DJRMH Citizen's Charte 2022_3rd Edition FINAL

6. Conduct of Procedure and Releasing of Result for CT Scan for Out-
Patient

This service involves the processing of conduct for procedure and releasing of results
for CT Scan that takes in from the time the client returns on the scheduled procedure.

Availability of Service: Procedure:
CT SCAN: Monday to Sunday, 8AM-12NN, 1PM-5PM
Releasing of Official Results: Monday to Sunday
(24 Hours)

Office or Division: Radiology and Imaging

Classification: Highly Technical

Type of Transaction: G2C - Government-to-Citizen

Who may avail: All Scheduled Patients (Non-Admitted Clients) for the Procedure

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

For Conduct of Procedure:

1. Duly Accomplished Request Form ER/OPD

(1 original copy)

2. Stamped “Paid” / MSS stamped charge Cash Operation Office / MSW Section

slip (1 original copy)

3. Pertinent Clearances, if needed Requesting doctor

(1 original copy)

For Releasing of Result:

1. Claim Slip (1 original copy) Radiology and Imaging

Admitting/Information Unit / OPD

2. Any Valid ID (1 photocopy/original GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
copy)
PhilHealth, BIR, PHLPost, LGU/Barangay,

School, Employer, Hospital

FEES

CLIENT STEPS AGENCY TO PROCESSING PERSON
ACTIONS
BE TIME RESPONSIBLE

PAID

1. Presents 1. Receives None 5 minutes Radiologic
documentary documentary
requirements and requirements & Technologist III
submits materials needed
(for procedure with materials (for Radiology and
contrast) then procedure with
goes to waiting contrast) then Imaging
area instructs
patient to None 30 minutes Radiologic
2.1 Waits until name is proceed to Technologist III
called and submits designated Radiology and
self for the waiting area.
procedure. Imaging
2.1 Calls patient’s
name, checks
compliance to
pre-procedural

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then prepares
materials (for
procedure with
contrast) and
instructs
patient on
what to do.

2.2 Undergoes 2.2 Conducts None Plain: Radiologic
procedure procedure 30 minutes Technologist III
Radiology and
With contrast:
1 hour and 30 Imaging

minutes Radiologic
Technologist III
2.3 Receives post 2.3 Provides post None 5 minutes Radiology and
procedural procedural None 5 minutes
instructions instructions Imaging
None 10 days Radiologic
3. Receives claim 3. Issues claim Technologist III
slip slip and Radiology and
instructs to
4.1 Returns to bring the Imaging
releasing counter claim slip
on the scheduled together with Radiologic
release of result any valid ID Technologist III
then submits claim upon claiming Radiology and
slip and presents the result on
any valid ID for specified Imaging
verification. date.

4.1 Receives the
claim slip
together with
required
document and
releases
official result to
the patient.

4.2 Signs the 4.2 Let the patient None 2 minutes Radiologic
releasing logbook signs the Technologist III
releasing Radiology and
logbook.
Imaging

TOTAL None Plain:
10 days,1 hour & 17 minutes

With contrast:
10 days, 2 hour 17 minutes

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7. Conduct of Procedure and Releasing of Result for Special
Procedures for Out-Patient

This service involves the processing of conduct for procedure and releasing of results
that takes in from the time the client returns on his/her scheduled procedure with the
required documents.

Availability of Service: Procedure:
Special Procedures:
Monday to Sunday, 8AM-12NN, 1PM-5PM
Releasing of Official Results: Monday to Sunday
(24 Hours)

Office or Division: Radiology and Imaging

Classification: Highly Technical

Type of Transaction: G2C - Government-to-Citizen

Who may avail: All Scheduled Patients (Non-Admitted Clients) for the Procedure

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

For Conduct of Procedure:

1. Duly Accomplished Request Form ER/OPD

(1 original copy)

2. Stamped “Paid” / MSS stamped charge Cash Operation Office / MSW Section

slip (1 original copy)

3. Pertinent Clearances, if needed Requesting doctor

(1 original copy)

For Releasing of Result:

1. Claim Slip (1 original copy) Radiology and Imaging

Admitting/Information Unit / OPD

2. Any Valid ID (1 photocopy/original GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
copy)
PhilHealth, BIR, PHLPost, LGU/Barangay,

School, Employer, Hospital

FEES

CLIENT STEPS AGENCY TO PROCESSING PERSON
ACTIONS
1. Presents BE TIME RESPONSIBLE
documentary 1. Receives
requirements and documentary PAID
submits materials requirements &
needed for needed None 5 minutes Radiologic
procedure then materials for
goes to waiting the procedure Technologist III
area then instructs
patient to Radiology and
proceed to
designated Imaging
waiting area.

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2.1 Waits until name is 2.1 Calls patient’s None 30 minutes Radiologic
called and submits name and Technologist III
self for the checks Radiology and
procedure. compliance to
pre-procedural Imaging
& material
requirements

2.2 Undergoes 2.2 Conducts None 1 hour Medical
procedure procedure Specialist III
Radiology and

Imaging

2.3 Receives post 2.3 Provides post None 5 minutes Radiologic
procedural procedural None 5 minutes Technologist III
instructions instructions Radiology and
None 5 days
3. Receives claim slip 3. Issues claim Imaging
slip and Radiologic
4.1 Returns to instructs to Technologist III
releasing counter bring the claim Radiology and
on the scheduled slip together
release of result with any valid Imaging
then submits claim ID upon
slip and presents claiming the Radiologic
any valid ID for result on Technologist III
verification. specified date. Radiology and

4.1 Receives the Imaging
claim slip
together with
required
document and
releases
official result to
the patient.

4.2 Signs the 4.2 Let the patient None 2 minutes Radiologic
releasing logbook signs the None Technologist III
releasing Radiology and
logbook.
Imaging

TOTAL 5 days, 1 hour and 52 minutes

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ANIMAL BITE TREATMENT CENTER
(ABTC)

External Service

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1. Availment of Animal Bite Services – Follow-up Vaccination

To ensure delivery of quality services among Animal Bite client for follow-up vaccination,
client must follow this step by step process starting from the presentation of the Rabies
Post-exposure Prophylaxis Card and Appointment Acknowledgment Receipt Form until
receipt of further instructions post vaccination.

Availability of Service: Monday to Friday (8:00 AM to 5:00 PM)

Office/Division: Nursing Service / Animal Bite Treatment
Center (ABTC)

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who May Avail: Animal Bite Clients for Follow-up
Vaccination

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Rabies Post-Exposure Prophylaxis Card ABTC / ER
(1 original copy)
ABTC / ER
2. Appointment Acknowledgment Receipt
Form (1 original copy) ABTC
Pharmacy
3. Prescription (1 original copy)
4. Order of Payment (1 original copy)

CLIENT STEPS AGENCY ACTION FEES PROCESSING PERSON
TO TIME RESPONSIBLE
1. Presents Rabies 1. Receives Rabies BE
Post-Exposure Post-Exposure PAID 3 minutes Nurse III
Prophylaxis Card Prophylaxis Card and None OPD
and Appointment Appointment
Acknowledgment Acknowledgment
Receipt Form. Receipt Form.

For Free Vaccine:
Proceeds to Step 6

2.a Receives 2.a Issues prescription None 3 minutes Nurse I
prescription and and instructs client to ABTC
proceeds to proceed to Pharmacy
Pharmacy then to then to cashier for
Cashier for payment.
payment.

*If patient will avail for 2.b Processes availment None 17 minutes SWO III
medical of medical MSW Section
assistance assistance.

2.b Proceeds to MSS for *MSW on duty will stamps on
availment of the charge slip
medical assistance.

If with excess, Proceed to

cashier (Step3)
If no excess, Proceed to

Step 4

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3. Presents charge 3. Issues official receipt. *Please 20 minutes Administrative
slip/order of refer to 10 minutes Officer V
payment and pays *Cashier on duty will stamped table
corresponding “Paid” with OR Number on the below Cash Operation
amount. charge slip Section
None
4. Proceeds to 4.a Dispenses Pharmacist III
Pharmacy to get the vaccines/medications Pharmacy Section
vaccines/medications.

5. Returns to ABTC and 5. Receives the vaccine. None 2 minutes Nurse I
endorses the vaccine. ABTC
5 minutes
6. Receives vaccination. 6. Administers vaccine to None 3 minutes Nurse I
client/patient. ABTC
7. Receives further Nurse I
instructions. 7. Instructs client/patient None ABTC
for follow-up doses
indicated in the PEP For Non-Free Vaccine
card. 1 hour and 3 minutes

*Please refer to table For Free Vaccine:
below 11 minutes

TOTAL *If patient will avail for
medical assistance
Amount to be paid
depends on the
discount given

PRICE LIST FOR ANIMAL BITE TREATMENT SERVICE

MEDICAL PRICE VACCINE PRICE
SUPPLIES 3.10 1,197.00
Insulin syringe (1cc) Active rabies 1,490.00
vaccine
1cc syringe 2.20 Passive rabies
vaccine

3cc syringe 2.20
5cc syringe 2.25
Alcohol pad 0.53
Cotton balls 5.00

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2. Availment of Animal Bite Services - New Animal Bite (Walk-In)
Clients (Category II & Category III bite exposures without
PhilHealth)

To ensure delivery of quality services among walk-in animal bite clients with category II
and III bite exposures without PhilHealth, this step by step process must be followed
starting from post clinical assessment of the client with initial vaccination until receipt of
Rabies Post-exposure Prophylaxis Card for subsequent appointment for succeeding
doses.

Availability of Service: Monday to Friday ( 5:00 PM to 8:00 AM succeeding day)
Saturday to Sunday ( 24 Hours )

Office/Division: Animal Bite Treatment Center (ABTC)

Classification: Simple

Type of G2C – Government to Citizen
Transaction:

Who May Avail: New Animal Bite Clients (Category II & Category III bite exposure
without PhilHealth) – Walk In

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Charge Slip (1 original copy) ER
2. Prescription (1 original copy) ER
3. Order of Payment (1 original copy) Pharmacy
4. Rabies Post-Exposure Prophylaxis ER

Card (1 original copy) ER
5. Appointment Acknowledgment

Receipt Form (1 original copy)

CLIENT STEPS AGENCY ACTION FEES PROCESSING PERSON
TO BE TIME RESPONSIBLE
1. Presents self and 1. Receives PAID
waits for client/patient and None 3 minutes Nurse II
instructions. gives ER
instructions.
For Free Vaccine:
Proceeds to Step 6

2.a Receives 2.a Issues None 3 minutes Nurse II
prescription and prescription and None 17 minutes ER
proceeds to instructs client to
Pharmacy then proceed to SWO III
to Cashier for Pharmacy then MSW Section
payment. to cashier for
payment.
*If patient will avail
for medical 2.b Processes
assistance availment of
medical
2.b Proceeds to MSS assistance.
for availment of
medical
assistance.

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If with excess: *MSW on duty stamps on
the charge slip
Proceeds to cashier
(Step 3) 3. Issues official *Please 20 minutes Administrative Officer
receipt. refer to V
If no excess: table
Proceeds to Step 4: *Cashier on duty will below Cash Operation
stamped “Paid” Section
3. Presents charge with OR Number on the None
slip/order of charge slip 10 minutes Pharmacist III
payment and Pharmacy Section
pays 4.a Dispenses
corresponding vaccines/medicat
amount. ions

4. Proceeds to 4.b Dispenses None 13 minutes Nurse II
Pharmacy and supplies None 2 minutes CSR Section
CSR to get the
vaccines/medicati 5. Receives supplies Nurse II
ons and supplies. and administers ER
vaccines.
5. Returns to ER
and endorses 6. Administers None 1 hour Nurse II
supplies and 5 minutes ER
vaccines/medicat vaccine to
ions for Nurse II
administration. client/patient ER

6. Receives 7. Provides Rabies None
vaccination
Post-Exposure
7. Receives Rabies
Post-Exposure Prophylaxis Card
Prophylaxis Card
and Appointment indicating the
Acknowledgment
Receipt Form and dates of follow
wais for further
Instructions. up doses and

Appointment

Acknowledgment

Receipt Form

* Please refer to table below for

applicable fees For Non-Free Vaccine
2 hours and 13 minutes
TOTAL *If patient will avail for
medical assistance For Free Vaccine:
1 hour and 8 minutes
Amount to be paid depends on
the discount given

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3. Availment of Animal Bite Services - New Animal Bite (Walk-In)
Clients (Category III bite exposure) with PhilHealth

To ensure delivery of quality services among walk-in animal bite clients with Category III
bite exposure with Philhealth, this step by step process must be followed starting from
post clinical assessment until receipt of Rabies Post-exposure Prophylaxis Card and
Appointment Acknowledgment Receipt Form for succeeding doses and other further
instructions.

Availability of Service: Monday to Friday ( 5:00 PM to 8:00 AM succeeding day)
Saturday to Sunday ( 24 Hours )

Office/Division: Animal Bite Treatment Center (ABTC)

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who May Avail: New Animal Bite Clients (Category III bite exposure) with
PhilHealth – Walk in

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Charge Slip (1 original copy) ER

2. Prescription (1 original copy) ER

3. Order of Payment (1 original copy) Pharmacy

4. PHIC Confirmation Note Billing and Claims

(1 original copy)

5. Rabies Post-Exposure Prophylaxis ER

Card (1 original copy)

6. Appointment Acknowledgment Receipt ER

Form (1 original copy)

FEES

CLIENT STEPS AGENCY ACTION TO PROCESSING PERSON
BE TIME RESPONSIBLE

PAID

1. Presents self and 1. Receives None 3 minutes Nurse II

waits for client/patient and ER

instructions. gives instructions.

2. Receives charge 2.a Issues charge slip None 3 minutes Nurse II

slip and prescription ER

and

proceeds to Billing

and Claims to ask

for PHIC 2.b Issues PHIC None 6 minutes Admin. Aide VI

Confirmation Note Confirmation Note Billing & Claims

Section

3. Proceeds to 3.a Dispenses None 10 minutes Pharmacist III

Pharmacy and CSR vaccines/medicatio Pharmacy Section

to get the ns

vaccines/medicatio

ns and supplies.

3.b Dispenses None 13 minutes Nurse II

supplies CSR Section

4. Returns to ABTC, 4. Receives PHIC None 1 hour Nurse II

presents PHIC Confirmation Note, ER

Confirmation Note supplies and

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and endorses administers vaccine
supplies and
vaccines/medicatio
ns

5. Receives Rabies 5. Provides Rabies None 5 minutes Nurse II
Post-Exposure Post-Exposure None ER
Prophylaxis Card Prophylaxis Card
and indicating the dates
Acknowledgment of follow up doses
Receipt of and
appointment and Acknowledgment
waits for further Receipt of
instructions. appointment.

TOTAL 1 hour & 40 minutes

\

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4. Availment of Animal Bite Services - New Animal Bite (With
Scheduled Appointment) Clients (Category III bite exposure) with
PhilHealth

To ensure delivery of quality services among animal bite clients with scheduled
appointment with Category III bite exposure, this step by step process must be followed
starting from post clinical assessment until receipt of Rabies Post-exposure Prophylaxis
Card and Appointment Acknowledgment Receipt Form for succeeding doses and other
further instructions.

Availability of Service: Monday to Friday ( 8:00 AM to 5:00 PM )

Office/Division: Animal Bite Treatment Center (ABTC)

Classification: Simple

Type of Transaction: G2C – Government to Citizen

New Animal Bite Clients (Category III bite exposure) with

Who May Avail: PhilHealth –

With Scheduled Appointment

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Charge Slip (1 original copy) ABTC

2. Prescription (1 original copy) ABTC

3. Order of Payment (1 original copy) Pharmacy

4. PHIC Confirmation Note (1 original copy) Billing and Claims

5. Rabies Post-Exposure Prophylaxis Card ABTC

(1 original copy)

6. Appointment Acknowledgment Receipt ABTC

Form (1 original copy)

CLIENT STEPS AGENCY ACTION FEES PROCESSING PERSON
TO TIME RESPONSIBLE
1. Presents self and waits 1. Receives BE
for instructions. client/patient and PAID 3 minutes Nurse I
gives instructions. None ABTC
2. Receives charge slip
and prescription and 2.a Issues charge slip None 3 minutes Nurse I
proceeds to Billing and ABTC
Claims to ask for PHIC 2.b Issues PHIC
Confirmation Note Confirmation Note

None 6 minutes Admin. Aide VI
Billing and Claims

Unit

3. Proceeds to Pharmacy 3.a Dispenses None 10 minutes Pharmacist III
and CSR to get the vaccines/medicatio Pharmacy Section
vaccines/medications ns None 13 minutes
and supplies. None 1 hour Nurse I
3.b Dispenses supplies CSR Section
4. Returns to ABTC, 4. Receives PHIC
presents PHIC Nurse I
Confirmation Note, ABTC

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Confirmation Note and supplies and None 5 minutes Nurse I
endorses supplies and administers vaccine ABTC
vaccines/medications
5. Receives Rabies Post- 5. Provides Rabies
Exposure Prophylaxis Post-Exposure
Card and Prophylaxis Card
Acknowledgment Receipt indicating the dates
of appointment and waits of follow up doses
for further instructions. and
Acknowledgment
Receipt of
appointment.

TOTAL 1 hour & 40 minutes

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CENTRAL SUPPLY ROOM
(CSR)

External Service

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1. Dispensing of Medical and Surgical Supplies

This service involves processing of patient’s request for medical and surgical supplies from
the time that the client presents charge slip until the time the patient receives requested
supplies. In order for the client/patient to avail the service, the following steps are to be
followed:

Availability of Service: Monday to Sunday ( 24 hours )

Office/Division: Nursing Service / Central Supply Room

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who May Avail: Out-Patients

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Charge Slip (1 original copy) ER/OPD
2. Official Receipt (1 original copy) Cashier

CLIENT STEPS AGENCY ACTION FEES PROCESSI PERSON
TO NG TIME RESPONSIB
BE
LE
PAID

1. Presents charge slip 1.1 Reviews charge slip/s None 2 minutes Nurse I
and receives and affixes CSR Section
instruction/s if any. corresponding amount
and provides instruction
if any

1.2 Directs to cashier for None 3 minutes Nurse I
payment CSR Section

2.a Presents charge 2.a Issues official receipt Please 20 minutes Administrative
slip and pays refer to 17 minutes Officer V
corresponding the table 3 minutes Cash
amount below Operations
Section
*If patient will avail for 2.b Processes Availment of for
medical assistance medical assistance applicab SWO III
le fees MSW Section
2.b Proceeds to MSS for *MSW on duty stamps on the
Availment of medical charge slip None Nurse I
assistance CSR Section
3. Receives Official None
If with excess: Receipt or MSS
Stamped Charge Slip
Proceeds to cashier (Step
3) *Cashier on duty will stamped
“Paid” with OR Number on the
If no excess: charge slip
Proceeds to Step 4:

3. Returns to CSR and
presents Official
Receipt or MSS
Stamped charge slip

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4. Checks dispensed 4. Dispenses supplies and None 5 minutes Nurse I
supplies and gives instructions if any CSR Section
receives instructions
if any Please refer to the 33 minutes
table below for
TOTAL applicable fees *If patient will avail for
medical assistance
*If patient will avail 50 minutes
for medical
assistance

Amount to be paid
depends on the
discount given

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PRICE LIST OF MEDICAL AND SURGICAL SUPPLIES AT CSR

As of MARCH 20, 2022

ITEM UNIT RATE ITEM UNIT RATE

Standard Senior Citizen Standard Senior Citizen

Absorbent cotton, Sterile Small Pack ₱ 5.00 ₱ 4.00 Bone Wax, 2.5 Piece Not Available Not Available

Big Pack ₱ 15.00 ₱ 12.00 BP rubber arm cuff Adult Piece ₱ 513.50 ₱ 410.80

Adhesive Plaster Roll ₱ 108.80 ₱ 87.04 with cloth Pedia Piece ₱ 676.00 ₱ 540.80

Alcohol, 70% Isoprophyl, 500 ml Bot. Not for Sale Not for Sale Infant Piece ₱ 513.50 ₱ 410.80

Alcohol pad Piece Not Available Not Available Breathing Circuit/System Adult Piece ₱ 806.00 ₱ 644.80

Anesthesia Face Mask #1 Infant Piece ₱ 361.40 ₱ 289.12 Pedia Piece ₱ 806.00 ₱ 644.80

Pedia Small Piece ₱ 416.00 ₱ 332.80 Jackson Rees Piece ₱ 3,640.00 ₱ 2,912.00

Pedia Large Piece ₱ 689.00 ₱ 551.20 Cervical Collar Adult Piece ₱ 394.00 ₱ 315.20

Adult-Small Piece ₱ 416.00 ₱ 332.80 Pedia Piece ₱ 570.65 ₱ 456.52

Adult-Medium Piece ₱ 361.40 ₱ 289.12 Chest Tube Thoracostomy Bottle Piece ₱ 1,105.00 ₱ 884.00

Adult-Large Piece ₱ 361.40 ₱ 289.12 Closed wound Suction Drainage Sytem Piece ₱ 1,625.00 ₱ 1,300.00

Armsling Adult Piece ₱ 71.50 ₱ 57.20 Colostomy Bag Adult, 24x15 cm Piece ₱ 42.25 ₱ 33.80

Pedia Piece ₱ 71.50 ₱ 57.20 Pedia, 20x14 cm Piece ₱ 42.25 ₱ 33.80

Bag Vave Mask Adult Piece ₱ 2,371.90 ₱ 1,897.52 Condom Catheter Small Piece ₱ 36.50 ₱ 29.20

Child/Pedia Piece ₱ 1,774.50 ₱ 1,419.60 Medium Piece ₱ 36.50 ₱ 29.20

Infant/Neonate Piece ₱ 1,612.00 ₱ 1,289.60 Large Piece ₱ 19.50 ₱ 15.60

BedPan Piece ₱ 87.75 ₱ 70.20 Cotton Applicator Stick Box ₱ 43.25 ₱ 34.60

Blood Administration Set Piece ₱ 119.60 ₱ 95.68 Sterile Pack ₱ 5.00 ₱ 4.00

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ITEM UNIT RATE ITEM UNIT RATE

Standard Senior Citizen Standard Senior Citizen

CTG Recording Paper Pack ₱ 780.00 ₱ 624.00 Foley Balloon Catheter, Fr. 8 Piece Not Available Not Available

ECG Cream Tube ₱ 361.40 ₱ 289.12 2-way Fr. 10 Piece ₱ 38.70 ₱ 30.96

ECG, Chest Electrodes Piece ₱ 9.75 ₱ 7.80 Fr. 12 Piece ₱ 38.70 ₱ 30.96

ECG Tracing paper 50mmX30m Roll ₱ 52.00 ₱ 41.60 Fr. 14 Piece ₱ 21.45 ₱ 17.16

80mmX20m Roll ₱ 304.20 ₱ 243.36 Fr. 16 Piece ₱ 38.70 ₱ 30.96

Welch Allyn Roll ₱ 715.00 ₱ 572.00 Fr. 18 Piece ₱ 37.05 ₱ 29.64

Elastic Bandage 2"X5yards Roll ₱ 23.80 ₱ 19.04 Foley Ballon Catheter, 3-way Fr. 18 Piece Not Available Not Available

4"X5yards Roll ₱ 27.30 ₱ 21.84 Fr. 22 Piece Not Available Not Available

6"X5yards Roll ₱ 36.40 ₱ 29.12 Fr. 24 Piece Not Available Not Available

Electrocautery grounding pad Piece ₱ 335.40 ₱ 268.32 Gloves Examination Small Pair ₱ 12.85 ₱ 10.28

Electrocautery pencil with tip Piece ₱ 299.00 ₱ 239.20 Medium Pair ₱ 12.85 ₱ 10.28

Endotracheal tube 2 Piece ₱ 39.00 ₱ 31.20 Large Pair ₱ 12.85 ₱ 10.28

2.5 Piece ₱ 39.00 ₱ 31.20 Elbow Length 6.5 Pair ₱ 74.10 ₱ 59.28

3 Piece ₱ 39.00 ₱ 31.20 7 Pair ₱ 74.10 ₱ 59.28

3.5 Piece ₱ 39.00 ₱ 31.20 7.5 Pair Not Available Not Available

4 Piece ₱ 46.15 ₱ 36.92 Surgical 6 Pair ₱ 22.88 ₱ 18.30

4.5 Piece ₱ 46.15 ₱ 36.92 6.5 Pair Not Available Not Available

5 Piece ₱ 53.30 ₱ 42.64 7 Pair ₱ 22.88 ₱ 18.30

5.5 Piece ₱ 49.40 ₱ 39.52 7.5 Pair ₱ 22.88 ₱ 18.30

6 Piece ₱ 49.40 ₱ 39.52 8 Pair ₱ 24.95 ₱ 19.96

6.5 Piece ₱ 49.40 ₱ 39.52 Heparin lock Piece ₱ 19.50 ₱ 15.60

7 Piece ₱ 44.20 ₱ 35.36 Hot water bag Piece ₱ 149.50 ₱ 119.60

7.5 Piece ₱ 49.40 ₱ 39.52 Hydrogen peroxide Bot ₱ 36.40 ₱ 29.12

8 Piece ₱ 49.40 ₱ 39.52 Hypoallergenic Plaster Roll ₱ 31.50 ₱ 25.20

Epidural set G18 Piece ₱ 2,184.00 ₱ 1,747.20 Ice Bag Piece ₱ 127.40 ₱ 101.92

Face Mask RespiratorN95 Piece Not for Sale Not for Sale ID Wrist Band Adult/ White Piece ₱ 3.87 ₱ 3.10

RespiratorKN95 Piece Not for Sale Not for Sale Child/ Pink Piece ₱ 3.87 ₱ 3.10

with eye Shield Piece ₱ 109.20 ₱ 87.36 Child/ Blue Piece ₱ 4.47 ₱ 3.58

earloop Piece ₱ 4.91 ₱ 3.93 Infusion Set Macroset Piece ₱ 15.60 ₱ 12.48

Feeding Tube Fr. 5 Piece ₱ 7.45 ₱ 5.96 Macroset, Needleless Piece ₱ 182.00 ₱ 145.60

Fr. 8 Piece Not Available Not Available Microset Piece ₱ 15.60 ₱ 12.48

167 | P a g e Fr. 10 Piece ₱ 10.40 ₱ 8.32 Microset, Needleless Piece ₱ 182.00 ₱ 145.60

Fr. 12 Piece ₱ 9.39 ₱ 7.51 With Burette/Soluset Piece ₱ 84.50 ₱ 67.60

Fr. 14 Piece ₱ 8.99 ₱ 7.19 Intubation Stylet Fr. 8 Piece Not Available Not Available

Fr. 16 Piece ₱ 16.25 ₱ 13.00 Fr. 12 Piece ₱ 390.00 ₱ 312.00

Fr. 16, silicon Piece ₱ 338.00 ₱ 270.40 Fr. 14 Piece ₱ 390.00
₱
Fr. 18 Piece ₱ 34.45 ₱ 27.56 312.00

ITEM UNIT RATE ITEM UNIT RATE

Standard Senior Citizen Standard Senior Citizen

IV Cannula G. 16 Piece ₱ 12.20 ₱ 9.76 Oxygen Nasal Cannula Adult Piece ₱ 20.80 ₱ 16.64

G. 18 Piece ₱ 16.55 ₱ 13.24 Pedia Piece ₱ 16.80 ₱ 13.44

G. 20 Piece ₱ 16.55 ₱ 13.24 Infant Piece ₱ 16.80 ₱ 13.44

G. 22 Piece ₱ 16.25 ₱ 13.00 Penrose drainage tube 1/4 inches Piece ₱ 19.24 ₱ 15.39

G. 24 Piece ₱ 16.25 ₱ 13.00 1/2 inches Piece ₱ 22.36 ₱ 17.89

G. 26 Piece ₱ 16.25 ₱ 13.00 1 inches Piece ₱ 33.80 ₱ 27.04

IV Dressing Piece ₱ 100.60 ₱ 80.48 Pill Crusher Piece ₱ 195.00 ₱ 156.00

IV Extension Set Piece ₱ 234.00 ₱ 187.20 Pill Cutter Piece ₱ 387.00 ₱ 309.60

IV Starter Kit Piece ₱ 122.20 ₱ 97.76 Plaster of Paris 4 inches Piece Not Available Not Available

IV Wrist Splint Adult Piece ₱ 78.00 ₱ 62.40 6 inches Piece ₱ 97.50 ₱ 78.00

Pedia Piece ₱ 55.90 ₱ 44.72 Pleural Puncture Set Piece Not Available Not Available

Infant/Neonate Piece ₱ 39.00 ₱ 31.20 Polypropylene mesh Piece Not Available Not Available

Kelly Pad Piece Not Available Not Available Povidone Iodine per cc cc ₱ 0.25 ₱ 0.20

Kidney Basin Piece ₱ 14.30 ₱ 11.44 40 cc in cup* cup ₱ 40.00 ₱ 32.00

Lubricating Jelly Tube Not Available Not Available Scub Brush Piece ₱ 78.00 ₱ 62.40

Nebulizing kit Piece ₱ 37.70 ₱ 30.16 Skin Stapler Piece ₱ 331.50 ₱ 265.20

Nebulizing kit with Mask Adult Piece ₱ 49.40 ₱ 39.52 Specimen Cup Stool Piece ₱ 6.90 ₱ 5.52

Pedia Piece ₱ 39.55 ₱ 31.64 Urine/Sputum Piece ₱ 7.80 ₱ 6.24

Needle G 18 Piece ₱ 1.65 ₱ 1.32 Spinal needle G. 23 Piece ₱ 52.00 ₱ 41.60

G 19 Piece ₱ 1.65 ₱ 1.32 G. 25 Piece ₱ 55.10 ₱ 44.08

G 21 Piece ₱ 1.45 ₱ 1.16 Stockinette Roll ₱ 3,250.00 ₱ 2,600.00

G 22 Piece Not Available Not Available Suction Catheter Fr. 5 Piece ₱ 11.70 ₱ 9.36

G 23 Piece ₱ 1.65 ₱ 1.32 Fr. 8 Piece ₱ 11.70 ₱ 9.36

G 26/25 Piece ₱ 1.48 ₱ 1.18 Fr. 10 Piece ₱ 11.65 ₱ 9.32

Oral Airway #0, 60mm, Black Piece ₱ 42.55 ₱ 34.04 Fr. 12 Piece ₱ 11.65 ₱ 9.32

#1, 70mm, White Piece ₱ 42.55 ₱ 34.04 Fr. 14 Piece ₱ 11.65 ₱ 9.32

#2, 70mm, White Piece ₱ 32.50 ₱ 26.00 Fr. 16 Piece ₱ 11.57 ₱ 9.26

#2, 80mm, Green Piece ₱ 32.50 ₱ 26.00 Fr. 18 Piece ₱ 11.65 ₱ 9.32

#3, 90mm, Yellow Piece ₱ 32.50 ₱ 26.00 Suction Poole Drain/ Yankauer Piece ₱ 192.40 ₱ 153.92

#4, 100mm, Red Piece ₱ 42.55 ₱ 34.04 Suction Bottle Piece Not Available Not Available

#5, 100mm, Red Piece ₱ 41.60 ₱ 33.28 Surgical Blade #10 Piece ₱ 4.68 ₱ 3.74
₱ 3.60 ₱ 2.88
168 | P a g e #5, 110mm, Blue Piece ₱ 32.50 ₱ 26.00 #11 Piece

Oral Care Kit Piece Not Available Not Available #15 Piece ₱ 3.64 ₱ 2.91

Oxygen Face Mask Adult Piece ₱ 39.00 ₱ 31.20 #20 Piece ₱ 4.68 ₱ 3.74

Pedia Piece ₱ 43.45 ₱ 34.76 #21 Piece ₱ 4.00 ₱ 3.20
₱ 91.00 ₱ 72.80
Neonate/Infant Piece ₱ 45.50 ₱ 36.40 #21 w/ handle Piece

with Reservoir, Adult Piece ₱ 71.50 ₱ 57.20 #22 Piece ₱ 4.00 ₱ 3.20

ITEM UNIT RATE ITEM UNIT RATE

Standard Senior Citizen Standard Senior Citizen

IV Cannula G. 16 Piece ₱ 12.20 ₱ 9.76 Oxygen Nasal Cannula Adult Piece ₱ 20.80 ₱ 16.64

G. 18 Piece ₱ 16.55 ₱ 13.24 Pedia Piece ₱ 16.80 ₱ 13.44

G. 20 Piece ₱ 16.55 ₱ 13.24 Infant Piece ₱ 16.80 ₱ 13.44

G. 22 Piece ₱ 16.25 ₱ 13.00 Penrose drainage tube 1/4 inches Piece ₱ 19.24 ₱ 15.39

G. 24 Piece ₱ 16.25 ₱ 13.00 1/2 inches Piece ₱ 22.36 ₱ 17.89

G. 26 Piece ₱ 16.25 ₱ 13.00 1 inches Piece ₱ 33.80 ₱ 27.04

IV Dressing Piece ₱ 100.60 ₱ 80.48 Pill Crusher Piece ₱ 195.00 ₱ 156.00

IV Extension Set Piece ₱ 234.00 ₱ 187.20 Pill Cutter Piece ₱ 387.00 ₱ 309.60

IV Starter Kit Piece ₱ 122.20 ₱ 97.76 Plaster of Paris 4 inches Piece Not Available Not Available

IV Wrist Splint Adult Piece ₱ 78.00 ₱ 62.40 6 inches Piece ₱ 97.50 ₱ 78.00

Pedia Piece ₱ 55.90 ₱ 44.72 Pleural Puncture Set Piece Not Available Not Available

Infant/Neonate Piece ₱ 39.00 ₱ 31.20 Polypropylene mesh Piece Not Available Not Available

Kelly Pad Piece Not Available Not Available Povidone Iodine per cc cc ₱ 0.25 ₱ 0.20

Kidney Basin Piece ₱ 14.30 ₱ 11.44 40 cc in cup* cup ₱ 40.00 ₱ 32.00

Lubricating Jelly Tube Not Available Not Available Scub Brush Piece ₱ 78.00 ₱ 62.40

Nebulizing kit Piece ₱ 37.70 ₱ 30.16 Skin Stapler Piece ₱ 331.50 ₱ 265.20

Nebulizing kit with Mask Adult Piece ₱ 49.40 ₱ 39.52 Specimen Cup Stool Piece ₱ 6.90 ₱ 5.52

Pedia Piece ₱ 39.55 ₱ 31.64 Urine/Sputum Piece ₱ 7.80 ₱ 6.24

Needle G 18 Piece ₱ 1.65 ₱ 1.32 Spinal needle G. 23 Piece ₱ 52.00 ₱ 41.60

G 19 Piece ₱ 1.65 ₱ 1.32 G. 25 Piece ₱ 55.10 ₱ 44.08

G 21 Piece ₱ 1.45 ₱ 1.16 Stockinette Roll ₱ 3,250.00 ₱ 2,600.00

G 22 Piece Not Available Not Available Suction Catheter Fr. 5 Piece ₱ 11.70 ₱ 9.36

G 23 Piece ₱ 1.65 ₱ 1.32 Fr. 8 Piece ₱ 11.70 ₱ 9.36

G 26/25 Piece ₱ 1.48 ₱ 1.18 Fr. 10 Piece ₱ 11.65 ₱ 9.32

Oral Airway #0, 60mm, Black Piece ₱ 42.55 ₱ 34.04 Fr. 12 Piece ₱ 11.65 ₱ 9.32

#1, 70mm, White Piece ₱ 42.55 ₱ 34.04 Fr. 14 Piece ₱ 11.65 ₱ 9.32

#2, 70mm, White Piece ₱ 32.50 ₱ 26.00 Fr. 16 Piece ₱ 11.57 ₱ 9.26

#2, 80mm, Green Piece ₱ 32.50 ₱ 26.00 Fr. 18 Piece ₱ 11.65 ₱ 9.32

#3, 90mm, Yellow Piece ₱ 32.50 ₱ 26.00 Suction Poole Drain/ Yankauer Piece ₱ 192.40 ₱ 153.92

#4, 100mm, Red Piece ₱ 42.55 ₱ 34.04 Suction Bottle Piece Not Available Not Available

169 | P a g e #5, 100mm, Red Piece ₱ 41.60 ₱ 33.28 Surgical Blade #10 Piece ₱ 4.68 ₱ 3.74

#5, 110mm, Blue Piece ₱ 32.50 ₱ 26.00 #11 Piece ₱ 3.60 ₱ 2.88

Oral Care Kit Piece Not Available Not Available #15 Piece ₱ 3.64 ₱ 2.91

Oxygen Face Mask Adult Piece ₱ 39.00 ₱ 31.20 #20 Piece ₱ 4.68 ₱ 3.74

Pedia Piece ₱ 43.45 ₱ 34.76 #21 Piece ₱ 4.00 ₱ 3.20

Neonate/Infant Piece ₱ 45.50 ₱ 36.40 #21 w/ handle Piece ₱ 91.00 ₱ 72.80

with Reservoir, Adult Piece ₱ 71.50 ₱ 57.20 #22 Piece ₱ 4.00 ₱ 3.20

ITEM UNIT RATE ITEM UNIT RATE

Standard Senior Citizen Standard Senior Citizen

Surgical Cap Piece ₱ 1.95 ₱ 1.56 3/O Piece ₱ 183.00 ₱ 146.40

Suture, Chromic O Cutting Piece ₱ 48.75 ₱ 39.00 4/O Piece ₱ 162.25 ₱ 129.80

O Round Piece ₱ 48.75 ₱ 39.00 Vicryl O Round Piece ₱ 496.50 ₱ 397.20

1 Cutting Piece ₱ 48.75 ₱ 39.00 1 Round Piece ₱ 484.60 ₱ 387.68

1 Round Piece ₱ 48.75 ₱ 39.00 2/O Round Piece ₱ 496.50 ₱ 397.20

2/O Cutting Piece ₱ 48.75 ₱ 39.00 3/O Cutting Piece ₱ 485.95 ₱ 388.76

2/O Round Piece ₱ 48.75 ₱ 39.00 3/o Round Piece ₱ 519.20 ₱ 415.36

3/O Cutting Piece ₱ 48.75 ₱ 39.00 4/O Cutting Piece ₱ 303.30 ₱ 242.64

3/O Round Piece ₱ 48.75 ₱ 39.00 Syringe O.5 mL Insulin Piece ₱ 12.70 ₱ 10.16

4/O Cutting Piece ₱ 43.87 ₱ 35.10 Syringe 1 mL Insulin Piece ₱ 3.10 ₱ 2.48

4/O Round Piece ₱ 43.87 ₱ 35.10 1 cc Piece ₱ 2.20 ₱ 1.76

5/O Round Piece ₱ 48.75 ₱ 39.00 3 cc Piece ₱ 2.20 ₱ 1.76

5/O Cutting Piece ₱ 43.87 ₱ 35.10 5 cc Piece ₱ 2.25 ₱ 1.80

Novosyn 3/O Round Piece ₱ 353.50 ₱ 282.80 10 cc Piece ₱ 2.80 ₱ 2.24

Polypropylene 1/0 round Piece ₱ 451.35 ₱ 361.08 20 cc Piece ₱ 11.45 ₱ 9.16

O Round & cutting, 1/0 cutting Piece ₱ 527.20 ₱ 421.76 50 cc Piece ₱ 20.50 ₱ 16.40

2/O Cutting Piece ₱ 487.50 ₱ 390.00 Asepto Piece ₱ 55.25 ₱ 44.20

2/O Round Piece ₱ 487.50 ₱ 390.00 Thoracic Catheter Fr. 28 Piece ₱ 585.00 ₱ 468.00

3/O Cutting Piece ₱ 595.75 ₱ 476.60 Fr. 32 Piece ₱ 780.00 ₱ 624.00

3/O Round Piece ₱ 577.75 ₱ 462.20 Fr. 36 Piece ₱ 773.50 ₱ 618.80

4/O Cutting Piece ₱ 433.30 ₱ 346.64 Tongue Depressor, Non-sterile Box ₱ 104.00 ₱ 83.20

4/O Round Piece ₱ 577.75 ₱ 462.20 Sterile Piece ₱ 1.00 ₱ 0.80

5/O Round,6/0 cutting, 7/0 cutting Piece ₱ 785.40 ₱ 628.32 Tourniquet Piece ₱ 26.00 ₱ 20.80

Silk O Cutting Piece ₱ 54.15 ₱ 43.32 Tracheostomy Care Kit Piece Not Available Not Available

O Round Piece ₱ 54.15 ₱ 43.32 Ultrasound gel 250 grams Bot ₱ 84.50 ₱ 67.60

Silk O w/o Needle Piece ₱ 48.75 ₱ 39.00 Umbilical Cord Clamp Piece ₱ 5.80 ₱ 4.64

1 Cutting Piece ₱ 54.15 ₱ 43.32 Underpad Piece ₱ 18.50 ₱ 14.80

1 Round Piece ₱ 54.15 ₱ 43.32 Urinal Piece ₱ 123.50 ₱ 98.80

2/O Cutting Piece ₱ 48.75 ₱ 39.00 Urine Bag Adult A Piece ₱ 29.90 ₱ 23.92

2/O Round Piece ₱ 54.15 ₱ 43.32 Urine Collector Pedia Piece ₱ 6.50 ₱ 5.20

2/O w/o Needle Piece ₱ 48.75 ₱ 39.00 Ventilator Tubing Adult Piece ₱ 1,014.00 ₱ 811.20

170 | P a g e 3/O Cutting Piece ₱ 48.75 ₱ 39.00 With Water Traps Piece ₱ 1,495.00 ₱ 1,196.00

3/O Round Piece ₱ 48.75 ₱ 39.00 Ventilator Filter Piece ₱ 715.00 ₱ 572.00

3/O w/o Needle Piece ₱ 54.15 ₱ 43.32 Wound Drain Jackson Pratt Piece ₱ 1,625.00 ₱ 1,300.00

4/O Cutting Piece ₱ 48.75 ₱ 39.00 Wadding Sheet 4 inches Piece ₱ 32.50 ₱ 26.00

4/O Round Piece ₱ 48.75 ₱ 39.00 6 inches Piece ₱ 50.70 ₱ 40.56

4/O w/o Needle Piece ₱ 54.15 ₱ 43.32 3-Way StopCock Piece ₱ 19.50 ₱ 15.60

5/O Cutting Piece ₱ 54.15 ₱ 43.32 Oxygen lbs ₱ 0.49 ₱ 0.39

Mersilk O Piece ₱ 198.00 ₱ 158.40 Sterile DS Pack ₱ 30.00 ₱ 24.00

2/O Piece ₱ 183.00 ₱ 146.40

CENTRAL SUPPLY ROOM
(CSR)

Internal Service

171 | P a g e

1. Dispensing of Medical and Surgical Supplies for Hospital Employees

This service involves processing of Hospital Employees request for medical and surgical
supplies from the time that the client presents charge slip until the time the patient receives
the medical and surgical supplies. In order for the client/patient to avail the service, the
following steps are to be followed:

Availability of Service: Monday to Sunday ( 24 Hours )

Office/Division: Nursing Service / Central Supply Room

Classification: Simple

Type of Transaction: G2G – Government to Government

Who May Avail: All DJRMH Employees who wants to avail salary deduction

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Charge Slip (1 original copy) ER/OPD

CLIENT STEPS AGENCY ACTION FEES PROCESSI PERSON
TO NG TIME RESPONSIB
BE
LE
PAID

1. Presents charge slip 1.1 Reviews charge slip/s *Pleas 2 minutes Nurse I

and affixes signature and affixes e refer CSR

at the back of it then corresponding amount to the

acknowledges and informs client for the table

amount to be amount to be deducted. below

deducted in his/her

salary. 1.2 Directs client to affix

signature at the back of None 3 minutes Nurse I

charge slip CSR

2. Checks dispensed 2. Dispenses supplies and None 5 minutes Nurse I

supplies and gives instructions if any CSR

receives instructions

if any

TOTAL None 10 minutes

172 | P a g e

EMERGENCY ROOM

External Service

173 | P a g e

1. Patient’s Registration

This service involves processing of patient’s registration from the time that the client presents
Hospital ID for verification and registration through IHOMIS. In order for the client/patient to be
registered, the following steps are to be followed:

Availability of Service: Monday to Sunday ( 24 hours )

Office/Division: Nursing Service / Emergency Department

Classification: Simple

Type of Transaction: G2C - Government-to-Citizen

Who May Avail: All patients for registration

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Hospital ID (1 original copy) Admitting Section

CLIENT STEPS AGENCY ACTION FEES PROCESSIN PERSON
TO BE G TIME RESPONSIB
PAID
LE

1. Proceeds to Triage Area 1. Receives patient None 1 minute Nurse II

for registration and requests for ER
Hospital ID
(Note: Attendance to patient’s
medical needs shall be given
utmost priority and the following
steps may be withheld
temporarily for an obviously
emergency case)

For Old Patient

1.a Presents Hospital ID and 1.a Receives None 2 minutes Nurse II
provides information for hospital ID for ER
registration through patient
IHOMIS verification and

For Old Patient with Lost registration
ID and for New Patient through IHOMIS

1.b. Watcher or significant 1.b.1 Instructs None 2 minutes Nurse II
other secures hospital ID Client/s or ER
as instructed Significant other

to secure hospital

ID at the

Admitting Section

1.b.2 Issues None 37 minutes Administrative
Hospital ID 2 minutes Officer II
Admitting
2. Presents secured hospital 2. Receives hospital None Section
ID ID for patient and Nurse II
registration ER
through IHOMIS

TOTAL None Old Patient:
5 minutes

Old Patient with Lost ID:
42 minutes

New Patient:
24 minutes

174 | P a g e

2. Patient’s Post Triage Disposition

This service involves processing patient’s post triage disposition from the time that the
client receives post triage advice until the client a.) transfers from ER to ward/room if for
Admission, b.) transferred to referral hospital if for Referral, c.) receives discharge instruction as
treated and sent home if Non-Admissible or d.) Discharged Against Medical Advice. In order for
the client/patient to avail the service, the following steps are to be followed:

Availability of Service: Monday to Sunday ( 24 hours )

Office/Division: Nursing Service / Emergency Department

Classification: Simple

Type of Transaction: Government-to-Citizen

Who May Avail: All patients directed to ER

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Emergency Room Form (1 original copy) Triage Section

2. Admission and Discharge Record Admitting Section

(1 original copy)

3. Prescription (1 original copy) ER

4. Diagnostic Request (1 original copy) ER

5. Official Receipt/ MSS Stamped Charge Slip Cashier/ Medical Social Service

(1 original copy)

6. Referral form, if applicable (1 original copy) Referring unit/hospital

CLIENT STEPS AGENCY FEES PROCESSIN PERSON
ACTION TO BE G TIME RESPONSIBL
1. Receives post triage PAID
advice 1. Receives None 2 minutes E
patient with ER Nurse II
Patients for Admission Form stating None
2.a.1 Patient or Significant post triage ER
assessment
other signs consent for 30 minutes MS III
Clinical Management 2.a.1 Gives Order ER
and/or Admission of Admission
and provides
necessary
management
at the
Emergency
Room

2.a.2 Significant other 2.a.2 Provides None 2 minutes Nurse II
proceeds to Admitting Admission ER
Section with Admission Slip and
Slip then, secure and directs
sign the Admission and significant
Discharge form. other to the
Admitting
Section for
issuance of
Admission
and

175 | P a g e

Discharge
form

2.a.3 Returns to the 2.a.3 Receives None 10 minutes Nurse II
Emergency Room with Admission None 10 minutes ER
the secured Admission and
and Discharge form Discharge None 10 minutes Nurse II
from the designated Form from None 10 minutes ER
staff of the Admitting the 30 minutes
Section. designated 2 minutes Nurse II
staff of the ER
Admitting
Section Nurse II
ER
2.a.4 Takes the medical 2.a.4 Provides
supplies in the Central Charge Slip MS III
Supply Room and and instructs ER
Medicines in the to proceed to
Hospital Pharmacy. Central Nurse II
Supply ER
Room to get
the medical
supplies
used then, to
Hospital
Pharmacy to
secure drugs
and
medicines.

2.a.5 Patient waits for 2.a.5 Endorses
ward/room transfer patient for
ward/room
transfer

2.a.6 Patient transfers from 2.a.6 Transports
ER to ward/room to ward/room
transfer
Patients for Referral
2.b.1 Gives
(Patients for referral in other necessary
hospitals in Dipolog City requiring management
ambulance conduction with at the
accompanying nurse trained in Emergency
EMT) Room and/or
Order of
2.b.1 Patient or Significant Referral
other signs consent for
Clinical Management
and/or Referral

2.b.2 Receives charge slips 2.b.2 Prepares
charge slips

176 | P a g e

for ER/
procedures/
services/sup
plies used.

2.b.3 Receives other 2.b.3 Gives 2 minutes Nurse II
instructions for Instructions ER
settlement of charges for
settlement of 17 minutes Nurse II
*If patient will avail charges. ER
for medical
assistance: 2.b.4 Processes 20 minutes Administrative
availment of Officer V
2.b.4 Proceeds to Medical discounts.
Social Service for Cash Operation
medical assistance *MSW on duty stamps Section
on the charge slip
If with excess:
2.b.5 Issues
Proceeds to cashier (Step 2.b.5) Official
If no excess: Receipt
Proceeds to Step 2.b.7:

2.b.5 Proceeds to Cashier
and pays
corresponding amount

*If patient will avail *Cashier on duty will 30 minutes SWO III
for Malasakit stamped “Paid” MSW Section
assistance:
with OR Number on the
2.b.6 Presents official receipt charge slip
and/or proof of medical
assistance 2.b.6 Checks
official
receipt/s
and/or proof
of medical
assistance
(Excess
Waived per
AO 137
Series of
2002,Patila
Pay,
Poor/Indigen
t ,C/O
Medical
Assistance
Program
(MAP )

2.b.7 Waits once patient is 2.b.7 Stabilize 30 minutes MS III
ready to transfer to patient and ER
higher institution and/or coordinates
hospital of choice. to the
receiving
health facility

177 | P a g e

2.b.8 Arranges 15 minutes Nurse II
and ER
conducts for
patient
transport.

Patients to be discharged from the ER

2.c.1 Patient or Significant 2.c.1 Provides None 3 hours MS III
other signs consent for necessary ER
Clinical Management management 2 minutes
and/or applicable forms at the 2 minutes Nurse II
for Discharge. Emergency ER
Room and 23 minutes
gives 20 minutes Nurse II
Discharge ER
Order 17 minutes
Admin. Aide VI
2.c.2 Receives charge slips. 2.c.2 Prepares None Billing & Claims
charge slips
for ER Section
services/sup
plies used. Administrative
Officer V
2.c.3 Receives other 2.c.3 Gives None
instructions for instructions Cash Operation
settlement of charges for Section
settlement of
charges and SWO III
directs client MSW Section
to go to
billing and
cashier

2.c.4 Proceeds to Billing 2.c.4.1 Billing None
Section then to Cashier Section –(for
for issuance of official status post
receipt for payment of sutured patients):
charges. Issues SOA

2.c.4.2 Cashier: Depends
Issues Official on
Receipt
SOA/Ch
arge

Slips or
any

equivale
nt

*if patient will avail 2.c.5 Processes None
for medical availment of
assistance medical

2.c.5 Proceeds to Medical
Social Service and/or
Malasakit Center for

178 | P a g e

medical assistance. assistance.

If with excess: *MSW on duty stamps
on the charge slip
Proceeds to cashier (Step 3)
If no excess:
Proceeds to Step 4:

*if patient will avail 2.c.6 Checks None 30 minutes SWO III
for Malasakit assistance official MSW Section
receipt/s None
2.c.6 Presents official and/or proof None
receipts and/or proofs of medical None
of medical assistance assistance None
and replenished and
medical supplies and replenishmen
medicines used. t of medical
supplies and
medicines
used.
assistance
(Excess
Waived per
AO 137
Series of
2002,Patila
Pay,
Poor/Indigent
,C/O Medical
Assistance
Program
(MAP )

2.c.7 Receives discharge 2.c.7 Gives 3 minutes Nurse II
instructions. discharge 1 hour ER
instructions.
3 minutes MS III
Discharge Against Medical Advice (DAMA) ER

2.d.1 Patient or Significant other 2.d.1 Provides MS III
necessary ER
signs consent for Clinical management at the
Management Emergency Room 5 minutes MS III
2.d.2 Explained the ER
2.d.2 Signs consent for the possible
Release from consequences and
Responsibility form. secures consent for
the release of
( Note: for minor responsibility.
patients the patient next 2.d.3 Instructs the
of kin will sign the significant other to
consent ) remove all the
contraptions.
2.d.3 Patient’s significant
others will remove all
the contraptions.

179 | P a g e

2.d.4 Receives charge slips. 2.d.4 Prepares None 2 minutes Nurse II
charge slips for ER None 2 minutes ER
2.d.5 Receives other services/supplies
instructions for used. Nurse II
settlement of charges ER
2.d.5 Gives
Instructions for
settlement of
charges and directs
client to go to billing
and cashier

2.d.6 Proceeds to Billing 2.d.6.1 Billing None 23 minutes Admin Aide VI
Section then to Cashier Section –(for Billing & Claims
for issuance of official status post
receipt for payment of sutured patients): Section
charges. Issues SOA

2.d.6.2 Cashier: Depends 20 minutes Administrative
Issues Official on 17 minutes Officer V
Receipt 30 minutes
SOA/Ch Cash Operation
*if patient will avail for arge Section

medical assistance/ Slips or Nurse II
Malasakit assistance: any ER

2.d.7 Proceeds to Medical equivale SWO III
Social Service and/or nt MSW Section
Malasakit Center for
medical assistance. 2.d.7 Processes None
availment of
If with excess: medical assistance

Proceeds to cashier (Step 3) *MSW on duty stamps
If no excess: on the charge slip
Proceeds to Step 4:
2.d.8 Checks None
2.d.8 Presents official official receipt/s
receipts and/or proofs and/or proof of
of medical assistance medical assistance
and replenished and replenishment
medical supplies and of medical supplies
medicines used. and medicines
used. assistance
2.d.9 Receives discharge (Excess Waived
instructions. per AO 137 Series
of 2002,Patila Pay,
Poor/Indigent ,C/O
Medical Assistance
Program (MAP )

180 | P a g e

*Cashier on duty will
stamped “Paid”
with OR Number on the
charge slip

2.d.9 Gives None 3 minutes Nurse II
discharge ER
instructions. Depends
on Patients for Admission
TOTAL 1 hour & 14 minutes
SOA/Ch
arge Patients for referral
1 hour and 43 minutes
Slips or
any Patients to be discharge
3 hours and 52 minutes
equivale
nt and DAMA
availmen 1 hour and 58 minutes

t of *if client will avail medical
medical assistance
assistan
Patients for referral
ce 2 hours and 30 minutes

Patients to be discharge
4 hours and 39 minutes

DAMA
2 hours and 45 minutes

181 | P a g e

3. Triaging and Admission of Suspect, Probable and Confirmed COVID-19

This service involves processing of patient’s triaging and admission as suspect, probable
and confirmed COVID-19 from the time that the referring facility notifies the hospital and gives
information related to health condition until the client receives appropriate medical/nursing
care. In order for the client/patient to avail the service, the following steps are to be followed:

Availability of Service: Monday to Sunday ( 24 hours )

Office/Division: Nursing Service / Emergency Room

Classification: Simple

Type of Transaction: G2C – Government to Citizen
G2G – Government to Government

Who May Avail: All patients for admission of suspect, probable and
confirmed case of Covid-19 with referral

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Referral form (1 original copy) Referring unit/hospital

CLIENT STEPS AGENCY FEES PROCESS PERSON
ACTION TO BE ING TIME RESPONSIB
PAID
LE

1. Notifies the health care facility in 1.1 Receives None 15 minutes Nurse II

advance prior transport and notification ER

gives information related to from referring

present health condition. facility.

*Arrival at the facility depends on the 1.2 Verifies referral None 5 minutes MS-III
distance where the referral came from. and determines ER
appropriatenes
s of admission
within the
capability of the
institution for its
management.

1.3 Prepares the None 10 minutes Nurse II
room/s for ISO
For suspect, probable patient’s
and confirmed covid-19 accommodatio MS-III
2.1 Submits self for clinical n and ER
necessary
assessment medical
supplies and
medical
equipment to
be used.

2.1.1 Performs None 15 minutes
clinical
assessment

2.1.2 Performs None 5 minutes
patient’s
Assessment Nurse II
ER

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using
COVID-19
Screening
Tool.

2.2 Proceeds to identified 2.2 Directs client/s None 5 minutes Nurse II
COVID-19 Isolation to identified None 10 minutes ER
Unit COVID-19 None 3 minutes
Isolation Unit. Nurse II
2.3 Signs consent for None 5 minutes ISO
Admission 2.3 Secures
consent for Nurse II
2.4 Provides requested data for admission ISO
Input to his/her Admission and
Discharge Form. 2.4 Asks to Nurse II
provide ISO
2.5 Submits self for demographic
assessment for data for his/her
appropriate medical/ Admission and
nursing care Discharge Form

2.5 Does patient
assessment for
appropriate
medical/nursing
care and
transports patient
to assigned room.

TOTAL None 1 hour and 13 minutes

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3. Patient’s Triage

This service involves processing patient’s triaging from the time that the client submits self
for assessment until transfer to emergency room for Post-triage assessment and disposition.
Patient triaging using the three (3) point triage scale category is done to ensure efficient
services at the Emergency Room.

Availability of Service: Monday to Sunday ( 24 hours )

Office/Division: Nursing Service / Emergency Department

Classification: Simple

Type of Transaction: G2C - Government-to-Citizen

Who May Avail: All patients for triage

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Referral form, if applicable (1 original copy) Referring unit/hospital

CLIENT STEPS AGENCY FEES PROCESSI PERSON
ACTION TO NG TIME RESPONSIB
BE
PAID LE

1. Proceeds to Triage Area for 1. Receives None 2 minutes Nurse II

assessment and submission of patient and ER

related documents patient’s

related

(Note: Attendance to patient’s medical needs documents
shall be given utmost priority and the such as
following steps may be withheld referral form if
temporarily for an obviously emergency available
case)

2. Provides requested data for 2. Does initial None 5 minutes Nurse II
proper assessment and client None 15 minutes ER
recording assessment and
data recording in Nurse II
FOR EMERGENT CASE/S the ER form ER
.
2.a Receives information regarding 2.a Gives advice
prioritization of care in the
Emergency Room. May be that their case
directed to designated area in the has 1st priority
Emergency Room immediately in the
upon entry as necessary. provision of
clinical
FOR URGENT CASE/S management.
May transfer
client directly
to designated
area in the
Emergency
Room.

2.b Receives information 2.b Gives None 2 hours Nurse II
regarding prioritization of care in advice that ER
the Emergency Room.
their case has
2nd priority in

the provision
of clinical

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FOR NON-URGENT CASE/S management. None 3 hours and Nurse II
None 40 minutes ER
2.c Receives information 2.c Gives advice
regarding that their case 2 minutes Nurse II
prioritization of care has 3rd priority ER
in the Emergency in the provision
Room. of clinical
management.
3. Transfers to Emergency Room for 3. Transports to
Post-triage assessment and designated area
disposition. in the
emergency room
for Post-triage
assessment and
disposition

For Emergent Case
24 minutes

TOTAL None For Urgent Case
2 hours & 9 minutes

For Non-Urgent Case
3 hours & 49 minutes

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OPERATIONAL CENTER
(OPCEN)

External Service

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1. Issuance of Triage Pass

The new normal due to the COVID-19 pandemic stresses observation of Infection
Prevention and Control protocols as well as contact traceability. The following steps must
be followed to facilitate delivery of goods/entry of persons inside health facility during this
pandemic.

Availability of Service: Monday to Friday ( 8:00 AM to 5:00 PM )

Office/Division: Operational Center (OPCEN)

Classification: Simple

Type of Transaction: Government-to-Citizen

Who May Avail: All watcher’s and visitors

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Watcher’s Pass, if applicable Admitting Section

(1 original copy)

If Deliveries of goods from areas with

positive case of COVID-19 (outside the

Province), if applicable

1. Proof of Identification/Proof of Supplier

Employment/Good’s Pass/Delivery Receipt

(1 original copy)

FEES

CLIENT STEPS AGENCY ACTION TO PROCESSING PERSON

BE TIME RESPONSIBLE

PAID

1. Wears appropriate PPE 1. Provides advice on None 2 minutes Security Guard

prior to entering the donning on Duty

hospital premises. appropriate PPE

prior to entering

hospital premises.

2.1 Performs hand wash/ 2.1 Directs client/s to None 5 minutes Security Guard

alcohol rub/foot bath hand on Duty

disinfection and wash/alcohol

presents watcher’s rub/foot bath

pass. disinfection and

receives

watcher’s pass

2.2 Submits self for 2.2 Assesses client None 5 minutes Nurse I
assessment in to for any of the Triage Area
designated Triage Area following :
(located at hospital gate)
and provides information a. Travel history to
as requested. areas with
positive case of
COVID 19.

b. Contact to person
with positive
COVID-19.

c. Signs and
Symptoms.

d. Body
temperature.

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If Deliveries of goods
from areas with
positive case of
COVID-19

2.2 Presents any proof of 2.3 Request for any None 5 minutes Nurse I
15 minutes Triage Area
transaction proof of 5 minutes
Security Guard
transaction
Nurse I
2.4 Allows hospital staff to 2.4 Disinfects vehicle None Triage Area
disinfect the vehicle and and provides None
receives advice to advice regarding
proceed to the Drop Off Drop Off Point.
Point
3. Registers client in
3. Registers in the Triage the Triage
Logbook and receives Logbook and
triage pass and other issues Triage
instructions. Pass and other
instructions as
*Note: necessary.
Only one watcher/visitor can go

inside the hospital premises.

TOTAL None 37 minutes

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OUT-PATIENT DEPARTMENT
(OPD)

External Service

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1. Availment of Out-Patient Department (OPD) Consultation

This service involves processing for availment of out-patient department consultation thru
OPD Appointment System from the time the client calls the OPD requesting appointment
for consultation until the time he/she receives clinical consultation and appointment date for
follow-up check up (if necessary).

Availability of Service: Monday to Friday (8:00AM to 5:00PM)

Office/Division: Out-Patient Department (OPD)
Classification: Simple

Type of Transaction: G2C- Government to Citizen

Who May Avail OPD Clients with Scheduled Consultation

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. OPD Registration Form (ORF) (1 original copy) OPD
2. Hospital ID Card (1 original copy)

3. Tagubilin Form (for Post-Admitted Patients) Ward
(1 original copy)

4. Appointment Reference Number OPD Appointment Desk

5. Health Declaration Form (1 original) OPD Guard

Situational Requirements (As needed): ER/OPD
6. Appointment Acknowledgement Reference Form

(AARF)

CLIENT STEPS AGENCY ACTION FEES PROCESSING PERSON
TO BE TIME RESPONSIBLE
PAID

Registration of client

Old Client
(New Cases/Follow up):

1.a.1. Presents Appointment 1.a.1 Requests None 15 minutes Nurse I
Reference Number, client to present None 15 minutes OPD
Accomplished Health required
Declaration Form, Tagubilin documents Nurse I
form, Hospital ID and AARF OPD
(If available). 1.a.2 Verifies
appointment and
New Client: data
completeness in
the computer

1.b.1 Presents Appointment 1.b.1 Requests None 5 minutes Nurse I
Reference Number, client to present OPD
Accomplished Health required
Declaration Form, Hospital documents
ID and AARF (If available).

1.b.2 Fills out ORF completely. 1.b.2. Instructs client None 5 minutes Nurse I
to completely fill out OPD
ORF.

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1.b.3. Submits completely filled 1.b.3. Receives None 15 minutes Data Controller
15 minutes III
out ORF. completely filled out 5 minutes HIM

ORF. Data Controller
III
1.b.4. Receives hospital 1.b.4. Provides client None HIM
ID card with Hospital ID None
card and records Nurse I OPD
If Old Client with No or Lost data
ID:
1.b.5 Gives client
1.b.5 Receives charge Slip and charge slip and
pay at cashier then goes back instructs to go to
to secure Hospital ID cashier for
payment

1.b.6 Receives Php 20 minutes Administrative
payment 30.00 10 minutes Officer V

2. Presents himself for 2. Assesses client None Cash Operation
assessment and vital signs for chief None Section
checking. complaints about Nurse I
their current
3. Presents self for consultation medical condition, 10 minutes Medical Officer
takes vital signs 5 minutes III/Medical
and queue client 5 minutes Specialist II
accordingly as to
the services Medical Officer
needed. III/Medical
Tagubilin form is Specialist II
asked as basis of Nurse I
follow-up check-
up.

3. Provides Clinical
Consultation

4. Receives instruction for 4. Carries out None
diagnostic examination, doctor’s order/s. None
therapeutic management. P30.00
5. Receives follow up 5. Set up
appointment acknowledgement appointment date
receipt and time for follow
check up
Old Client :
TOTAL 1 hour

New Client:
1 hour and 10 minutes

Old Client without or Lost ID:
1 hour and 25 minutes

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2. Availment of Out-Patient Department (OPD) Appointment via call or
online

This service involves processing for availment of out-patient department consultation thru
OPD Appointment System from the time the client calls the OPD requesting for
appointment of consultation until the time the client receives the confirmation of the
appointment.

Availability of Service: Monday to Friday (8:00AM to 5:00PM) except holidays

Please call our hotline number: 09557437620 (Globe/TM) ; 09631092928 (Smart/Sun/TnT)

or visit our portal (https://bit.ly/djrmh_ooas)

Office/Division: Out-Patient Department (OPD)
Classification: Simple

Type of Transaction: G2C- Government to Citizen
Who May Avail OPD Clients

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

None AGENCY ACTION None PROCESSING PERSON
FEES TIME RESPONSIBLE
CLIENT STEPS 1.1 Receives call TO BE
from clients PAID 15 minutes Nurse 1
For Appointment via Call: requesting for OPD
appointment for None
1. Calls designated contact consultation and
numbers for consultation confirmed
appointment and waits for schedule and
reference number & provides
confirmation reference number

For Appointment via Online:
1. Goes to the prescribed

website/portal
(https://bit.ly/djrmh_ooas) for
Online OPD Appointment
System or scans the QR
Code.

TOTAL None 15 minutes

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TUBERCULOSIS DIRECT OBSERVED
TREATMENT SHORT-COURSE
(TB-DOTS)

External Service

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1. Availment of TB-DOTS Service – New TB DOTS Clients

The TB-DOTS clinic caters to patients- adults and children who are diagnosed and
suspected with Tuberculosis. The clinic operates in accordance with DOH and WHO
standard protocol. Treatment regimen are given for free to admitted TB patients and to
enrolled TB patients.

Availability of Service: Monday to Friday (8:00 AM to 5:00 PM) except for Holidays
Office/Division: TB-DOTS Clinic

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who May Avail: New TB DOTS Clients

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

NONE AGENCY ACTION NONE PROCESSING PERSON
FEES TIME RESPONSIBLE
CLIENT STEPS 1. Receives
client/patient TO 5 minutes Nurse I
1. Presents self and fills and gives BE 10 minutes TB-DOTS
up attended patient instructions. PAID
list logbook. NONE 20 minutes MO IV
2. Provides TB-DOTS
2. Presents self for Clinical NONE 43 minutes
Physician Consult Consultation Nurse I
3. Provides NONE TB-DOTS
3. Receives instruction instructions
by the TB-DOTS pertaining to NONE
Nurse laboratory and
diagnostics then
advise to follow-up
per physician’s
schedule given

TOTAL:

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2. Availment of TB-DOTS Service – Follow-up Patient (TB-DOTS Client) –
to be treated at Rural Health Unit/City Health Office

As part of the Universal Health Care, the Dr. Jose Rizal Memorial Hospital TB DOTS
partners with other health care facilities to strengthen the service delivery network. It
aims to give patients the right to choose their treatment partner for better treatment
outcome.

Availability of Service: Monday to Friday (8:00 AM to 5:00 PM) except for Holidays

Office/Division: TB-DOTS Clinic

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who May Avail: TB-DOTS Client – Diagnose as TB Patient wants to be
treated at Rural Health Unit/City Health Office

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

NONE AGENCY NONE PROCESSING PERSON
ACTION FEES TIME RESPONSIBLE
CLIENT STEPS
1. Receives TO 30 minutes Nurse I
1. Presents self and fills client/patient BE TB-DOTS
up attended patient list and gives PAID 10 minutes
logbook and waits name instructions. MO IV
to be called for NONE 3 minutes TB-DOTS
consultation 2. Provides 43 minutes
Clinical NONE Nurse I
2. Presents self for Consultation TB-DOTS
Physician Consult NONE
3. Prepares and
3. Receives NTP Referral Issues NTP NONE
Form and further Referral Form
instructions then gives
further
instructions.
TOTAL:

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3. Availment of TB-DOTS Service – Follow-up Patient (TB-DOTS Client) –
to be treated at the hospital

The Dr. Jose Rizal Memorial Hospital TB-DOTS clinic as an accredited Philhealth facility
can avail TB DOTS Package from patients who are philhealth beneficiary. Furthermore,
non-member patients can still avail of the free services of TB medications and consultation.

Availability of Service: Monday to Friday (8:00 AM to 5:00 PM) except for Holidays
Office/Division: TB-DOTS Clinic

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who May Avail: TB-DOTS Client – Diagnose as TB Patient wants to be
treated at the hospital

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

PHIC Note (1 original copy) Billing and Claims Unit

CLIENT STEPS AGENCY ACTION FEES PROCESSING PERSON
TO TIME RESPONSIBLE
BE
Nurse I
PAID TB-DOTS

1. Presents self and fills 1. Receives MO IV
client/patient and TB-DOTS
up attended patient gives instructions.
Nurse I
list logbook and waits 2. Provides Clinical NONE 30 minutes TB-DOTS
Consultation
name to be called for
3.aFor client/patient
consultation with PhilHealth:
Instructs patients to
2. Presents self for go the PhilHealth NONE 10 minutes
Section
Physician Consult

3.a For client/patient

with PhilHealth: NONE 3 minutes

Proceeds to

Philhealth Section

and asks for PHIC

note

3.b For client/patient 3.bFor client/patient
w/o PhilHealth:
Proceeds to Step 5 w/o PhilHealth:

4. Returns to TB-DOTS Proceeds to Step 5
Clinic then presents
PHIC Note 4. Receives PHIC Note Nurse I
TB-DOTS
5. Receives NTP ID and enroll patient as NONE 30 minutes
Card and instructions
for follow-up schedule TB Client NONE
NONE
5. Issues NTP ID Card

then gives 3 minutes Nurse I
TB-DOTS
instructions for follow-

up schedule

TOTAL: w/ PHIC
1 hour and
16 minutes

w/o PHIC
43 minutes

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4. Availment of TB-DOTS Service – Follow-Up Patient
(Enrolled TB Clients)

The Dr. Jose Rizal Memorial Hospital TB-DOTS clinic as a DOH Certified facility can give
available Anti-TB medication to enrolled patients as well as provide follow up check up. It
aims to provide care to patient undergoing treatment.

Availability of Service: Monday to Friday (8:00 AM to 5:00 PM) except for Holidays
Office/Division: TB-DOTS Clinic

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who May Avail: Enrolled TB Clients

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

NTP ID Card (1 original copy) TB-DOTS Clinic

CLIENT STEPS AGENCY FEES PROCESSING PERSON
ACTION TO TIME RESPONSIBLE
BE
Nurse III
PAID TB-DOTS

1. Presents NTP ID Card 1. Receives NONE 3 minutes Nurse III
and awaits instructions NTP ID Card TB-DOTS
and gives
2. Receives Anti-TB instructions Nurse III
medication and TB-DOTS
instructions. 2. Gives Anti-TB
medication and NONE 2 minutes
3. Receives appointment instructs for
schedule for follow up. follow-up NONE 2 minutes
schedule. NONE 7 minutes
3. Gives follow
up appointment
schedule.

TOTAL

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FEEDBACK AND COMPLAINTS

FEEDBACK AND COMPLAINTS MECHANISM

How to send feedback Fill-up the client feedback/customer satisfaction form and drop it

at the designated drop box in the frontline offices.

How feedbacks are Every Friday, the Integrity Management Committee

processed Chair/Authorized Representative opens the drop box and

complies and records all feedback submitted.

Feedback requiring answers are forwarded to the relevant

offices and they are required to answer within three (3) days of

the receipt of the feedback.

The answer of the office is then relayed to the citizen.

For inquiries and follow-ups, clients may reach the following

contact details:

Telephone No. : (065) 908-8037 / (065) 908-8310

Email: [email protected]

How to file a complaint Fill-up the client Complaint Form and drop it at the designated

drop box in the frontline offices.

Complaints can also be filed via telephone or email. Make sure

to provide the following information:

3. Name of person being complained

4. Incident

5. Evidence

For inquiries and follow-ups, clients may reach the following

contact details:

Telephone No. : (065) 908-8037 / (065) 908-8310

Email: [email protected]

How complaints are The Integrity Management Committee Chair/Authorized

processed Representative opens the complaints drop box on a daily basis

and evaluates each complaint.

Upon evaluation, Integrity Management Committee

Chair/Authorized Representative shall start the investigation

and forward the complaint to the relevant office for their

explanation.

The Integrity Management Committee Chair/Authorized

Representative will create report after the investigation and

shall submit it to the Head of Agency for appropriate action.

The Integrity Management Committee Chair/Authorized

Representative will give the feedback to the client.

For inquiries and follow-ups, clients may reach the following

contact details:

Telephone No. : (065) 908-8037

Email: [email protected]

Contact Information of CCB: [email protected]

CCB, PCC, ARTA SMS: 0908-8816565 / Tel#: 1-6565

Presidential Complaints Center: Hotline: 8888

ARTA: [email protected]
: 1-ARTA (2782)
: 478-5093

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LIST OF OFFICES

Office Address Contact Information
Outpatient Department (OPD) Dr. Jose Rizal Memorial (065) 213-6222/
Hospital, OPD Temporary (065) 908-8037
Emergency Room (E.R) Building
Admitting Section Dr. Jose Rizal Memorial (065) 213-6222/
Health and Information Hospital, Main Building (065) 908-8037
Management (HIM) Dr. Jose Rizal Memorial (065) 213-6222/
Clinical Pathology Department Hospital, Main Building (065) 908-8037
Radiology Dr. Jose Rizal Memorial (065) 213-6222/
Central Supply Room (CSR) Hospital, Main Building (065) 908-8037
Pharmacy DJRMH – Laboratory (065) 213-6222/
Medical Social Work Building (065) 908-8037
Billing and Claims Dr. Jose Rizal Memorial (065) 213-6222/
Cashier Hospital, Main Building (065) 908-8037
Animal Bite Treatment Center Dr. Jose Rizal Memorial (065) 213-6222/
Hospital, Main Building (065) 908-8037
TB-DOTS Clinic DJRMH , Pharmacy (065) 213-6222/
Building (065) 908-8037
Procurement Dr. Jose Rizal Memorial (065) 213-6222/
Materials and Management Hospital, Main Building (065) 908-8037
Office (MMO) Dr. Jose Rizal Memorial (065) 213-6222/
Hospital, Main Building (065) 908-8037
Dr. Jose Rizal Memorial (065) 213-6222/
Hospital, Main Building (065) 908-8037
Dr. Jose Rizal Memorial (065) 213-6222/
Hospital, OPD Temporary (065) 908-8037
Building
Dr. Jose Rizal Memorial (065) 213-6222/
Hospital, OPD Temporary (065) 908-8037
Building
DJRMH Procurement (065) 213-6222/
Office (065) 908-8037
DJRMH - MMO (065) 213-6222/
(065) 908-8037

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