Health Facility Geographic Form F: Acility Name and Address

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Republic of the Philippines

Department of Health
HEALTH FACILITIES AND SERVICES REGULATORY BUREAU

Health Facility Geographic Form

FACILITY NAME AND ADDRESS

1. Official Name of the Health


CAUAYAN DISTRICT HOSPITAL
facility

2. Health Facility Type


HOSPITAL
(Example: Hospital)

3. Street name and number ROSEMARIE REYES ST.

4. Building name and number


(when applicable)

5. Official Region name CAGAYAN VALLEY

6. Official Province name ISABELA

7. Official Municipality/City CAUAYAN CITY

8. Official Barangay name DISTRICT I

GEOGRAPHIC COORDINATES OF THE FACILITY (FROM GOOGLE MAP) – PLEASE READ THE
INSTRUCTION ON PAGES 2 TO 3 BEFORE ANSWERING NUMBERS 9 TO 12:

No, the image is not clear enough (blurry,


9. Can the health facility be located in clouds,...)
Google Map? (check the option that
applies)

 Yes, the facility can be seen clearly

10. Scale at the moment of taking the


coordinate (maximum: 50 meters)
5 0 m

11. Latitude: 1 6 . 9 1 8 5 1

1 2 1 7 6 6 3 2
12. Longitude: .
HF Geo Form
Revision:02
12/03/2014
Page 1 of 3

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