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  • Dhi Claimant Form

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    Jose Orbe
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    The document appears to be a medical record for Eleisha Maniquiz Orbe who presented with dengue symptoms including on and off fever since October 7, 2023. She was seen at Sta. Cecilia Medical Center by Dr. Adonis Calaycay on October 11, 2023 and diagnosed with dengue. She was prescribed 3 days of treatment. Her billing from October 14, 2023 was 10,456 pesos.

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    The document appears to be a medical record for Eleisha Maniquiz Orbe who presented with dengue symptoms including on and off fever since October 7, 2023. She was seen at Sta. Cecilia Medical Center by Dr. Adonis Calaycay on October 11, 2023 and diagnosed with dengue. She was prescribed 3 days of treatment. Her billing from October 14, 2023 was 10,456 pesos.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views3 pages

    Dhi Claimant Form

    Uploaded by

    Jose Orbe
    The document appears to be a medical record for Eleisha Maniquiz Orbe who presented with dengue symptoms including on and off fever since October 7, 2023. She was seen at Sta. Cecilia Medical Center by Dr. Adonis Calaycay on October 11, 2023 and diagnosed with dengue. She was prescribed 3 days of treatment. Her billing from October 14, 2023 was 10,456 pesos.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 3

    400010890 ORBE, ELEISHA MANIQUIZ 04 11 20 2 3

    Purok 3 Sto. Rosario, Iba, Zambales 2201

    Dengue

    October 11, 2023

    On and Off fever

    October 7, 2023
    See attached APS, Laboratory
    10/11/2023 Sta. Cecilia Medical Center Dr. Adonis Calaycay Dengue Test & Medical Certificate

    10/11/2023 Dr. Adonis Calaycay Sta. Cecilia Medical Center Dengue 3 days

    1 0 1 1 20 2 3 1 0 11 2 0 2 3 3 Dengue

    N/A

    N/A N/A

    N/A
    N/A
    N/A N/A

    N/A N/A

    N/A

    N/A

    10/14/2023 46345 See attached Billing 10,456.00


    Landbank

    Jose D. Orbe, Jr. 1 1 2 5 0 7 6 1 5 3

    Jose D. Orbe, Jr. Iba, Zambales 1 0 1 8 2 0 2 3

    Jose D. Orbe, Jr. Iba, Zambales 1 0 1 8 2 0 2 3

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