UNIVERSITY OF SANTO TOMAS HOSPITAL

España, Manila

Department of Medicine
Private Division

June 08, 2024

Charito Malong-Consolacion, MD
Medical Director
University of Santo Tomas Hospital

Greetings in the name of St. Thomas!

This is to request for a copy of a clinical abstract for patient Balajadia, Julie Aquino admitted in
University of Santo Tomas Hospital, Room 3084 San Rafael Ward. The abstract shall be used in order to
request for financial assistance.

The following are the pertinent details surrounding the patient’s case:

A. Name: Balajadia, Julie Aquino

B. Age and Gender: 86 year old female
C. Address: 1452 Alvarez St., Sta Cruz, Manila
D. Attending Consultant: Dr. Kristianne Medina
E. Date Admitted: May 31, 2024
F. Reason for Request: DSWD and PSCO application
G. Name of Institution where certificate will be addressed to: Department of Social Welfare and
Development (DSWD) and Philippine Charity Sweepstakes Office (PCSO)
H. Final Diagnosis: Acute complicated UTI; ASHD CAD; Hypertension St. II; Acute kidney
injury sec to infection (UTI) on top of probable Chronic kidney infection
sec to Hypertensive nephrosclerosis
I. Medications:
1. Atorvastatin 20mg/tab OD
2. NaHCO3 tablet TID
3. Trimetazidine 35mg/tab OD
4. Anidulafungin 100mg/IV q24h
5. Meropenem 1gm/IV in 50ml PNSS x 1-2hrs q8h
6. Salbutamol + Ipratropium nebule

Respectfully yours,

Dr. Kristianne Medina / Christine Tan

Attending Physician/ Nephrology Fellow
University of Santo Tomas Hospital

Note: This document is issued upon the patient or patient’s relative request. This cannot be used for medico-legal purposes.