REQUEST FOR REGIONAL PERSONNEL ORDER

DTRACK No.
Date: December 29, 2021
Division/Section Requesting:
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
POST DUTY QUARANTINE: SPECIMEN DRIVER

Date of Travel: DECEMBER 5,2021 UNTIL RECOMMENDED BY MEDICAL TEAM

Place/Venue: FACILITY QUARANTINE
● Check in date and time (if applicable):
● Check out date and time (if applicable):
Name/s of Staff: (Please Write Legibly)
NAME/s DIVISION/UNIT START OF QUARANTINE END OF QUARANTINE

1 MR. MARVIN CAHIG SPECIMEN DRIVER DECEMBER 5,2021

Until Recommended by
medical team
10

Vehicle and Driver, if any: N/A

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD, FPAFP

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief

Page 1 of 7
 CONFIRMATION OF REQUEST FOR REGIONAL PERSONNEL ORDER
DTRACK No.
Date: December 29, 2021
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
UNDERGO QUARANTINE / DAILY MONITORING BY MEDICAL TEAM

Date of Travel: November 3, December 6 &7, 2021 - until recommended by Medical Team
Place/Venue: HOME/FACILITY QUARANTINE
● Check in date and time (if applicable):
● Check out date and time (if applicable):
Name/s of Staff: (Please Write Legibly)
NAME/s DIVISION/UNIT START OF QUARANTINE END OF QUARANTINE

1 MS. CARMELITA POTANE LHSD - WATER LABORATORY December 7, 2021

2 MS. BILLEVIC PRECIOSO RESU / OPCEN December 7, 2021 Until Recommended by medical
team / or release of Rapid
3 MS. LAVERNE ODCHIGUE ARD - RESEARCH UNIT December 6, 2021 Antigen results

4 MS. NANCY S. JELIANGGAO MSD - HRDU/ TRAINING UNIT November 3, 2021

Vehicle and Driver, if any: N/A

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD, FPAFP

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief

REQUEST FOR REGIONAL PERSONNEL ORDER

DTRACK No.
Date:
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
DOH CHD CARAGA - QUARANTINE FACILTY MEDICAL TEAM DUTY

Date of Travel: NOVEMBER 24, 2021 - DECEMBER 11, 2021

Place/Venue: MAZAUA QUARANTINE FACILITY
● Check in date and time (if applicable):
● Check out date and time (if applicable):
Name/s of Staff: (Please Write Legibly)
NAME/s DIVISION/UNIT

MS. JOSAIRA O. GAJO

Vehicle and Driver, if any:

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief
 REQUEST FOR REGIONAL PERSONNEL ORDER
DTRACK No.
Date: December 29, 2021
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
TO RENDER OVERTIME TO CONDUCT GENERAL DISINFECTION OF DOH CHD CARAGA & QUARANTINE
FACILITIES AS PART OF THE IMPLEMENTATION OF SAFETY PRECAUTIONS ON COVID-19 PREVENTION

Date of Travel: OCTOBER 30 - DECEMBER 4, 2021

Place/Venue: DOH CHD CARAGA OFFICE, SPECIMEN ROOM & QUARANTINE FACILITIES
● Check in date and time (if applicable):
● Check out date and time (if applicable):
Name/s of Staff: (Please Write Legibly)
DIVISION/UNIT October 30, 2021 November 6, 2021 November 13, 2021
November 20, 2021 November 27, 2021 December 4, 2021
1 LHSD-INFECTIOUS MR. MICHAEL DUANE MEDROSO MR. MARK LYNDE GASCON MR. ADELO R. BORJA

2 LHSD-INFECTIOUS MR. ZOILO E. CASTRO MR. CLEEFORD S. SUAREZ MR. JULITO J. PAROG

3 LHSD-INFECTIOUS

Vehicle and Driver, if any:

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD, FPAFP

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief

REQUEST FOR REGIONAL PERSONNEL ORDER

DTRACK No.
Date: December 29, 2021
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
UNDERGO QUARANTINE AND MANDATORY RT-PCR TESTING/ MONITORING

Date of Travel: AUGUST 13, 2021 - UNTIL RELEASE OF NEGATIVE RT-PCR RESULTS
Place/Venue: HOME QUARANTINE
● Check in date and time (if applicable):
● Check out date and time (if applicable):
Name/s of Staff: (Please Write Legibly)
NAME/s DIVISION/UNIT START OF QUARANTINE END OF QUARANTINE
ONE HOSPITAL
1 Dr. Panfilo Jorge M. Tremedal III COMMAND CENTER August 13, 2021
ONE HOSPITAL UNTIL RELEASE OF
2 Mr. Daryl Estrella COMMAND CENTER August 13, 2021
NEGATIVE RT-PCR RESULTS
ONE HOSPITAL
3 Mr. Harvey Montañez COMMAND CENTER August 13, 2021

Vehicle and Driver, if any:

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief
 REQUEST FOR REGIONAL PERSONNEL ORDER

DTRACK No.
Date: December 29, 2021
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
DOH CHD CARAGA - QUARANTINE FACILTY MEDICAL TEAM DUTY

Date of Travel: OCTOBER 4 to 31, 2021

Place/Venue: DOH QUARANTINE FACILITIES
● Check in date and time (if applicable):
● Check out date and time (if applicable):

Name/s of Staff: (Please Write Legibly)

NAME/s DIVISION/UNIT START OF DUTY END OF DUTY
QUARANTINE FACILITY
1 DR. MARY GRACE O. LEOPARDAS MEDICAL TEAM HEAD November 1, 2021 November 30, 2021

QUARANTINE FACILITY
2 MR. TOM FERNAN BERSABE MEDICAL TEAM November 1, 2021 November 30, 2021

November 1, 2021 November 7, 2021

3 MS. GRETCHIEN CAÑIZARES LHSD - INFECTIOUS:
4 MS. KRIZIA MAY DIEZ
QUARANTINE FACILITY November 15, 2021 November 21, 2021
MEDICAL TEAM
November 29, 2021 December 5, 2021

5 MS. SHEIRA MONIQUE OTACAN LHSD - INFECTIOUS: November 8, 2021 November 14, 2021
QUARANTINE FACILITY
6 MS. ANGIELENE PHIL MADELO MEDICAL TEAM November 22, 2021 November 28, 2021

Vehicle and Driver, if any: N/A

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD, FPAFP

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief
 REQUEST FOR REGIONAL PERSONNEL ORDER

DTRACK No.
Date: December 29, 2021
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
POST DUTY QUARANTINE - QUARANTINE FACILTY MEDICAL TEAM

Date of Travel: NOVEMBER 1 - DECEMBER 5, 2021

Place/Venue: HOME QUARANTINE
● Check in date and time (if applicable):
● Check out date and time (if applicable):

Name/s of Staff: (Please Write Legibly)

NAME/s DIVISION/UNIT START OF QUARANTINE END OF QUARANTINE

November 1, 2021 November 7, 2021

1 MS. SHEIRA MONIQUE OTACAN LHSD - INFECTIOUS:
2 MS. ANGIELENE PHIL MADELO
QUARANTINE FACILITY November 15, 2021 November 21, 2021
MEDICAL TEAM

November 29, 2021 December 5, 2021

LHSD - INFECTIOUS: November 8, 2021 November 14, 2021

3 MS. GRETCHIEN CAÑIZARES QUARANTINE FACILITY
4 MS. KRIZIA MAY DIEZ MEDICAL TEAM
November 22, 2021 November 28, 2021

Vehicle and Driver, if any: N/A

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD, FPAFP

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief
 REQUEST FOR REGIONAL PERSONNEL ORDER

DTRACK No.
Date: December 29, 2021
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
DOH CHD CARAGA - ASSESSMENT TEAM FOR LSIs & RETURNING RESIDENTS

Date of Travel: NOVEMBER 1 - 30, 2021

Place/Venue: NASIPIT PORT, AGUSAN DEL NORTE
● Check in date and time (if applicable):
● Check out date and time (if applicable):

Name/s of Staff: (Please Write Legibly)

NAME/s DIVISION/UNIT START OF QUARANTINE END OF QUARANTINE
MR. RICHARD PETER LHSD - INFECTIOUS
1
SARABOSING (ASSESSMENT TEAM) November 1, 2021 November 30, 2021

LHSD - INFECTIOUS
2 MR. BERNARD LLANETA (ASSESSMENT TEAM) November 1, 2021 November 15, 2021

LHSD - INFECTIOUS
3 MR. PRINCE DARAYL CAHANAP (ASSESSMENT TEAM) November 1, 2021 November 15, 2021

LHSD - INFECTIOUS
4 MS. JOSAIRA O. GAJO (ASSESSMENT TEAM) November 1, 2021 November 15, 2021

LHSD - INFECTIOUS
5 MR. VINGE DANZO JABUTAY (ASSESSMENT TEAM) November 16, 2021 November 30, 2021

MR. JOSEPH CHRISTIAN A. LHSD - INFECTIOUS

6
HORNIDO (ASSESSMENT TEAM) November 16, 2021 November 30, 2021

LHSD - INFECTIOUS
7 MR. JAY MICHAEL URBIZTONDO (ASSESSMENT TEAM) November 16, 2021 November 30, 2021

Vehicle and Driver, if any:

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD, FPAFP

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief
 REQUEST FOR REGIONAL PERSONNEL ORDER

DTRACK No.
Date: December 29, 2021
Division/Section Requesting: LHSD - INFECTIOUS
Name/Title of the Travel/Training/Activity: (Please Write Legibly)
POST DUTY QUARANTINE - ASSESSMENT TEAM FOR LSIs & RETURNING RESIDENTS

Date of Travel: NOVEMBER 16 - DECEMBER 15, 2021

Place/Venue: HOME QUARANTINE
● Check in date and time (if applicable):
● Check out date and time (if applicable):

Name/s of Staff: (Please Write Legibly)

NAME/s DIVISION/UNIT START OF QUARANTINE END OF QUARANTINE
LHSD - INFECTIOUS
1 MR. BERNARD LLANETA (ASSESSMENT TEAM) November 16, 2021 November 30, 2021

LHSD - INFECTIOUS
2 MR. PRINCE DARAYL CAHANAP (ASSESSMENT TEAM) November 16, 2021 November 30, 2021

LHSD - INFECTIOUS
3 MS. JOSAIRA O. GAJO (ASSESSMENT TEAM) November 16, 2021 November 30, 2021

LHSD - INFECTIOUS
4 MR. VINGE DANZO JABUTAY (ASSESSMENT TEAM) December 1, 2021 December 15, 2021

MR. JOSEPH CHRISTIAN A. LHSD - INFECTIOUS

5
HORNIDO (ASSESSMENT TEAM) December 1, 2021 December 15, 2021

LHSD - INFECTIOUS
6 MR. JAY MICHAEL URBIZTONDO (ASSESSMENT TEAM) December 1, 2021 December 15, 2021

Vehicle and Driver, if any: N/A

Requested by: Noted by:

MARY GRACE O. LEOPARDAS, MD, FPAFP

____________________________________ ERNESTO E. PAREJA, MD, MPH
_______________________________
Program Coordinator/Staff Division/Cluster Chief