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Dr. Bonifacia V.

Albano Memorial Hospital


Bacarra, Ilocos Norte
WORK ACCOMPLISHMENT
Name of Employee: __________________________________________
Room No.
201
202
203
204
205
206
208
210
211
212
213
214
215
216
217
220
221
123
Charity(110 &111)
Pharmacy
Laboratory
OPD
Supply Room
Accounting Office
Stock Room
Information
Nurses Stations
Nursing Service
OTHERS

Floor

Comfort Room

Date:_______________
Shift: first shift:_____ second shift: ______
Ceiling

Acknowledgement by
Patient/Watcher

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