PhilHealth Annex "C": Amount after PATIENT INFORMATION MEMBER INFORMATION Sub-groups of application
Fill PhilHealth Annex "C": Amount after PATIENT INFORMATION MEMBER INFORMATION Sub-groups of application 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: Name of the PhilHealth accredited SARS-CoV-2 testing laboratory, PhilHealth Accreditation Number (PAN) , Address, PATIENT INFORMATION, Signature over printed name of the authorized signatory of the, Date signed, Signature over printed name of the Head of the.
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