REP. PEDRO G.

TRONO MEMORIAL HOSPITAL

Guimbal, Iloilo

ACCOMPLISHMENT REPORT
FOR THE MONTH OF _______________________________

NAME: _______________________________ Area of Assignment/Office: _________________

Designation: __________________________ Division: ________________________________

Remarks (# of
Done Not Done High Risk Low Risk
Function and Duties Functions Done)
Medical Technologist

1. Participates in the quality Assurance Program

of the laboratory

2. Receives laboratory specimen for examination.

3. Collects blood specimen for examination

4. Process specimen for examination

5. Performs all laboratory examination available in

the laboratory.

6. Release laboratory results and counter signed by

regular medical technologist staff on duty

7. Prepares and signed patient charge slip

8. Performs other related functions

9. Attends seminar, workshop and training as part of

continuing education program.

Please rate the following(if):

1. - Very Good Prepared by:______________________________________
2. - Satisfactory
3. - Poor
Approved: By:

*Indicate Number of functions done in the Remarks

section ULYSSES G. GILO
 Admin. Officer IV

Noted By:

RAFAEL S. SABANDO, M.D., DPAMS,FICS, FPSMS

Chief of Hospital II
 REP. PEDRO G. TRONO MEMORIAL HOSPITAL
Guimbal, Iloilo

ACCOMPLISHMENT REPORT
FOR THE MONTH OF _______________________________

NAME: _______________________________ Area of Assignment/Office: _________________

Designation: __________________________ Division: ________________________________

Remarks (# of
Done Not Done High Risk
Function and Duties Functions Done)
Dental Aide

1. Receives and record all dental patients.

2. Checks vital signs.

3. Assists the Dentist in all dental activities.

4. Sets up tray.

5. Does charting / new patients.

6. Maintains the cleanliness and sterilization

of all dental instruments and supplies.

7. Assists patients for referral to medical officer

and ward visit.

8.Maintains the cleanliness of the dental clinic.

9. Attends meetings and conferences.

Please rate the following(if):

1. - Very Good Prepared by: ______________________________________
2. - Satisfactory
3. - Poor
Approved: By:

*Indicate Number of functions done in the Remarks

section ANA MARIA C. BELLEZA, DMD
Dentist II
Noted By:

RAFAEL S. SABANDO, M.D., DPAMS,FICS, FPSMS

Chief of Hospital II
Area of Assignment/Office: _________________

Division: ________________________________

Low Risk

______________________________________
 REP. PEDRO G. TRONO MEMORIAL HOSPITAL
Guimbal, Iloilo

ACCOMPLISHMENT REPORT
FOR THE MONTH OF _______________________________

NAME: _______________________________ Area of Assignment/Office: _________________

Designation: __________________________ Division: ________________________________

Remarks (# of
Done Not Done High Risk
Function and Duties Functions Done)
Dentist II

1. Makes oral examination/Check up and

case diagnosis of patient's chief complaints.

2. Gives dental treatment on case basis:

a. Dental Restoration
b. Oral Prophylaxis
c. Dental Extraction (simple & complicated case)
d. Dental medication, etc.

3. Gives chairside instruction and education

to patient after dental treatment or procedure.

4. Attends and ward visits admitted patients with

oral health problem and with dental referral.

5. Documents/Records fees for services rendered.

6. Supervises subordinate.

7. Checks the overall condition and activities at

the dental clinic

8. Gives referrals and coordinates with medical

doctors or specialists for medically compromised
patients or cases that needs further evaluation
and clearances.

9. Issues dental certificates and dental clearances.

10. Issues medico legal.

11. Attends meetings and conferences.

Please rate the following(if):
1. - Very Good Prepared by: ______________________________________
2. - Satisfactory
3. - Poor
Approved: By:

*Indicate Number of functions done in the Remarks

section ULYSSES G. GILO
Admin. Officer IV

Noted By:

RAFAEL S. SABANDO, M.D., DPAMS,FICS, FPSMS

Chief of Hospital II
Area of Assignment/Office: _________________

Division: ________________________________

Low Risk
______________________________________
 REP. PEDRO G. TRONO MEMORIAL HOSPITAL
Guimbal, Iloilo

ACCOMPLISHMENT REPORT
FOR THE MONTH OF _______________________________

NAME: _______________________________ Area of Assignment/Office: _________________

Designation: __________________________ Division: ________________________________

Function and Duties Remarks (# of

Done Not Done Functions Done) High Risk
Medical Officer III

1. Performs consultations.

2. Performs minor surgeries.

3. Admits patients for treatment.

4. Make daily rounds on patients.

5. Handle deliveries.

6. Attends staff conferences and scientific updates

for further advancement.

7. Issue medical certificates.

8. Complete medical records of patients.

Please rate the following(if):

1. - Very Good Prepared by: ______________________________________
2. - Satisfactory
3. - Poor
Approved: By:

*Indicate Number of functions done in the Remarks

section ULYSSES G. GILO
Admin. Officer IV

Noted By:
RAFAEL S. SABANDO, M.D., DPAMS,FICS, FPSMS
Chief of Hospital II
_________________
__________________

Low Risk

________________
 REP. PEDRO G. TRONO MEMORIAL HOSPITAL
Guimbal, Iloilo

ACCOMPLISHMENT REPORT
FOR THE MONTH OF _______________________________

NAME: _______________________________ Area of Assignment/Office: _________________

Designation: __________________________ Division: ________________________________

Remarks (# of
Done Not Done High Risk
Function and Duties Functions Done)
Radiologic Technician

Please rate the following(if):

1. - Very Good Prepared by:______________________________________
2. - Satisfactory
3. - Poor
Approved: By:
*Indicate Number of functions done in the Remarks
section ULYSSES G. GILO
Admin. Officer IV

Noted By:

RAFAEL S. SABANDO, M.D., DPAMS,FICS, FPSMS

Chief of Hospital II
_____________

______________

Low Risk

_____________
 REP. PEDRO G. TRONO MEMORIAL HOSPITAL
Guimbal, Iloilo

ACCOMPLISHMENT REPORT
FOR THE MONTH OF _______________________________

NAME: _______________________________ Area of Assignment/Office: ________

Designation: __________________________ Division: _______________________

Date Done Not Done

Function and Duties
From To Pharmacist

Please rate the following(if):

1. - Very Good Prepared by: ______________________________
2. - Satisfactory
3. - Poor
Approved: By:
*Indicate Number of functions done in the Remarks
section ULYSSES G. GILO
Admin. Officer IV

Noted By:

RAFAEL S. SABANDO, M.D., DPAMS,FICS, FPSMS

Chief of Hospital II
HOSPITAL

____________

Area of Assignment/Office: _________________

Division: ________________________________

Remarks (# of High Low

Functions Done) Risk Risk

______________________________________

Approved: By:
ULYSSES G. GILO
Admin. Officer IV