PARA MAGKA
#BAGONGBUKAS
Sumulat Kay Camille
REQUIREMENTS FOR MEDICAL ASSISTANCE
ORIGINAL or CERTIFIED TRUE COPY
1 set of ORIGINAL 1 set of PHOTOCOPY
- UPDATED MEDICAL CERTIFICATE/CLINICAL ABSTRACT
With date of issuance, complete name, handwritten signature and licensed no. of the attending physician - LABORATORY REQUEST
With date of issuance, complete name, handwritten signature and licensed no. of the attending physician - UPDATED HOSPITAL BILL/STATEMENT OF ACCOUNT
With (Outstanding Balance), complete name & handwritten signature of billing clerk - FORMAL QUOTATION
Offical Price Form - PROMISSORY NOTE
With date of issuance, full name and handwritten signature of credit and collection officer - BRGY INDIGENCY
Purpose: DSWD Medical/Financial Assistance (With handwritten signature of Brgy. Captain/Brgy. Kagawad) - UPDATED PRESCRIPTION
With date of issuance, complete name, handwritten signature and licensed no. of the attending physician - 2 GOVERNMENT ID’S OF CLAIMANT AND PATIENT
(With Present Address) - SOCIAL CASE STUDY
(For special case only)
REQUIREMENTS FOR EDUCATIONAL ASSISTANCE
ORIGINAL or CERTIFIED TRUE COPY
1 set of ORIGINAL and 1 set of PHOTOCOPY
- VOTER’S CERTIFICATION
- GRADES FROM PREVIOUS SEMESTER
- VALIDATED SCHOOL ID
- 2 GOVERNMENT ID’S (any of this)
Barangay ID, NBI, Police Clearance, Passport, PhilHealth, National ID - BRGY INDIGENCY
Purpose: DSWD Medical/Financial Assistance (With handwritten signature of Brgy. Captain/Brgy. Kagawad) - CERTIFICATE OF REGISTRATION/REGISTRATION FORM
Purpose: DSWD Educational Assistance / To whatever legal purpose it may serve (With dry seal, full name, full position, handwritten signature of the registrar) - CERTIFICATE OF NON- ISSUANCE OF ID
(If your school or university can’t provide validated school ID)
Purpose: DSWD Educational Assistance / To whatever legal purpose it may serve
(With dry seal, full name, full position, handwritten signature of the registrar) - CERTIFICATION OF ENROLLMENT
Purpose: DSWD Educational Assistance / To whatever legal purpose it may serve
(With dry seal, full name, full position, handwritten signature of the registrar)
REQUIREMENTS FOR BURIAL ASSISTANCE
ORIGINAL or CERTIFIED TRUE COPY
1 set of ORIGINAL and 1 set of PHOTOCOPY
- REGISTERED DEATH CERTIFICATE
With date of issuance, name and signature of Civil Registrar, Name of informant and deceased patient - FUNERAL CONTRACT
With outstanding balance, complete name and Signature of Funeral Representative - CERTIFICATION OF BALANCE / CERT. OF UNSETTLED BILL AT YOUR FUNERAL SERVICE
Balance indicated must same as shown in your contract, with full name, position and handwritten signature of Funeral Representative - BRGY INDIGENCY
Purpose: DSWD Burial/Financial Assistance, with name of Claimant and Deceased Patient (Note: With handwritten signature of Brgy. Captain/Brgy. Kagawad) - 2 GOVERNMENT ID’S OF CLAIMANT AND PATIENT
With Present Address