NCD Template
NCD Template
NCD Template
NCD PATIENT
Name of Health Facility: DATU BINASING PIGCAWAYAN Report Month/Year: JUNE/ 2023
No. NAME OF PATIENT MEDICATIONS GIVEN
HPN DM (Indicate the number of treatment packs dispensed) OTHERS
LAST FIRST MIDDLE DATE OF AGE SEX Amlo. 5mg Amlo. 10mg Losartan 50mg Gliclazide Metropolol Acyclovir
BIRTH 30 tabs/TP 30 tabs/TP 30 tabs/TP 30mg 50mg 90 200mg
Tablet tabs/TP Tablet
1. AKMAD ZENAIDA ASGAR 05/16/1971 40 F √ √
2. AKMAD ASGAR SAMAD 03/15/1957 67 M √ √
3. AKMAD BABAI LUNDAYAN 02/05/1972 47 F √ √
4. AMAN SALABANON GUINTAWAN 02/28/1930 79 F √ √
5. ASGAR ANGI SAMAD 05/05/1959 60 M √ √
6. ASGAR MORSIE SINARIMBO 10/02/1980 42 M √ √ √
7. BALAO RAYBA BINASING 08/05/1948 71 F √ √
8. BALUMOL SURAIDA MAMA 03/15/1944 59 F √ √
9. BANSIL MINDOG KEDO 03/24/1935 84 M √ √
10. BINAISNG NARISSA PADILA 01/05/1976 46 F √ √
11. BINASING KALIMA BAITO 06/19/1960 62 F √ √
12. BINASING SOFIA KATING 08/12/1978 44 F √ √
13. BINASING CAMIA DUMASIL 09/24/1964 54 F √ √
14. BINASING ABUBAKAR ABEDIN 03/15/1939 83 M √ √
15. BINASING MONIB KASAN 12/13/1973 49 M √ √
16. BINASING MIKE KASAN 05/13/1978 44 M √ √
17. BINASING MUSBAI GUIANDAL 05/11/1971 51 F √ √
18. DELLAVA SALLY KABELARA 12/07/1973 59 F √ √
19. DIMA BRA BINASING 08/20/1954 68 M √
20. ECAYAN HARRY DIOCAMPO 01/15/1956 66 F √ √
21. ANTAL AMBAI DADING 02/14/1961 61 F √ √
22. GANI KADIGUIA ASGAR 04/22/1954 68 F √ √
23. GUIANDAL BAISARA ENGCONGAN 07/24/1962 60 F √ √
24. GUIANDAL ISHAK LANGCOB 02/15/1970 52 M √ √
25. GUIANDAL SAKINA ENGCONGAN 03/01/1960 62 F √ √
26. GUIANDAL NORAIDA ENGCONGAN 11/05/1976 55 F √ √
27. GUINTAWAN TATA KALIPO 02/25/1998 22 F √ √
28. KASIM FATIMA MUSA 03/03/1945 77 F √ √
29. KIRAM SINARIMBO KASIM 10/11/1969 53 M √ √
30. KUSAIN MAISALAM OMAR 10/19/1974 48 F √ √
31. KUSAIN AMINA BINASING 01/11/1946 76 F √ √
32. KUSAIN ABUBAKAR BINASING 03/03/1966 56 M √ √
33. LAOG ESMAEL MALIGA 11/01/1947 75 M √ √
34. LILAN HAIRHEA GANI 09/17/1985 37 F √ √
35. LUBPANGAN KAMARUDIN RACMAN 04/15/1975 47 M √ √
36. MILINDO SUMIYA BALUNO 01/01/1973 49 F √ √
37. MINDOG TAYAN BANSIL 06/08/1955 67 F √ √
38. MOKAMADALI ROWENA BINASING 08/23/1973 49 F √ √
39. PADILA BONIE ABEDIN 05/12/1977 45 M √ √
40. RACMAN SORAYA GUIAPAR 02/27/1974 48 F √ √
41. RASUL FAUDZIA ASGAR 03/05/1964 58 F √ √
42. SAMAMA SHAHABODIN CIANO 04/23/1950 72 M √ √
43. SAMPULNA NORMINA MAKALILAY 09/30/2980 42 F √ √
44. SANSALUNA MINDA KANAKAN 04/03/2972 51 F √ √
45. SANSALUNA PATIMA MAPAS 09/28/1978 44 F √ √
46. SINARIMBO NORAISA SINARIMBO 11/11/1965 57 F √ √
47. SINARIMBO NORODIN ASGAR 02/05/1974 48 M √ √
48. TAHIR GANI MUSTAPHA 03/11/1970 52 M √ √
49. TAMPAR SITTIE GANI 09/20/1970 52 F √ √
50. TUMINDEG FARIDA KASAN 04/10/1966 56 F √ √
51. TUMINDEG KADIGUIA MAMA 06/01/1962 60 F √ √
52. UMPI BAINOT GUIANDAL 06/27/1980 42 F √ √
TOTAL
Prepared by: NARISSA G. SINARIMBO, RM Noted by: ___________________________ Approved by: ____________________________
Nurse/Midwife Assigned Supervisor Municipal Health Officer