Sto. Domingo Hea Sample
Sto. Domingo Hea Sample
CO-TERMINOUS
9,327.00 2 3 3 8 152
BANDA JOSE BALEAN 03-26-1953 MALE 10-000006719-3 BRGY. CAPT. (GOVERNMENT) SAN JUAN
CO-TERMINOUS
FEMALE 6,993.00 0
TRAVECILLA GLADY BIGUERAS 05-21-1964 10-203069026-2 BRGY. KGD. (GOVERNMENT) SAN JUAN
BHW VOLUNTEER (DULY
FEMALE 1,200.00 0
BIGUERAS JANETH BUENAOBRA 01-26-1981 10-025046617-4 BHW REGISTERED/ACCREDITED) SAN JUAN
CO-TERMINOUS
JR. MALE 1,200.00 0
RODRIGUEZ PEDRO MILANTE 12-18-1977 BRGY. TANOD (GOVERNMENT) SAN JUAN
BHW VOLUNTEER (DULY
FEMALE 1,000.00 0
BALTAR LOVELLA BALINO 11/8/1988 10-025220033-3 BHW REGISTERED/ACCREDITED) SAN JUAN
BHW VOLUNTEER (DULY
FEMALE 1,000.00 0
YANZON ROWENA CHING 1/10/1967 03-025778607-9 BHW REGISTERED/ACCREDITED) SAN JUAN
BHW VOLUNTEER (DULY
FEMALE 1,000.00 0
BALUNSAY NENA GALINDO 05-26-1954 2300-0448-7449 BHW REGISTERED/ACCREDITED) SAN JUAN
BHW VOLUNTEER (DULY
FEMALE 1,000.00 0
BALTAR MYRNA BALINO 8/4/1951 10-202712819-7 BHW REGISTERED/ACCREDITED) SAN JUAN
BHW VOLUNTEER (DULY
FEMALE 1,000.00 0
ALEGRE RAFAELA BALDERAMA 10-24-1969 08-025884909-8 BHW REGISTERED/ACCREDITED) SAN JUAN
APPROVED BY:
ALBERT A. ALESNA, MD
MUNICIPAL HEALTH OFFICER
SALARY MONTHLY LOW
MONTHLY LOW LOW LOW MODERAT MODERAT MODERAT MODERAT HIGH-
GRADE - STEP - (FOR BASIC RISK- LOW RISK- MODERATE- HIGH- HIGH- HIGH- HIGH-
BASIC SALARY RISK- RISK- RISK- E- E- E- E- NATURE
PRC ID (FOR GOVERNMEN SALARY - NATURE NUMBER OF LOW NUMBER OF MODERATE TYPE OF WORK TOTAL NUMBER OF
DATE OF BIRTH PHILHEALTH NO. - (FOR PLACE OF TYPE OF WORK TOTAL TYPE OF WORK NATURE TOTAL OF HIGH-
LAST NAME FIRST NAME MIDDLE NAME SUFFIX SEX NUMBER (IF POSITION TITLE CADRE EMPLOYMENT STATUS GOVERNMEN T (FOR OF HOURS RISK- HOURS - HEALTH SETTING SCORE HOURS
(mm/dd/yyyy) (000000000000) GOVERNMENT ASSIGNMENT HEALTH SETTING SCORE HEALTH SETTING OF WORK SCORE WORK REMARKS
APPLICABLE) T EMPLOYEES PRIVATE WORK PHYSICALLY REMARKS PHYSICALLY REMARKS FACILITY PHYSICALLY
EMPLOYEES FACILITY FACILITY
EMPLOYEES ONLY) EMPLOYEES RENDERED RENDERED (A) (B) (A+B+C) RENDERED
ONLY) (A) (B) (A+B+C) (A) (B) (C) (A+B+C) (C)
ONLY) ONLY) (C)
APPROVED BY:
ALBERT A. ALESNA, MD
MUNICIPAL HEALTH OFFICER
SALARY MONTHLY LOW
MONTHLY LOW LOW LOW MODERAT MODERAT MODERAT MODERAT HIGH-
GRADE - STEP - (FOR BASIC RISK- LOW RISK- MODERATE- HIGH- HIGH- HIGH- HIGH-
BASIC SALARY RISK- RISK- RISK- E- E- E- E- NATURE
PRC ID (FOR GOVERNMEN SALARY - NATURE NUMBER OF LOW NUMBER OF MODERATE TYPE OF WORK TOTAL NUMBER OF
DATE OF BIRTH PHILHEALTH NO. - (FOR PLACE OF TYPE OF WORK TOTAL TYPE OF WORK NATURE TOTAL OF HIGH-
LAST NAME FIRST NAME MIDDLE NAME SUFFIX SEX NUMBER (IF POSITION TITLE CADRE EMPLOYMENT STATUS GOVERNMEN T (FOR OF HOURS RISK- HOURS - HEALTH SETTING SCORE HOURS
(mm/dd/yyyy) (000000000000) GOVERNMENT ASSIGNMENT HEALTH SETTING SCORE HEALTH SETTING OF WORK SCORE WORK REMARKS
APPLICABLE) T EMPLOYEES PRIVATE WORK PHYSICALLY REMARKS PHYSICALLY REMARKS FACILITY PHYSICALLY
EMPLOYEES FACILITY FACILITY
EMPLOYEES ONLY) EMPLOYEES RENDERED RENDERED (A) (B) (A+B+C) RENDERED
ONLY) (A) (B) (A+B+C) (A) (B) (C) (A+B+C) (C)
ONLY) ONLY) (C)
APPROVED BY:
ALBERT A. ALESNA, MD
MUNICIPAL HEALTH OFFICER
SALARY MONTHLY LOW
MONTHLY LOW LOW LOW MODERAT MODERAT MODERAT MODERAT HIGH-
GRADE - STEP - (FOR BASIC RISK- LOW RISK- MODERATE- HIGH- HIGH- HIGH- HIGH-
BASIC SALARY RISK- RISK- RISK- E- E- E- E- NATURE
PRC ID (FOR GOVERNMEN SALARY - NATURE NUMBER OF LOW NUMBER OF MODERATE TYPE OF WORK TOTAL NUMBER OF
DATE OF BIRTH PHILHEALTH NO. - (FOR PLACE OF TYPE OF WORK TOTAL TYPE OF WORK NATURE TOTAL OF HIGH-
LAST NAME FIRST NAME MIDDLE NAME SUFFIX SEX NUMBER (IF POSITION TITLE CADRE EMPLOYMENT STATUS GOVERNMEN T (FOR OF HOURS RISK- HOURS - HEALTH SETTING SCORE HOURS
(mm/dd/yyyy) (000000000000) GOVERNMENT ASSIGNMENT HEALTH SETTING SCORE HEALTH SETTING OF WORK SCORE WORK REMARKS
APPLICABLE) T EMPLOYEES PRIVATE WORK PHYSICALLY REMARKS PHYSICALLY REMARKS FACILITY PHYSICALLY
EMPLOYEES FACILITY FACILITY
EMPLOYEES ONLY) EMPLOYEES RENDERED RENDERED (A) (B) (A+B+C) RENDERED
ONLY) (A) (B) (A+B+C) (A) (B) (C) (A+B+C) (C)
ONLY) ONLY) (C)
APPROVED BY:
ALBERT A. ALESNA, MD
MUNICIPAL HEALTH OFFICER
CADRE
DOCTOR
DENTIST
NURSE
PHARMACIST
MEDICAL TECHNOLOGIST
RADIOLOGIC TECHNOLOGIST
NUTRITIONIST-DIETITIAN
PSYCHOLOGIST
HEALTH PHYSICIST
PHYSICAL THERAPIST
SOCIAL WELFARE OFFICER
MIDWIFE
RESPIRATORY THERAPIST
OCCUPATIONAL THERAPIST
BARANGAY HEALTH WORKER (NON-COVID)
BHW FOR COVID-19 RESPONSE
KEY OFFICIALS
TECHNICAL STAFF
SUPPORT STAFF
ADMINISTRATIVE STAFF
JANITORIAL
SECURITY
OTHERS
DEFINITION
1
2
3
Refers to the personnel of a company/organization contracted by another
company/organization to perform specific tasks for a specific period of time.
MOOE
# LAST FIRST MIDDLE SUFFIX CADRE EMPLOYMEN POSITION LOW LOW LOW
NAME NAME NAME T STATUS TITLE TOTAL TOTAL COMPUTED
SCORE OF HRS HEA
1 SAN JUAJUAN LAUREL JR.
2 SANTOSELIAS MENDOZIII
3 CRUZ JEAN DIAZ
SUMMARY TOTAL AMOUNT Total No. of HCWs
HIGH Total No. of HCWs with
ZERO Amount
MODERATE Total Number
LOW
TOTAL