DJRMH Citizen's Charte 2022_3rd Edition FINAL

1. Request for Procurement of Goods & Services and Infrastructure/
Civil Works (General Procedure in Public Bidding)

This process provides end-users with clear and concise information on the public
procurement of goods &services and infrastructure/civil works by knowing the
steps that need to be taken to effect such procurement in the manner prescribed by RA
9184, otherwise known as the “Government Procurement Reform Act”, and its IRR-A.
This also provides the stages of goods and services procurement, from the preparation
of bid documents, to the actual bidding activity, the approval of the contract and the
contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

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

1. Submits 1. Receives None 5 minutes Administrative

approved approve Assistant I
Purchase Purchase Procurement Section

Request (PR) Request (PR)

2. Attends Pre- 2.1.1 Invites end None 2 hours Administrative Officer V

procurement user to join Procurement Section

Conference the pre-

procurement

conference.

2.1.2 Conducts Bids and Awards
Pre- Committee (BAC),
Procurement Technical Working
Conference
and Group (TWG)
BAC Secretariat

prepares/draft

of ITB and

other bidding

documents.

2.2 Preparation of None 2 calendar BAC, TWG, BAC

IB & Bidding days Secretariat

Documents

2.3 Advertise/Post None 1 calendar day BAC Secretariat

IB

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2.4 Availability and None 20 calendar BAC Secretariat
Issuance of None days
Bidding
3. Attends Pre-bid Documents None 1 calendar day BAC, TWG, BAC
Conference Secretariat
3.1 Invites end None
4. Attends Opening user to join the None 1 calendar day BAC, TWG, BAC
of Bids pre-bid None Secretariat
conference. None
5. Follow-up None 7 calendar BAC, BAC Secretariat
approved/ Status 3.2 Conducts pre- None days
of PO bid conference None
Issuance of Bid None 45 calendar TWG
Bulletin days BAC, BAC Secretariat

4.1.1 Invites end- 15 calendar
user to join days
the Opening
of Bids. 1 Calendar HOPE, BAC Secretariat
day
4.1.2 Conducts
Opening of 30 Calendar HOPE, SAO, BAC
Bids days Secretariat

4.2 Prepares 15 Calendar HOPE, SAO, BAC
Abstract of days Secretariat
Bids/ Bid
Evaluation 5 minutes Administrative Officer V
Procurement Section
4.3 Conducts
Post-
qualification

4.4 Prepares BAC
Resolution to
Declare and
Recommend
Award

4.5 Issue/ Post
Notice of
Award

4.6 Prepares
Purchase
Order (PO)/
Contract and
Approval

4.7 Issue/Post
Notice to
Proceed

5. Instruct end-
user to proceed to
MMO for Contract
Implementation.

TOTAL 138 Calendar days, 2 hours and 10
minutes

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2. Request for Procurement of Consulting Services (General Procedure
in Public Bidding)

This process provides end-users with clear and concise information on the public
procurement of consulting services by knowing the steps that need to be taken to
effect such procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
goods and services procurement, from the preparation of bid documents, to the actual
bidding activity, the approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

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

1. Submits 1. Receives None 5 minutes Administrative

approved approve Assistant I
Purchase Purchase Procurement Section

Request (PR) Request (PR)

2. Presents Letter 2.1.1 Invites end None 2 hours Administrative Officer V
of Intent (LOI) user to join Procurement Section
and Valid ID the pre-
procurement
conference. Bids and Awards
Committee (BAC),
2.1.2 Conducts Technical Working
Pre-
Procurement Group (TWG)
Conference BAC Secretariat
and
prepares/draft
of ITB and
other bidding
documents.

2.2 Preparation of None 2 calendar BAC, TWG, BAC
IB & Bidding days Secretariat
Documents

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2.3 Advertise/Post None 1 calendar day BAC Secretariat
IB

2.4 Conducts None 1 calendar day BAC and TWG

Eligibility Check

& Short listing

2.5 Availability and None 27 calendar BAC Secretariat
Issuance of days
Bidding
Documents

3. Attends Pre-bid 3.1 Invites end None 1 calendar day BAC, TWG, BAC
Conference user to join the Secretariat
pre-bid
conference.

3.2 Conducts pre-
bid conference
Issuance of Bid
Bulletin

4. Attends Opening 4.1 Invites end-user None 1 calendar day BAC, TWG, BAC
of Bids to join the Secretariat
Opening of
Bids. Conducts
Opening of Bids

4.2 Prepares None 21 calendar BAC, BAC Secretariat
Abstract of days
Bids/ Bid
Evaluation

4.3 Prepares None 3 calendar BAC, TWG, BAC
Notification for days Secretariat
Negotiation

4.4 Conducts None 10 calendar BAC, TWG, BAC
Negotiation days Secretariat

4.5 Conducts Post- None 30 calendar TWG

qualification days

4.6 Prepares BAC None 15 calendar BAC, BAC Secretariat
Resolution to days
Declare HRRB
and
Recommend
Award

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4.7 Issue/ Post None 1 Calendar HOPE, BAC Secretariat
day
Notice of Award

4.8 Prepares None 30 Calendar HOPE, SAO, BAC
Purchase Order days Secretariat
(PO)/ Contract
and Approval

4.9 Issue/Post None 15 Calendar HOPE, SAO, BAC
Notice to days Secretariat
Proceed

5. Follow-up 5. Instruct end- None 5 minutes Administrative Officer V
approved/ Status of user to proceed Procurement Section
PO to MMO for
Contract
Implementation

TOTAL None 158 Calendar days, 2 hours and 10
minutes

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3. Request for Procurement through Alternative Methods (Limited
Source Bidding)

This process provides end-users with clear and concise information on the public
procurement of goods, infrastructure projects and consultancy services through
the alternative method by knowing the steps that need to be taken to effect such
procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
procurement, from the preparation of bid documents, to the actual bidding activity, the
approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

FEE

CLIENT STEPS AGENCY S TO PROCESSING PERSON
ACTIONS BE TIME RESPONSIBLE

PAID

1. Submits approved 1.1 Receives None 5 minutes Administrative

Purchase Request approve Assistant I

(PR) Purchase Procurement Section

Request (PR)

1.2 Recommend None 2 Calendar BAC and HOPE
change in days
mode of
Procurement
through a BAC
Resolution
approved by
the HOPE

1.3 Prepares None 1 Calendar BAC, TWG, BAC
Bidding day Secretariat
Documents

2. Attends Pre- 2.1.1 Invites end None 1 Calendar BAC, TWG, BAC
procurement user to join day Secretariat
Conference the pre-
procurement
conference

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2.1.2 Conducts
Pre-
Procurement
Conference.

2.2 Post None 7 Calendar BAC Secretariat
days
Procurement

activity

3. Attends 2.3 Send IBs/REI None 1 Calendar BAC, BAC Secretariat
Pre-procurement to pre- None day
Conference selected BAC, TWG, BAC
suppliers in 1 Calendar Secretariat
the list day

3.1.1 Invites end
user to join
the pre-bid
conference.

3.1.2 Conducts
Pre-bid
Conference.

4. Attends Opening of 4.1.1 Invites end- None 90 calendar BAC, TWG, BAC
Bids user to join days Secretariat
the Opening
of Bids.

4.1.2 Conducts
Opening of
Bids

4.1.3 Conducts bid
evaluation,
post-
qualification
and
succeeding
activities up
to contract
award.

4.2 Proceed with None 1 Calendar HOPE, SAO,
the Contract day Procurement unit Staff,
Signing Materials Management
5 minutes
5 Follow-up 5. Instruct end- None Officer
Administrative Officer V
approved/ Status of user to proceed
Procurement Section

PO to MMO for

Contract

Implementation

.

TOTAL None 104 Calendar days and 10 minutes

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4. Request for Procurement through Alternative Methods (Direct
Contracting)

This process provides end-users with clear and concise information on the public
procurement of goods, infrastructure projects and consultancy services through
the alternative method by knowing the steps that need to be taken to effect such
procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
procurement, from the preparation of bid documents, to the actual bidding activity, the
approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

FEE

CLIENT STEPS AGENCY S TO PROCESSING PERSON
ACTIONS BE TIME RESPONSIBLE

PAID

1. Submits approved 1.1 Receives None 5 minutes Administrative

Purchase Request approve Assistant I
(PR) Purchase Procurement Section

Request (PR)

1.2 Recommends None 3 Calendar BAC
change in days
Mode of
Procurement to
Direct
Contracting
through a BAC
Resolution
approved by
the HOPE

1.3 Prepares & None 3 Calendar BAC, BAC Secretariat
Post RFQs days

1.4 Prepares & None 3 Calendar BAC, BAC Secretariat
Post NOA None days
Administrative
1.5 Prepares 13 Calendar Assistant III
Contract / days
Purchase Procurement Section
Order

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1.6 Proceeds with None 1 Calendar HOPE, SAO,
the contract day Procurement Staff,
signing Materials Management

2. Follow-up 2. Instruct end- None 5 minutes Administrative Officer V
None Procurement Section
approved/ Status user to proceed

of PO to MMO for

Contract

Implementation

TOTAL 23 Calendar days and 10 minutes

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5. Request for Procurement through Alternative Methods (Repeat Order)

This process provides end-users with clear and concise information on the public
procurement of goods, infrastructure projects and consultancy services through
the alternative method by knowing the steps that need to be taken to effect such
procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
procurement, from the preparation of bid documents, to the actual bidding activity, the
approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR)\ End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

FEE

CLIENT STEPS AGENCY S TO PROCESSING PERSON
ACTIONS BE TIME RESPONSIBLE

PAID

1. Submits approved 1.1 Receives None 5 minutes Administrative

Purchase Request approve Assistant I
(PR) Purchase Procurement Section

Request (PR)

1.2 Recommends None 3 Calendar BAC
change in days
Mode of
Procurement to
Repeat Order
through a BAC
Resolution
approved by
the HOPE

1.3 Confirmation of None 10 Calendar BAC, BAC Secretariat
Repeat days
Order/Posting
of Performance
Security

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1.4 Preparation None 3 Calendar Administrative
days Assistant III
and Approval of
3 Calendar Procurement Section
Contract/PO days
HOPE
1.5 Post NOA for None BAC, BAC Secretariat
information
purposes

2. Follow-up 2. Instruct end- None 5 minutes Administrative Officer V
approved/ Status of user to proceed to Procurement Section
PO MMO for Contract
Implementation.

TOTAL None 19 Calendar days and 10 minutes

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6. Request for Procurement through Alternative Methods (Shopping)

This process provides end-users with clear and concise information on the public
procurement of goods, infrastructure projects and consultancy services through
the alternative method by knowing the steps that need to be taken to effect such
procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
procurement, from the preparation of bid documents, to the actual bidding activity, the
approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

FEES

CLIENT STEPS AGENCY TO PROCESSIN PERSON
ACTIONS BE G TIME RESPONSIBLE

PAID

1. Submits approved 1.1 Receives None 5 minutes Administrative

Purchase Request approve Assistant I
(PR) Purchase Procurement Section

Request (PR)

1.2 Recommends None 3 Calendar BAC
change in days
Mode of
Procurement to
Shopping
through a BAC
Resolution
approved by
the HOPE

1.3 Post items in None 3 Calendar Administrative
PhilGEPS, days Assistant III
Agency’s
website and at Procurement Section
any
conspicuous
place.

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1.4 Conducts Bid None 22 Calendar BAC, TWG
Evaluation and days
prepares
recommendatio
n/ resolution/
Notice of Award
(NOA) for
approval of the
HOPE

1.5 Prepares PO None 3 Calendar Administrative
Days Assistant III
1.6 Approves PO None
None 1 Calendar Procurement Section
1.7 Post NOA for day HOPE
information
purposes 3 Calendar BAC, BAC Secretariat
days

2. Follow-up 2. Instruct end- None 5 minutes Administrative Officer V
approved/ Status of user to proceed Procurement Section
PO to MMO for
Contract
Implementation

TOTAL None 35 Calendar days and 10 minutes

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7. Request for Procurement through Alternative Methods (Negotiated
“Two-Failed Biddings, Section 53.1 Revised IRR of RA 9184”)

This process provides end-users with clear and concise information on the public
procurement of goods, infrastructure projects and consultancy services through
the alternative method by knowing the steps that need to be taken to effect such
procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
procurement, from the preparation of bid documents, to the actual bidding activity, the
approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

CLIENT STEPS AGENCY FEES PROCESSI PERSON
ACTIONS TO BE NG TIME RESPONSIBLE
PAID

1. Submits approved 1. Receives None 5 minutes Administrative

Purchase Request approve Assistant I
(PR) Purchase Procurement Section

Request (PR)

2. Attends Pre- 2.1.1 Invite end- None 1 Calendar BAC, TWG, BAC
Procurement user to join day Secretariat
conference the Pre-
procurement
conference.

2.1.2 Conducts
Pre-
Procurement
Conference

2.2 Post None 7 Calendar Administrative
Procurement days Assistant III
opportunity in
PhilGEPS, Procurement Section
Agency’s
website and at
any
conspicuous
place.

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3. Attends Pre-bid 2.3 Negotiates with None 1 Calendar BAC
Conference suppliers, None day BAC, BAC Secretariat
contractors or
consultants 1 Calendar
day
3.1 Invites end-user
to join the pre-
bid conference

3.2 Conduct Pre- None 1 Calendar BAC, TWG, BAC
bid conference day Secretariat

3.3 Conduct
opening of bids

3.4 Conducts Bid None 52 Calendar BAC & TWG
Evaluation/Post days
-qualification

3.5 Prepares None 15 Calendar BAC, BAC Secretariat,
resolution days HOPE
recommending
award to be
approved by the
HOPE

3.6 Prepares and None 3 Calendar BAC, BAC Secretariat,
approves NOA
days HOPE

3.7 Issues None 1 Calendar BAC Secretariat

approved NOA day

3.8 Prepares and None 3 Calendar Administrative
approves days Assistant III
contract/PO
None 3 Calendar Procurement Section
3.9 Post NOA in days
Philgeps, HOPE
agency’s BAC Secretariat
website and at
any
conspicuous
place

4. Follow-up 4. Instruct end-user None 5 minutes Administrative Officer V
None Procurement Section
approved/ Status of to proceed to MMO
88 Calendar days and 10 minutes
PO for Contract

Implementation.

TOTAL

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8. Request for Procurement through Alternative Methods (Negotiated
“Emergency Cases & Small Value Procurement, Section 53.2 and 53.9
Revised IRR of RA 9184”)

This process provides end-users with clear and concise information on the public
procurement of goods, infrastructure projects and consultancy services through
the alternative method by knowing the steps that need to be taken to effect such
procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
procurement, from the preparation of bid documents, to the actual bidding activity, the
approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

FEES

CLIENT STEPS AGENCY TO PROCESSING PERSON
ACTIONS BE TIME RESPONSIBLE

PAID

1. Submits approved 1.1 Receives None 5 minutes Administrative

Purchase Request approve Assistant I
(PR) Purchase Procurement Section

Request (PR)

1.2 Prepares None 3 Calendar Administrative
resolution days Assistant III
recommending
the change in Procurement Section
mode of
procurement to
be approved
by the HOPE

1.3 Post None 7 Calendar BAC Secretariat
Procurement days
opportunities in
Philgeps,
Agency’s
website and at
any
conspicuous
place.

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1.4 Negotiates with None 1 Calendar BAC
the previous day
suppliers,
contractors or
consultants

1.5 Prepares None 15 Calendar BAC, HOPE
resolution days
recommending
award to be
approved by
the HOPE

1.6 Prepares and None 3 Calendar BAC, BAC Secretariat,
Approves NOA days HOPE

1.7 Issues None 1 Calendar BAC Secretariat

approved NOA day

1.8 Prepares and None 3 Calendar Administrative
Approves days Assistant III
Contract/PO
Procurement Section
1.9 Post NOA in None 3 Calendar
Philgeps, days HOPE
Agency’s BAC Secretariat
website and at
any
conspicuous
place.

2. Follow-up 2. Instruct end-user None 5 minutes Administrative Officer V
None Procurement Section
approved/ Status to proceed to MMO

of PO for Contract

Implementation.

TOTAL 42 Calendar days and 10 minutes

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9. Request for Procurement through Alternative Methods (Procurement
Through PS-DBM “Section 53 (e)”)

This process provides end-users with clear and concise information on the public
procurement of goods, infrastructure projects and consultancy services through
the alternative method by knowing the steps that need to be taken to effect such
procurement in the manner prescribed by RA 9184, otherwise known as the
“Government Procurement Reform Act”, and its IRR-A. This also provides the stages of
procurement, from the preparation of bid documents, to the actual bidding activity, the
approval of the contract and the contract implementation.

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

Office or Division: Procurement

Classification: Highly Technical

Type of Transaction: G2C – Government to Citizen

Who may avail: End-users

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Approved Purchase Request (PR) End-user

(1 original copy)

2. Contract / Purchase Order (PO) Procurement

(1 original copy)

FEES

CLIENT STEPS AGENCY TO PROCESS PERSON
ACTIONS BE ING TIME RESPONSIBLE

PAID

1. Submits approved 1.1 Receives None 5 minutes Administrative

Purchase Request approve Assistant I
(PR) Purchase Procurement Section

Request (PR)

1.2 Obtain the None 2 Calendar Administrative

latest price list days Officer V
& preparation of Materials Management
APR
Section

1.3 Allocates funds None 1 Calendar Administrative

day Officer V
Budget Section

1.3 Prepares None 1 Calendar Accountant III
Accounting Section
Disbursement day

Voucher

1.4 Reviews APR None 1 Calendar Supervising Administrative

day Officer
Office of the SAO

1.5 Approves APR, None 1 Calendar Medical Center Chief I
Office of the MCC
PO and day

voucher

1.6 Prepares and None 2 Calendar Administrative Officer V

approves days Cash Operations

Checks Medical Center Chief I

Office of the MCC

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1.7 Submits None 1 Calendar Administrative
Checks to PS- day Officer V
DBM
Materials Management
1.8 Coordinates None 1 Calendar Section
schedule of day
delivery. Administrative
Officer V
2. Follow-up 2. Instruct end-user None 5 minutes
approved/ Status to proceed to MMO Materials Management
of PO for Contract Section
Implementation.
Administrative Officer V
Procurement Section

TOTAL None 10 Calendar days and 10 minutes

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SUPERVISING ADMINISTRATIVE
OFFICER OFFICE

External Service

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1. Request for Data/Information under EO No. 2

The Office of the Supervising Administrative Officer is in charged in receiving request

for information under EO no. 2 which pertains to Freedom of Information (FOI). The

service rendered is open to all Filipino Citizen that wants to access/asks for

records/information

Office/Division: Office of the Supervising Administrative Officer (SAO)

Classification: Highly Technical

Type of Transaction: G2C - Government-to-Citizen

Who May Avail: Any Filipino Citizen

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Any valid government-issued Land Transportation Office, Professional
identification card (1 original copy) Regulation Commission, GSIS, SSS, OSCA,
OWWA, COMELEC
2. FOI Request Form (1 original copy) Office of the SAO

CLIENT STEPS AGENCY ACTION FEES PROCESSING PERSON
TO TIME RESPONSIBLE
1. Fills up a request 1.1 Receives, BE
form and submits evaluates and 15 working days FOI Receiving
to the FOI classifies the PAID (maybe extended Officer (FRO)
Receiving Officer information being None
with the copy of requested and with 5 working
valid ID. transmit it to the days of
FOI Decision
Maker for proper processing period
assessment. as the need
arises)

1.2 Checks if the None FOI Decision
agency holds the Maker (FDM)
information
requested, if it is
already
accessible, or if
the request is a
repeat of any
previous request.
Forwards request
to the officials
involved to locate
the requested
information.

1.3 Retrieves all None Concerned Official
relevant
information,
checks if any
exemptions
apply and
recommends
appropriate

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response to the
request.

2. Receives the 1.4 Approves or None FOI Decision
information/ denies the None Maker (FDM)
Records on the request and
desired format. notifies the FRO. FOI Receiving
Officer (FRO)
Receives notice 2. If approved,
of denial. releases 15 working days
Information/ ( 20 working days if with 5 working
Records on the
desired format. days extension)

If denied, informs
of denial.

TOTAL None

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ADMITTING/INFORMATION UNIT

External Services

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1. Availment on Re-issuance of Patients Hospital Identification Card

This process starts from the time the patient /significant other request and provides
patient’s data for the re-issuance of Patient’s Identification Card and ends after he/she
received the Hospital ID card with the existing hospital number which serves as the
patient’s permanent record in this health facility.

Availability of Service: Monday –Sunday (24 hours)

Office or Division: Admitting/Information Unit

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who may avail: Patients managed at the Emergency Room

(Old Patient with lost Hospital ID)

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Charge Slip (1 original copy) Admitting Section Window 1

CLIENT STEPS AGENCY FEES PROCESSING PERSON
ACTIONS TO TIME RESPONSIBLE
BE
1. Requests at the 1. Checks in the PAID 8 minutes Administrative Officer II
admitting staff for computer for None Admitting/Information
the re-issuance of the patient’s
Hospital ID and existing None Unit
provides patient’s hospital record
data Php 3 minutes Administrative Officer II
2. Issues charge 30.00 Admitting/Information
2. Receives charge slip and
slip and proceeds directs to None Unit
to cashier for cashier for
payment payment of None 20 minutes Administrative Officer V
charges Cash Operations
3. Presents charge Php Section
slip and pays 3. Issues official 30.00
corresponding receipt 3 minutes Administrative Officer II
amount Admitting/Information
*Cashier will
4. Returns to stamped “Paid” with Unit
admitting section OR Number on the
and presents charge slip 3 minutes Administrative Officer II
stamped paid Admitting/Information
charge slip with 4. Receives
OR number stamped paid Unit
charge slip
5. Receives Patient’s with OR
identification Card number

5. Issues
Patient’s
Identification
Card

TOTAL 37 minutes

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2. Request for Patient’s Data Correction

This service involves the processing of availment of patient’s data correction from the
time the client requests from the admitting staff for any corrections on the patient’s data
until the receives notification for data changes.

Availability of Service: Monday –Sunday (24 hours)

Office or Division: Medical and Ancillary / Admitting Section

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who may avail: In-Patients

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Any Valid ID (1 original) BIR, Post Office, DFA, PSA, SSS, GSIS,

PAG-IBIG, LTO, COMELEC, Church, Employer

2. Patient’s Data Correction Form (PDCF) Admitting Section Window 1
(1 original copy)

CLIENT STEPS AGENCY FEES PROCESSING PERSON
ACTIONS TO TIME RESPONSIBLE
BE
1. Request from the 1. Retrieves the PAID 10 minutes Administrative Officer II
Admitting Staff for patient’s data Admitting Section
any corrections on from the None
the patients’ data IHOMIS,
and fills-out PDCF. verifies with the
filled-out
admission slip
and instructs
the patient/
watcher to
provide any
valid document
to support the
changes and
provides PDCF

2. Submits 2. Receives PDCF None 10 minutes Administrative Officer II
None Admitting Section
accomplished with the valid

PDCF together documents and

with photocopy of corrects the

any valid patient’s data

document needed and notifies

to support the client for the

changes and data changes.

receives

notification for the

data changes.

TOTAL 20 minutes

74 | P a g e

DENTAL

External Service

75 | P a g e

1. Availment of Dental Service

This process starts with presenting the OPD Form until receiving of dental procedures
and instructions for oral care:

Availability of Service: Monday to Friday; 8:00 am to 5:00 pm, except holidays

Office or Division: Dental

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who may avail: Out-Patient Clients

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Out Patient Department (OPD) Form Out-Patient Department Triage

(1 original copy)

2. Stamped-Paid Charge Slip Cash Operations

(1 original copy)

3. Medical Social Work (MSW) Stamped Medical Social Work (MSW)

Charge Slip (1 original)

Situational Requirements:

For Aerosol Generated Procedures Accreditted COVID Testing Lab
and Complicated Extractions:
Negative - Rapid Antigen Test Result
(1 original copy)

If with COVID related symptoms: Accreditted COVID Testing Lab
Negative RT-PCR Result (3 days prior
the procedure) (1 original copy)

CLIENT STEPS AGENCY FEES PROCESSING PERSON
ACTIONS TO BE TIME RESPONSIBLE
PAID
1. Presents OPD 1. Receives None 10 minutes Dental Aide
Form OPD Form Dental
for initial
examination

2.a Receives 2.a Issues None 5 minutes Dentist II
prescription and prescription None Dental
charge slip then & charge
proceeds to slip and 17 minutes Social Welfare Officer I
cashier for instructs Medical Social Work
payment. client to go
to cashier
*If patient will avail for for payment
medical assistance
2.b Processes
2.b Proceeds to MSW Availment of
for Availment of medical
medical assistance
assistance

76 | P a g e

If with excess: *MSW on Duty Php 20 minutes Administrative Officer V
Proceeds to cashier stamps on the charge 300.00 Cash Operations
(Step 3) slip Section
If no excess:
Proceeds to Step 4 3. Issues
Official
3. Presents charge Receipt.
slip and/or
prescription and *Cashier on duty will
pays corresponding stamped “Paid”
amount with OR Number on
the charge slip

4. Returns to Dental 4. Initiates None 1 hour Dentist II
Clinic and presents Dental Dental
stamped “Paid” Procedures
charge slip with OR None 5 minutes Dentist II
Number/MSS 5. Gives final Dental
Stamped charge oral care
Slip instruction

5. Receives
instruction for oral
care

Php 1 hour & 40 minutes
300.00

*If patient *If patient will avail for medical assistance
will avail
1 hour & 57 minutes
for
TOTAL medical
assistance
Amount to
be paid
depends
on the
discount

given

77 | P a g e

HEALTH INFORMATION
MANAGEMENT SECTION

External Services

78 | P a g e

1. Facilitate Completion of Insurance Forms

This service involves the process of facilitating the completion of insurance forms from
the time the client presents request form until the time the clients receives the filled up
forms from the doctor. In order for the client to avail the service, the following steps are
to be followed:

Availability of Service: Monday to Friday 8:00 AM to 5:00 PM except on Holidays.

Next of kin refers to the following: spouse, parents, children, and sibling/s.

Office or Division: Medical and Ancillary / Health Information Management Service

Classification: Highly Technical

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

Government

Who may avail: Patient

Next of kin/ Authorized Representative

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Primary requirements for principal:

(includes Parent of minor patient):

1. Duly Accomplished Request Form HIMS Window 1

(1 original copy)

2. Valid ID (1 photocopy) GSIS, SSS, Pag-ibig, LTO, DFA, COMELEC,

PhilHealth, BIR, PHLPost, LGU/Barangay,

School, Employer, Admitting Section Window 1

3. Charge Slip (1 original copy) HIMS Window 1
4. Stamped “Paid” Charge Slip with OR Cash Operations Section Window 1
HIMS Window 1
Number (1 original copy) Insurance Office
5. Claim Stub (1 original copy)
6. Insurance Form (from the client) GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
PhilHealth, BIR, PHLPost, LGU/Barangay,
(1 original copy) School, Employer
Situational Requirements (additional
requirements):
Authorized Representative:
7. Valid ID (1 photocopy)

8. Authorization letter/Special Power of Requesting party (patient/principal)
Attorney (1 original copy)

CLIENT STEPS AGENCY FEES PROCESSING PERSON
ACTIONS TO BE TIME RESPONSIBLE
1. Presents duly PAID
accomplished 1. Receives duly None 15 minutes Administrative Officer V
request form accomplished HIM Section
together with the request form
documentary together with
requirements and the
documentary

79 | P a g e

undertakes requirements
interview and interviews
client.

2. Receives charge 2. Issues charge None 2 minutes Administrative Officer V
slip and proceeds slip and HIM Section
to cashier for directs to Php
payment cashier for 150.00 20 minutes Administrative Officer V
payment of Cash Operations
3. Presents charge charges None Section
slip and pays
corresponding 3. Issues official 14 days Administrative Officer V
amount receipt HIM Section

4.1 Returns to *Cashier on duty
Health will stamped
Information “Paid” with OR
Management Number on the
Office and charge slip
presents
Stamped paid 4. 1Receives
charge slip with stamped paid
OR Number charge slip
with OR
number and
retrieves the
health record
and endorsed
to attending
physician for
form
completion
and sign

4.2 Receives claim 4.2 Gives claim None 2 minutes Administrative Officer V
stub and stub and HIM Section
instruction/s if instruction/s if
any any

5.1 Presents Claim 5.1 Receives None 2 minutes Administrative Officer V
Stub and signs claim stub and HIM Section
the insurance Instructs client None
releasing logbook to sign the Php 2 minutes Administrative Officer V
insurance 150.00 HIM Section
5.2 Receives the releasing
completed logbook
Insurance Forms
5.2 Releases the
completed
Insurance
Forms

TOTAL 14 days and 43 minutes

80 | P a g e

2. Issuance of Various Photocopied Health Records

This service involves the processing of issuance of various photocopied health records
from the time the client presents the duly accomplished request form for a photocopied
health records up to the releasing of health records like laboratory/diagnostic results,
records of operations, medical abstract, discharge summary and issued certificates. This
excludes initial releasing of certain diagnostic health records and patient for transfer per
doctor’s order. In order for the client to avail the service, the following steps are to be
followed:

Availability of Service: Monday to Friday 8:00 AM to 5:00 PM
Saturday and Sunday 8: AM to 12:00 PM except on Holidays.

Next of kin refers to the following: spouse, parents, children, and sibling/s.

Office or Division: Medical and Ancillary / Health Information Management Service

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who may avail: a.) Spouse and next of kin of the deceased or their Authorized

Representative/Patient

b.) Next of kin/ Authorized Representative/Guardian

c.) Courts and Administrative bodies exercising quasi-judicial and/or

investigative function

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Primary requirements for principal

(includes Parent of minor patient):

1. Duly Accomplished Request Form HIM Window 1

(1 original copy)

2. Any Valid ID (1 photocopy) GSIS, SSS, PagIbig, LTO, DFA, COMELEC,

PhilHealth, BIR, PHLPost, LGU/Barangay,

School, Employer, Admitting Section Window 1

3. Charge Slip (1 original copy) HIM Window 1

4. Stamped “Paid” Charge Slip with OR Cashier Window 1

Number (1 original copy)

Situational Requirements (additional

requirements):

Authorized Representative:

5. Any Valid ID (1 photocopy) GSIS, SSS, PagIbig, LTO, DFA, COMELEC,

PhilHealth, BIR, PHLPost, LGU/Barangay,

School, Employer

6. Authorization letter/Special Power of Requesting party (patient/principal)

Attorney (1 original copy)

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

1. Presents duly 1. Receives duly None 15 minutes Administrative Officer V

accomplished accomplished HIM Section

request form request form

together with the together with

documentary the

81 | P a g e

requirements and documentary None 2 minutes Administrative Officer V
undertakes requirements None HIM Section
interview and interviews
client.
2. Receives charge 2.1. Issues charge
slip and proceeds slip and
to cashier for directs to
payment cashier for
payment of
charges 3 hours Administrative Officer V
2.2 Retrieves 20 minutes Cash Operations
patient’s chart Section

3. Presents charge 3. Issues official Php Administrative Officer V
slip and pays receipt 2.00/ HIM Section
corresponding copy
amount *Cashier on duty will 15 minutes Administrative Officer V
stamped “Paid” with None HIM Section
4.1 Returns to Health OR Number on the
Information None 3 minutes Administrative Officer V
Management charge slip HIM Section
Office and Php
presents Stamped 4.1 Receives 2.00/
paid charge stamped copy
slip with OR paid charge
Number slip with OR
number and
4.2 Receives photocopy the
photocopied requested
health record/s health
record/s

4.2 Releases the
photocopied
health
record/s

TOTAL 3 hours and 55 minutes

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3. Issuance of Unregistered Death Certificate

This service involves the processing of Issuance of Unregistered Death Certificate from
the time the client presents duly accomplished request form until the time the clients
receives the Unregistered Death Certificate (for Inpatient & Emergency Room, except for
Dead on Arrival). Further, this service is necessary for the registration of Death
Certificate at the Local Civil Registry. In order for the client to avail the service, the
following steps are to be followed:

Availability of Service: Monday to Friday 8:00 AM to 5:00 PM
Saturday and Sunday 8: AM to 12:00 PM except on Holidays.

Next of kin refers to the following: spouse, parents, children, and sibling/s.

Office or Division: Medical and Ancillary / Health Information Management Service

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who may avail: Next of Kin of the deceased or their Authorized Representative

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Primary requirements for principal:

(includes Parent of minor patient):

1. Duly Accomplished Request Form HIMS Window 1

(1 original copy)

2. Valid ID (1 photocopy) GSIS, SSS, Pag-ibig, LTO, DFA, COMELEC,

PhilHealth, BIR, PHLPost, LGU/Barangay,

School, Employer

3. Hospital Card (1 original copy) Admitting Section Window 1

4. Charge Slip (1 original copy) HIMS Window 1

5. Stamped “Paid” Charge Slip with OR Cash Operations Section Window 1

Number (1 original copy)

6. Duly Signed Waiver Form HIMS Window 1

(1 original copy)

7. Claim Stub (1 original copy) HIMS Window 1

Situational Requirements (additional

requirements):

Authorized Representative:

8. Any Valid ID (1 photocopy) GSIS, SSS, PagIbig, LTO, DFA, COMELEC,

PhilHealth, BIR, PHLPost, LGU/Barangay,

School, Employer

9. Authorization letter/Special Power of Requesting party
Attorney (1 original copy)

CLIENT STEPS AGENCY FEES PROCESSING PERSON
ACTIONS TO BE TIME RESPONSIBLE
PAID
1. Presents duly 1. Receives duly None 15 minutes Administrative Officer V
accomplished accomplished HIM Section
request form request form
together with the together with
documentary the
requirements and documentary

83 | P a g e

undertakes requirements
interview and interviews
client.

2. Receives charge 2.1 Issues charge None 2 minutes Administrative Officer V
slip and proceeds slip and HIM Section
to cashier for directs to None
payment cashier for 3 hours Administrative Officer V
payment of Php HIM Section
3. Presents charge charges 50.00
slip and pays None 20 minutes Administrative Officer V
corresponding 2.2 Retrieves Cash Operations
amount patient’s chart Section
and validates
4.1 Returns to Health the entries in 2 days Administrative Officer V
Information the Death HIM Section
Management Certificate
Office and Draft
presents Stamped
paid charge slip 3. Issues official
with OR Number receipt
then validates
entries and *Cashier on duty will
receives claim stamped “Paid” with
stub and OR Number on the
instruction/s if any charge slip

4.1 Receives
stamped paid
charge slip
with OR
number then
prepares the
Death
Certificate
then gives
claim stub and
instruction/s if
any

4.2 Presents Claim 4.2 Receives None 2 minutes Administrative Officer V
Stub and signs the claim stub and HIM Section
releasing logbook instructs client
to sign the
releasing
logbook

4.3 Receives the 4.3 Releases the None 3 minutes Administrative Officer V
unregistered unregistered HIM Section
Death Certificate Death Php
Certificate 50.00

TOTAL 2 days, 3 hours and 42 minutes

84 | P a g e

4. Issuance of Various Certificates

This service involves the processing of Issuance of Various Certificates such as
Certificate of Confinement, Medical Certificate and Other Certificates from the time
the client presents duly accomplished request form until the time the client receives
the requested certificate. For detainees and WCPU cases no charges shall be applied. In
order for the client to avail the service, the following steps are to be followed:

Availability of Service: Monday to Friday 8:00 AM to 5:00 PM except Holidays.

Next of kin refers to the following: spouse, parents, children, and sibling/s.

Office or Division: Medical and Ancillary / Health Information Management Service

Classification: Simple

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

Who may avail: Patient

Next of kin/ Authorized Representative

Courts and Administrative bodies exercising quasi-judicial and/or

investigative function

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Primary requirements for principal: HIMS Window 1
(includes Parent of minor patient):
1. Duly Accomplished Request Form GSIS, SSS, Pag-ibig, LTO, DFA, COMELEC,
PhilHealth, BIR, PHLPost, LGU/Barangay, School,
(1 original copy) Employer
2. Any Valid ID (1 photocopy) Admitting Section Window 1
HIMS Window 1
3. Hospital Card (1 original copy) Cash Operations Section Window 1
4. Charge Slip (1 original copy)
5. Stamped “Paid” Charge Slip with OR HIMS Window 1

Number (1 original copy)
6. Claim Stub (1 original copy)

Situational Requirements (additional GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
requirements): PhilHealth, BIR, PHLPost, LGU/Barangay, School,
Authorized Representative: Employer
7. Any Valid ID (1 photocopy)

8. Authorization letter/Special Power of Requesting party (patient/principal)

Attorney, Affidavit of guardianship (for

minor with no next of kin)

(1 original copy)

CLIENT STEPS AGENCY FEES PROCESSING PERSON
TO BE TIME RESPONSIBLE
ACTIONS PAID
None 15 minutes Administrative Officer V
1. Presents duly 1. Receives duly HIM Section
accomplished accomplished
request form request form
together with the together with the
documentary documentary

85 | P a g e

requirements and requirements None 2 minutes Administrative Officer V
undertakes and interviews HIM Section
interview client.
2. Receives charge 2.1 Issues charge
slip and proceeds to
cashier for payment slip and
directs to
cashier for
payment of
charges

3. Presents charge slip 2.2 Retrieves None 3 hours Administrative Officer V
and pays patient’s chart Php 20 minutes HIM Section
corresponding 30.00
amount 3. Issues official Administrative Officer V
receipt None Cash Operations
4.1 Returns to Health Section
Information *Cashier on duty
Management will stamped “Paid”
Office and presents with OR Number on
Stamped paid
charge slip with OR the charge slip
Number 4.1 Receives

stamped paid 4 hours
charge slip with 2 days
OR number and 2 minutes
prepares the 2 minutes
Certifications

a. Certificate of
Confinement

4.2 Receives claim b. Medical None Administrative Officer V
stub and Certificates / None HIM Section
instruction/s if any Other
Certificates Administrative Officer V
HIM Section
4.2 Gives claim
stub and Administrative Officer V
instruction/s if HIM Section
any
Administrative Officer V
5. Presents Claim 5.1 Receives claim None HIM Section

Stub and Signs the stub and None
Php
hospital copy of Instructs client 30.00

requested to sign the

Certificate hospital copy of

the

requested

certificate

5.2 Releases the 2 minutes
Administrative Officer V
requested HIM Section

certificate For Certificate of Confinement:
7 hours and 43 minutes
TOTAL
For Medical Certificates/Other
Certificates

2 days, 3 hours and 43 minutes

86 | P a g e

5. Issuance of Medico-Legal Certificates

This service involves the processing of Medico-Legal Certificates from the time
the client presents duly accomplished request form until the time the clients
receives the requested certificate. For detainees and WCPU cases no charges
shall be applied. In order for the client to avail the service, the following steps
are to be followed:

Availability of Service: Monday to Friday 8:00 AM to 5:00 PM except on
Holidays.

Next of kin refers to the following: spouse, parents, children, and sibling/s.

Office or Division: Medical and Ancillary / Health Information Management Service

Classification: Complex

Type of Transaction: G2C – Government to Citizen

G2G – Government to Government

Who may avail: Patient

Next of kin/ Authorized Representative

Courts and Administrative bodies exercising quasi-judicial and/or

investigative function

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Primary requirements for principal: HIM Window 1
(includes Parent of minor patient):
1. Duly Accomplished Request Form GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
PhilHealth, BIR, PHLPost, LGU/Barangay,
(1 original copy) School, Employer, Admitting Section Window 1
2. Valid ID (1 photocopy)

3. Charge Slip (1 original copy) HIM Window 1

4. Stamped “Paid” Charge Slip with OR Number Cashier Window 1
(1 original copy) HIM Window 1
Clerk of Court, PNP, NBI and enforcement
5. Claim Stub (1 original copy) agencies
6. Court Order/ Police Request indicating the
GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
name of the authorized claimant PhilHealth, BIR, PHLPost, LGU/Barangay,
(1 original copy) School, Employer
Situational Requirements (additional
requirements):
Authorized Representative:
7. Valid ID (1 photocopy)

8. Authorization letter/Special Power of Attorney, Requesting party (patient/principal)
Affidavit of guardianship (for minor with no
next of kin) (1 original copy)

87 | P a g e

CLIENT STEPS AGENCY FEES TO PROCESSIN PERSON RESPONSIBLE
ACTION BE PAID G TIME Administrative Officer V
1. Presents duly HIM Section
accomplished 2. Receives duly None 15 minutes
request form accomplished Administrative Officer V
together with the request form None 2 minutes HIM Section
documentary together with
requirements and the None 1 hour Administrative Officer V
undertakes documentary Php50.00 20 minutes HIM Section
interview requirements
and interviews None 6 days Administrative Officer V
2.1 Receives charge client. Cash Operation Section
slip and proceeds
to cashier for 2.1 Issues charge Administrative Officer V
payment slip and HIM Section
directs to
3. Presents charge cashier for
slip and pays payment of
corresponding charges
amount
2.2 Retrieves
4.1 Returns to Health patient’s chart
Information
Management 3. Issues official
Office and receipt:
presents
Stamped paid *Cashier on duty will
charge slip with stamped “Paid” with
OR Number OR Number on the
charge slip

4.1 Receives
stamped paid
charge slip
with OR
number and
prepares the
Certifications

4.2 Receives claim 4.2 Gives claim None 2 minutes Administrative Officer V
stub and stub and None HIM Section
instruction/s if any instruction/s if
any None 2 minutes Administrative Officer V
5.1 Presents Claim Php 50.00 HIM Section
Stub and Signs 5.1 Receives
the hospital copy claim stub 2 minutes Administrative Officer V
of requested and Instructs HIM Section
Certificate client to sign
the hospital
5.2 Receives the copy of the
requested requested
certificate certificate

5.2 Releases the
requested
certificate

TOTAL 6 days, 1 hour and 43 minutes

88 | P a g e

6. Processing of Unregistered Certificate of Live Birth

This service involves the processing of Unregistered Certificate of Live Birth from the
time the client presents duly accomplished request form until the completion of certificate
of live birth form or the issuance of unregistered certificate of live birth for personal
submission. Further, this service is necessary for the registration of Certificate of Live
Birth at the Local Civil Registry. In order for the client to avail the service, the following
steps are to be followed:

Availability of Service: Monday to Friday 8:00 AM to 5:00 PM
Saturday and Sunday 8: AM to 12:00 PM except on Holidays.

Principal: Parents, Next of Kin

Office or Division: Medical and Ancillary / Health Information Management Service

Classification: Simple

Type of Transaction: G2C – Government to Citizen

Who may avail: Parents

Authorized Representative

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

Primary requirements for principal

1. Duly Accomplished Request Form HIMS Window 1

(1 original copy)

2. Charge Slip (1 original copy) HIMS Window 1

3. Stamped “Paid” Charge Slip with OR Cashier Window 1

Number (1 original copy)

Situational Requirements (additional GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
requirements): PhilHealth, BIR, PHLPost, LGU/Barangay, School,
Authorized Representative: Employer, Admitting/Information Unit
4. Valid ID (1 photocopy)

5. Authorization letter/Special Power of Requesting Party
Attorney (1 original copy)

For Married: LCR/PSA
6. Marriage Certificate (1 photocopy)

For Unmarried(Mother): LCR/PSA
Any of the following as mentioned Church
respectively: GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
6. Certificate of Live Birth (1 photocopy) PhilHealth, BIR, PHLPost, LGU/Barangay, School,
Employer, Admitting/Information Unit
Baptismal Certificate (1 photocopy)
Valid ID (1 photocopy) LCR/PSA
Church
For unmarried father of the child who GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
opted to acknowledge and/or to use his
surname:
6. Certificate of Live Birth (1 photocopy)

Baptismal Certificate (1 photocopy)
Valid ID (1 photocopy)

89 | P a g e

PhilHealth, BIR, PHLPost, LGU/Barangay, School,
Employer, Admitting/Information Unit

For personal submission of Certificate of HIM WINDOW 1
Live Birth to LCR(additional requirements:
6. Notarized Waiver Form (1 original) HIM WINDOW 1
7. Claim Stub (1 original copy)

CLIENT STEPS AGENCY FEES PROCESSING PERSON
ACTIONS TO BE TIME RESPONSIBLE
PAID Administrative Officer V

1. Presents duly 1. Receives duly None 10 minutes HIM Section
accomplished accomplished
request form request form None 2 minutes Administrative Officer V
together with the together with HIM Section
documentary the None 10 minutes
requirements and documentary Administrative Officer V
undertakes requirements Php 20 minutes HIM Section
interview and interviews 50.00
client. Administrative Officer V
2. Receives charge None 13 minutes Cash Operations
slip and proceeds 2.1 Issues charge Section
to cashier for slip and
payment directs to Administrative Officer V
cashier for HIM Section
3. Presents charge payment of
slip and pays charges
corresponding
amount 2.2 Retrieves
patient’s Birth
For hospital Certificate
submission of (Draft)
Certificate of Live
Birth to LCR 3. Issues official
4.a.1 Returns to receipt
Health Information
Management Office *Cashier on duty will
and presents stamped “Paid” with
Stamped paid charge OR Number on the
slip with OR Number charge slip

4.a.1 Receives
stamped
paid charge
slip with OR
number and
prepares the
Birth
Certificate

90 | P a g e

4.a.2 Reviews the 4.a.2 Shows the None 5 minutes Administrative Officer V
correctness of entries draft for None 2 days HIM Section
at the birth certificate verification
draft and receives and gives Administrative Officer V
instruction/s if any instruction/s HIM Section
if any
For personal
submission of 4.b.1 Receives
Certificate of Live stamped paid
Birth to LCR charge slip with
4.b.1 Returns to OR number then
Health Information prepares the Birth
Management Office Certificate then
and presents gives claim stub
Stamped paid charge and instruction/s if
slip with OR Number any
then validates entries
and receives claim
stub and instruction/s
if any

4.b.2 Presents Claim 4.b.2 Receives None 3 minutes Administrative Officer V
Stub then sign the claim stub and HIM Section
releasing logbook instructs client to None
sign the releasing Php
logbook 50.00

4.b.3 Receives the 4.b.3 Releases 3 minutes Administrative Officer V
unregistered the unregistered HIM Section
Certificate of Live Certificate of Live
Birth Certificate Birth

TOTAL For hospital submission of Certificate
of Live Birth to LCR
1 hour

For personal submission of Certificate
of Live Birth to LCR
2 days and 48 minutes

91 | P a g e

CLINICAL PATHOLOGY DEPARTMENT

External Services

92 | P a g e

1. Availment of Blood Units

The service involves storage and releasing of blood units, compatibility testing &
antibody screening, testing for transfusion transmissible infection and releasing of blood
units to outpatients who avail this service. This service involves in processing of
availment of blood units from the time the client presents blood request form until the
time of acquisition of blood unit.

Availability of Service: Monday to Sunday (24 hours)

Office or Division: Clinical Pathology Department

Classification: Simple

Type of Transaction: G2C-Government to Citizen; G2B-Government to Business;

G2G-Government to Government

Who may avail: Out-Patients/Walk-in Patients that needs blood units

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

1. Blood Request Form (1 original copy) Requesting Physician

2. Charge Slip (1 original copy) Clinical Pathology Department

CLIENT STEPS AGENCY FEES TO PROCESSIN PERSON
ACTIONS
BE PAID G TIME RESPONSIBLE

1.1 Presents blood 1.1Receives and None 5 minutes Laboratory Aide III
request form assesses the Clinical Pathology
request form
Department

1.2 Waits for the 1.2Checks for the None 15 minutes Medical
advice on blood availability of Technologist III
unit availability blood unit Clinical Pathology
requested
Department
1.3 Secures a 1.3Instructs client None 10 minutes
container with ice to provide 2 minutes Medical
pack for the transport None 20 minutes Technologist III
transportation of container and Clinical Pathology
blood unit(s) ice packs. Refer to
fees for Department
2. Receives charge 2. Issues charge
slip slip and directs the Laboratory Aide III
and proceeds to to cashier for specific Clinical Pathology
cashier for payment of procedure
payment blood screening Department
fee of the blood
3. Presents charge unit(s). Administrative
slip and pays Officer V
corresponding 3. Issues official
amount receipt Cash Operations
Section

4. Presents Stamped 4. Receives None 30 minutes Medical
Technologist III
paid charge slip Charge Slip and Clinical Pathology

with OR Number instructs client

93 | P a g e

and waits while to wait while Department
the blood unit(s) blood unit is
is prepared being packed None 5 minutes Medical
for transport. Technologist III
5. Gets the donor’s 5. Hands-over the Refer to Clinical Pathology
screening result donor’s fees for the
together with the screening result Department
packed blood unit separately from specific
the packed procedure
blood unit(s)

TOTAL 1 hour and 27 minutes

PRICELIST FOR BLOOD UNITS PRICE
As of March 23, 2022 1,800.00
1,500.00
SERVICES / SUPPLIES 1,000.00
Whole Blood
Packed RBC 150.00
Platelet and other blood

components
Crossmatching

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2. Availment of Laboratory Services for Out-Patients

Clinical Pathology services are sought to assist the clinical management of patients.
Various procedures within the scope of its license as a secondary laboratory can be
availed by Outpatients. This service involves processing for availment of laboratory
services from the time the client presents laboratory request until the client receives the
result.

ROUTINE TESTS INCLUDES: Routine Blood SPECIAL TESTS
 Complete Blood Count (with Platelet) Chemistry INCLUDE:
 Gram Staining
 Urinalysis  FBS/RBS  KOH
 HIV Testing
 Fecalysis/ Stool Exam  BUN  HbsAg
 Blood Typing  Creatinine

 Lipid Profile

 BUA

 SGPT

 SGOT

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

Office or Division: Clinical Pathology Department

Classification: Simple

Type of Transaction: G2C-Government to Citizen; G2B-Government to Business;

G2G-Government to Government

Who may avail: Out-Patients

CHECKLIST OF REQUIREMENTS WHERE TO SECURE

For conduct of procedure:

1. Completely filled up laboratory request Requesting Agency / OPD

(1 original copy) Cashier/MSW

2. Official Receipt/ Stamped Paid with OR Clinical Pathology Department
number or MSW Stamped Charge Slip or

its equivalent (1 original copy)

For Releasing of Result: Clinical Pathology Department
Claim Slip (1 original copy)

*For lost claim slip: GSIS, SSS, PagIbig, LTO, DFA, COMELEC,
Valid ID (patient/client) (1 photocopy/original) PhilHealth, BIR, PHLPost, LGU/Barangay, School,
Employer, Hospital

CLIENT STEPS AGENCY FEES TO PROCESS PERSON
ACTIONS BE PAID ING TIME RESPONSIBLE
1. Presents Laboratory
request/s and 1. Reviews None 10 minutes Laboratory Aide III
receives submitted Clinical Pathology
instruction/s for the Laboratory
procedure request/s and Department
provides
instructions
for the
procedure

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2.a Receives charge 2.a.1 Generates None 10 minutes Laboratory Aide III
slip and proceeds Charge Slip Clinical Pathology
to cashier for None 2 minutes
payment 2.a.2 Issues Department
charge slip None 17 minutes Laboratory Aide III
*If patient will avail and directs to Clinical Pathology
for medical cashier for
assistance payment of Department
2.b Proceeds to MSS charges
Social Welfare
for Availment of 2.b Process Officer III
medical assistance Availment of
medical Medical Social Work
If with excess: Assistance
Administrative
Proceed to cashier for *MSW staff will Officer V
Payment Stamped on the charge
slip Cash Operations
Section
If no excess: 3. Issues official Refer to fees 20 minutes
Proceeds to Step 4.1: receipt for the Laboratory Aide III
specific Clinical Pathology
3. Presents charge slip *Cashier on duty will
for payment and stamped “Paid” with OR procedure Department
pays Number on the charge
corresponding slip None 3 minutes
amount
4.1 Receives
4.1 Presents Stamped stamped paid
paid charge slip charge slip
with OR Number / with OR
MSS Stamped number / MSS
Charge Slip Stamped
together with the charge slip
laboratory then receives
request/s laboratory
request/s

4.2 Presents self for 4.2 Verifies the None 10 minutes Medical
sample extraction clients’ Technologist III
and/or gives information Clinical Pathology
sample then proceeds
to extraction Department
and/or receive
specimen

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4.3 Receives claim slip 4.3 Provides None 2 minutes Laboratory Aide III
and waits for the claim slip for Clinical Pathology
result the claiming of
results Department

4.4 Processes None Routine: Medical
and analyzes None within 4 Technologist III
specimen hours upon
according to receiving of Laboratory
the procedure samples
requested Medical
Routine Technologist III
7. Presents claim slip 5. Gets and Blood
and signs verifies claim Chemistry: Laboratory
Releasing Logbook slip and 8 hours
upon claiming the releases upon
Laboratory Results laboratory receiving of
results samples
5 minutes

TOTAL Check Routine:
schedule of 4 hours and 49 minutes
*If patient will avail for medical
fees
assistance
*If patient = 5 hours and 3 minutes
will avail for
Routine Blood Chemistry:
medical 8 hours and 49 minutes
assistance *If patient will avail for medical

Depends on assistance
the = 9 hours and 3 minutes

assistance
availed

CLINICAL PATHOLOGY DEPARTMENT Price
PRICELIST AS OF MARCH 23, 2022
350.00
SN Tests 150.00
1 Alkaline Phosphatase 450.00
2 Albumin
3 APTT 90.00
4 Blood Typing 950.00
5 bHCG 125.00
6 BUA 150.00
7 BUN 250.00
8 Bilirubin

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9 Bilirubin (T,D, I) 350.00
10 CA 125 1,000.00
11 Creatinine
12 CBC only 145.00
13 CBC with Platelet 175.00
14 Chloride 210.00
15 Calcium 250.00
16 Cholesterol 275.00
17 CTBT 200.00
18 Dengue Antibody
19 Dengue NS1 Antigen 75.00
20 ESR 650.00
21 Fasting Blood Sugar 300.00
22 Fecalysis 150.00
23 FT3
24 FT4 95.00
25 Gram staiing 100.00
26 HBA1c 850.00
27 Hemoglobin/hematocrit 850.00
28 HBsAg (screening-rapid) 150.00
29 HCV (screening- rapid) 700.00
30 HIV ½ (screening-rapid) 145.00
31 H. pylori 250.00
32 HDL/LDL 330.00
33 KOH 165.00
34 Lipid profile 500.00
35 Magnesium 400.00
36 Occult Blood 200.00
37 OGTT 550.00
38 Potassium 300.00
39 Protime 175.00
40 Pregnancy Test 500.00
41 Random Blood Sugar 275.00
42 Reticulocyte 450.00
43 Sodium 150.00
44 Sodium and Potassium
45 SGOT 85.00
46 SGPT 150.00
47 Syphilis (screening-rapid) 275.00
48 Salmonella 500.00
49 Total Protein 200.00
50 Triglycerides 200.00
51 Trop I (Qualitative) 100.00
43 Sodium 600.00
44 Sodium and Potassium 150.00
45 SGOT 200.00
46 SGPT 1,000.00
47 Syphilis (screening-rapid) 275.00
48 Salmonella 500.00
49 Total Protein 200.00
200.00
100.00
600.00
150.00

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50 Triglycerides 200.00
51 Trop I (Qualitative) 1,000.00
52 Trop T 1,000.00
53 TSH
54 TPAG 900.00
55 T3 350.00
56 T4 700.00
57 Urinalysis 700.00
100.00
Blood Services Screening Fee
58 Whole Blood 1,800.00
59 Packed RBC 1,500.00
60 Platelet and other blood components 1,000.00
61 Crossmatching
150.00
Biopsy (send outs)
62 Small-medium 1,250.00
63 Large 1,800.00
64 Radical 1,900.00
65 Cytology 1,200.00

Send Outs 2,000.00
66 Alpha Feto Protein 1,900.00
67 Amylase 2,700.00
68 CEA 3,500.00
69 Culture and Sensitivity (blood) 2,900.00
70 Culture and Sensitivity (wound) 2,400.00
71 Lipase 2,000.00
72 Peripheral Blood Smear

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