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Philhealth Member Data Record

No., Code

Last Name

First NameLegitimate spouse who is not an NHIP Member.Parent who is 60 years old and above, not an NHIP member/retiree/pensioner and dependent on me for support.acknowledged and illegitimate or legally adopted/step Unmarried child 21 years old & above with physical/ mental disability, cochild, below 21 years old.acquired and wholly dependent on me for support.Signature of MemberPrinted Name & Signature of Witness to Thumbmark

philhealth member data record
., CodeSignature Over Printed Name of Authorized RepresentativeDate SignedOfficial CapacityMember's CopyThis portion should be completely filled up, detached by the hospital and given to memberName of Member :SSS/GSIS/MEC/PhilHealth No.

:Name of Patient :Confinement Period :Name of Hospital :PhilHealth Forms Received by : of Patient to Member ( Check applicable box if patient is a dependent )RF-1-Quarterly Remittance Report formME-5-Contributions Payment Return form for employed sector MI-5-Contributions Payment Return form for individually paying membersM1b-Membership Data Record form for individually payingE1-SSS Membership form for new memberE4-SSS Member's Data Ammendment formT.
I don't know with her. basta ako member ng philhealth
i dont think so coz we have Philhealth to help us with the meds. kailangan mo nga lang maging member. are u pos as well??
Good Evening Mr President! Are you a Philhealth member? Thank you po :)
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