PhilHealth Annex C.6: Checklist of Mandatory and Other Services for Surveillance
Fill PhilHealth Annex C.6: Checklist of Mandatory and Other Services for Surveillance 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, Last Name, First Name, Middle Name, Suffix, PhilHealth ID Number, Right, Mammography (contralateral if, Date conducted (mm/dd/yyy), Ultrasound breast, Gynecological evaluation and, Clinical Consultation, Date of Consultation (mm/dd/yyyy), 2D echo, Bone densitometry.
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