Name: ______________________________________________ Rating: _________________
Year & Section: ______________________________________ Date: ___________________
Instructor: ___________________________________________
A. Instructions: Coordinate a visit to a barangay health center (BHC). Complete the form below
by conducting an interview with the BHC officials.
1. Date: ____________________
2. Name of the BHC officials:
________________________________________________________________________
3. Location of the BHC:
________________________________________________________________________
4. Contact details of the BHC:
Name: __________________________________________________________________
Address: ________________________________________________________________
Contact Person: __________________________________________________________
Telephone/Fax: __________________________________________________________
Email: __________________________________________________________________
5. General Information
5.1 Achievement/Success Stories of the BHC:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5.2 Issues
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5.3 Number of Personnel
________ Total Number of Personnel
________ Total Number of Permanent (with regular) Item Personnel
________ Total Number of Casual Item Personnel
________ Total Number of Contractual Item Personnel
________ Total Number of Doctors
________ Total Number of Dentists
________ Total Number of Medical Technologists
________ Total Number of Medical Laboratory Technicians
________ Total Number of Nurses
________ Total Number of Nutritionists/Dieticians
________ Total Number of Midwives
________ Total Number of Barangay Health Workers
________ Total Population of the Barangay
5.4 Compute for the health personnel ratio (doctors, dentists, nurses, etc.) versus the total
population.
5.5 BHC Administrative Setup. Illustrate the administrative setup of the BHC by using a
schematic diagram. Make sure to show the line of responsibility per job category.
5.6 Identify the different jobs/work at the BHC. Write the job description for each position in
the BHC.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5.7 Are there job items for medical technologists or medical laboratory technicians? If yes,
what are the tasks of medical technologists in a BHC?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5.8 Laboratory Diagnosis. Complete the table by supplying all the necessary information
needed in a clinical laboratory in the BHC.
Laboratory Examination Purpose
Hematology
Clinical Chemistry
Clinical Parasitology
Clinical Microscopy
Clinical Microbiology
Other Examinations
B. Instructions: Based on your learning feedback diary, write a general reflection of what
happened during your visit to a clinic/hospital. Use the following form to help you organize
your ideas.
Areas Feedback
Content
(What have I learned?)
Process
(How did I learn it?)
Reasons
(Why did I learn it?)
Academic and
professional development
(How does this learning
experience contribute to
my academic and
professional
development?)
Personal development
(What does this learning
experience mean to me?)
Place photo documentation as evidence of your visit.
