PhilHealth Annex C.2: Checklist of Mandatory and Other Services for Surgery
Fill PhilHealth Annex C.2: Checklist of Mandatory and Other Services for Surgery online and download the official form as a PDF, ready to print. Every input is mapped to its printed box, so IDs, dates and amounts land digit by digit in the right cells, and a value the form cannot hold is refused with the reason instead of being printed wrong.
What you will need: Case No, 1. Last Name, First Name, Middle Name, Suffix, 2. PhilHealth ID Number, Right, cStage 0, cStage IIA, cStage IIB, cStage IIIA, cStage IIIB, cStage IIIC, cStage IV, Partial mastectomy or lumpectomy.
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