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Republic of the Philippines Department of Health Manila HOSPITAL STATISTICAL REPORT For the Year Statform3 Name of Hospital: Complete Address: Region: Catchment Population : Contact No. Fax No. E-mail
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Comments and Help with hospital census report format
Non-Training) 2. Patient Profile Description: 3.1. 3.3. 3.4. 3.5. 3.6. 3.7. 3.8. 3.9. 3.10. 3.11. 3.12. 3.13. 3.14. 3.15. 3.16. 3.17. 3.18. 4. Other: 5. Special Notes: 6. References: 7. Special Instructions to Patients: 8. Additional Information for Patients: 1. Patients will be notified only by e-mail, including to whom the notification is being sent and when the information will be mailed to the patient. 2. Medical records from other institutions, with the consent of the patient or the person in charge of the other institution (if available), will not be released to the patient. 3. The patient is responsible for taking all necessary precautions while attending any patient care activity or during travel to any hospital, particularly in the Philippines. 4.
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