT TACLIBON
Birthday: 04/21/1949 P2LT MALICSE/CPT ZAMORA
Address: Quezon City Approved:
DOA: 14 Dec 2022
Swab: 03 Jan 2022 Negative MAJ DENNIS PAOLO H ABADILLA MC
Weight: 65 kg Department Head