Republic of the Philippines

Caloocan City North Medical Center

Camarin Road, Caloocan City
Manila, Philippines
E-mail Address: ccnmcmolelab@gmail.com

SUMMARY OF SPECIMENS REFERRED FOR COVID-19 TESTING

Disease Reporting Unit (Hospital/Agency): CALOOCAN CITY MEDICAL CENTER Date of Specimen Shipment: 07/04/2022
(mm-dd-yyyy)
Region: NCR Province: METRO MANILA Time of Specimen Shipment: PM
(hh:mm)
Contact Person: APRIL KATRINA UY, RMT Courier/Agency Vehicle:
Telephone Number/Mobile Number: 5310-7921 Official Email address: laboratory.ccmc2013@gmail.com

Date of Time of Remarks Date/ Time

Name of Patient Date of Age Sex
N SPECIME Saliv NPS/ Specimen Specimen (indicate if 1st Requested
Birth
o N CODE a OPS Collection Collection or 2nd)
. (Surname, First Name, Middle Name) (mm/dd/yyyy) (mm/dd/yyyy) (hh/mm) AM/PM
(M/F
)
1 NPS/ 1. CUNANAN, CAROLYN CRUZ 05/29/1979 43 F 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
2 NPS/ 2. WHITWELL, FIDES MALAPITAN 05/21/1993 29 F 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
3 NPS/ 3. PRADO, PATRICK LALU 12/07/1970 51 M 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
4 NPS/ 4. DEL ROSARIO, CARLIZA MAY 07/04/2022 8:00 AM 1ST 07/04/2022
05/16/1974 48 F
OPS
5 NPS/ 5. ASISTIO, LUIS III ORILLAZA 07/04/2022 8:00 AM 1ST 07/04/2022
01/09/1990 31 M
OPS
6 NPS/ 6. TEH-LIMSICO, ANNA KARINA REBUELTA 07/04/2022 8:00 AM 1ST 07/04/2022
01/31/1987 35 F
OPS
7 NPS/ 07/04/2022 8:00 AM 1ST 07/04/2022
7. HENSON, AURORA JR ASISTIO 12/29/1972 49 F
OPS
8 NPS/ 8. ABEL, MERWYN LENNON DELA CRUZ 07/04/2022 8:00 AM 1ST 07/04/2022
07/18/1997 24 M
OPS
9 NPS/ 9. ARUELO, EDGARDO NAZARETH 07/04/2022 8:00 AM 1ST 07/04/2022
10/31/1957 64 M
OPS
10 NPS/ 07/04/2022 8:00 AM 1ST 07/04/2022
10. HERNANDEZ, ORVINCE HOWARD ANIEVAS 10/18/1996 25 M
OPS
11 NPS/ 07/04/2022 8:00 AM 1ST 07/04/2022
11. DE VERA, VERGEL JAVIER 12/06/1974 47 M
OPS
12 NPS/ 12. CARALDE, ALEXANDER MARIANO 07/04/2022 8:00 AM 1ST 07/04/2022
03/30/1969 52 M
OPS
13 NPS/ 13. DIVINA, ARNOLD TAGULAO 07/04/2022 8:00 AM 1ST 07/04/2022
01/27/1967 54 M
OPS
14 NPS/ 14. DEL ROSARIO, JOESEPH CARMELO 07/04/2022 8:00 AM 1ST 07/04/2022
07/16/1976 45 M
OPS

Total No. Specimens Submitted: ____________________ Submitted by:IRVIN WHYLES DE GUZMAN,RMT Received by: _______________________

Republic of the Philippines

Caloocan City North Medical Center
Camarin Road, Caloocan City
Manila, Philippines
E-mail Address: ccnmcmolelab@gmail.com

SUMMARY OF SPECIMENS REFERRED FOR COVID-19 TESTING

Disease Reporting Unit (Hospital/Agency): CALOOCAN CITY MEDICAL CENTER Date of Specimen Shipment: 07/04/2022
(mm-dd-yyyy)
Region: NCR Province: METRO MANILA Time of Specimen Shipment: PM
(hh:mm)
Contact Person: APRIL KATRINA UY, RMT Courier/Agency Vehicle:
Telephone Number/Mobile Number: 5310-7921 Official Email address: laboratory.ccmc2013@gmail.com

Date of Time of Remarks Date/ Time

Name of Patient Date of Age Sex
N SPECIME Saliv NPS/ Specimen Specimen (indicate if 1st Requested
Birth
o N CODE a OPS Collection Collection or 2nd)
. (Surname, First Name, Middle Name) (mm/dd/yyyy) (mm/dd/yyyy) (hh/mm) AM/PM
(M/F
)
1 NPS/ 16. CERALDE, THERESITA MEANA 07/17/1959 63 F 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
2 NPS/ 17. LAVADIA, ROMEO JR CERALDE 04/20/1987 35 M 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
3 NPS/ 18. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
4 NPS/ 19. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
 5 NPS/ 20. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
6 NPS/ 21. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
7 NPS/ 07/04/2022 8:00 AM 1ST 07/04/2022
22.
OPS
8 NPS/ 23. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
9 NPS/ 24. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
10 NPS/ 07/04/2022 8:00 AM 1ST 07/04/2022
25.
OPS
11 NPS/ 07/04/2022 8:00 AM 1ST 07/04/2022
26.
OPS
12 NPS/ 27. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
13 NPS/ 28. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS
14 NPS/ 29. 07/04/2022 8:00 AM 1ST 07/04/2022
OPS

Total No. Specimens Submitted: ____________________ Submitted by:IRVIN WHYLES DE GUZMAN,RMT Received by: _______________________