PHILHEALTH AND DOH

DISCHARGED ACCREDITED BIRTHING

DOONG MATERNITY CLINIC
INSTRUCTIONS Purok 29, Poblaion, Makilala Cotabato CENTER
cjdoongbiochemistrysolutions@yahoo.com
639500951286

DATE OF DISCHARGED: _____________________ TIME OF DISCHARGED : ________________

NAME OF MOTHER :____________________________________________________________

ADDRESS : ____________________________________________________________________

DISCHARGED INSTRUCTIONS:
1. PAGPATUTOY : PATUTOYA SI BABY PER DEMAND OR EVERY 2-3 hours
2. IBULAD SI BABY SA EARLY MORNING SUNLIGHT 10-15 MINUITES
3. LIMPYUHAN ANG PUSOD GAMIT ANG 70% ALCOHOL, WALAY BIGKIS
4. LIGUON SI BABY KADA ADLAW
5. FOLLOW UP CHECK UP ON: __________ BCG INJECTION: ___________
6. KUHAA ANG NEWBORN SCREENING RESULT PAGKAHUMAN 14 DAYS.
VITAL SIGNS OF THE MOTHER:
BLOOD PRESSURE: ____________ CARDIAC RATE: ______________
BODY TEMPERATURE: _________ RESPIRATORY RATE: __________
AMOUNT LOCHIA : _______________________

TAKE HOME MEDICATION ROUTE TIME REMARKS

AMOXICILLIN 500MG TAKE THE
CEFALEXIN 500MG MEDICINE BY
CLINDAMYCIN 300MG MOUTH
MULTIVITAMINS BEFORE SLEEP
MEFENAMIC ACID 500MG FOR PAIN ONLY

REPORT TO THE HEALTH CENTER

DATE OF DELIVERY :_____________________ TIME OF DELIVERY : ________________ SEX: _______

WEIGHT OF THE BABY : _____________________ APGAR SCORE: __________________
TREATMENT AND CARE GIVEN:
VITAMIN K INJECTION ESSENTIAL NEWBORN CARE EYE PROPHYLAXIS
HEPA B VACCINE INJECTION NEWBORN SCREENING
VITAL SIGN OF THE BABY:
BODY TEMPERATURE: ______________ CARDIAC RATE: ______________
RESPIRATORY RATE : _______________

Prepared and discharged by: Instruction Received by:

CHARIS JOY R. DOONG, RN, RM ___________________________________

Attending Midwife Signature Over Printed Name of Mother

Sa Doong Maternity Clinic, Priority Ka!

 Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION
PHILHEALTH REGIONAL OFFICE XII
Plaza de Espanol, Cor. Posadas & Abad Santos Sts., Koronadal City
Tel. No. (083) 228-9731-35, Tel/Fax. 228-4733
Email: accre.pro12@philhealth.gov.ph

Monthly Mortality Census of Non Hospital Facility for Maternity Care Package(MCP)
Providers

For the Month of NOVEMBER 2017

Accreditation No. M12026826 Type of Facility: BIRTHING CENTER

Name of Facility: DOONG MATERNITY CLINIC
Address: PUROK 29, POBLACION MAKILALA, COTABTO

Total Number of Deliveries: 17

MATERNAL TOTAL
NO. DIAGNOSIS/CAUSE OF DEATH NHIP NON-NHIP
1 NONE
2
3
4
5

NEWBORN TOTAL
NO. DIAGNOSIS/CAUSE OF DEATH NHIP NON-NHIP
1 NONE
2
3
4
5

Prepared by: Certified Correct:

MARIA CRISTINA R. DOONG CHARIS JOY R. DOONG, RN,RM
Administrator Clinic Manager and Owner