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  • 05.08 Annex - H

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    Jason Jesus Llamasares
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    This document reports on the results of water analysis tests conducted at a health facility. It lists the source of water, areas of the health facility tested, including the operating room, delivery room, ICU, emergency room, and ward. For each area, it provides the date the test was conducted, the type of test, the frequency of testing, the test findings, and any actions taken. The document is signed by the preparer and an approver to verify the results.

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    05.08 annex_h

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    This document reports on the results of water analysis tests conducted at a health facility. It lists the source of water, areas of the health facility tested, including the operating room, delivery room, ICU, emergency room, and ward. For each area, it provides the date the test was conducted, the type of test, the frequency of testing, the test findings, and any actions taken. The document is signed by the preparer and an approver to verify the results.

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    © All Rights Reserved
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    12 views1 page

    05.08 Annex - H

    Uploaded by

    Jason Jesus Llamasares
    This document reports on the results of water analysis tests conducted at a health facility. It lists the source of water, areas of the health facility tested, including the operating room, delivery room, ICU, emergency room, and ward. For each area, it provides the date the test was conducted, the type of test, the frequency of testing, the test findings, and any actions taken. The document is signed by the preparer and an approver to verify the results.

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    © All Rights Reserved
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    of 1

    ANNEX – H

    A.O. No. 2012-0012


    Name of Health Facility
    Complete Address

    REPORTS ON RESULTS OF WATER ANALYSIS

    SOURCE OF WATER: _________________________

    AREA OF HEALTH TEST FREQUENCY OF


    DATE FINDINGS ACTION TAKEN
    FACILITY CONDUCTED TESTING

    Operating Room

    Delivery Room

    ICU

    Emergency Room

    Ward

    Etc.

    Prepared by: Verified and Approved by:


    _______________________________ _____________________________________
    DOH-AO2012-0012 Annex H Reports on Results of Water Analysis
    Revision:01
    01/20/2015

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