PhilHealth Annex H.4: Checklist of Essential Health Services for Post -Cardiac Surgery Services
Fill PhilHealth Annex H.4: Checklist of Essential Health Services for Post -Cardiac Surgery Services 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, Suffix, Middle Name, 2. PhilHealth ID Number, Same as patient (Answer the following only if the patient is a dependent), Type of Surgery Performed, Date of Procedure, A. Cardiac Rehabilitation Sessions*, Electrocardiogram (ECG), Date Conducted/Dispensed, Cardiac Stress Test, Complete blood count (CBC), Fasting blood sugar (FBS).
Free to try: 5 forms a day without an account; a free account gets 14 days of clean PDFs, then 25 a month. Not affiliated with BIR, SSS, PhilHealth, Pag-IBIG or any government agency.