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Republic of the Philippines

Department of Health

OFFICE OF THE SECRETARY


},|AY 2

ADMINISTRATIVE ORDER
No.2016

2016

00ll4

SUBJECT: Implementins Guidelines on the Orsanization of Health Clubs for


Patients with Hvpertension and Diabetes in Health Facilities

I. RATIONALE
Non-communicable Diseases (NCDs) continue to be the top causes of deaths among
Filipinos. Of these, hypertension remains the leading illness. Diabetes continues to be
significantraffecting around 5Yo of our adult population (Source: FNRI - National Nutrition
Survey,20l3).
To address the call for health interventions that are cost-effective and sustainable, the focus is
on the most vulnerable risk group using two most common and easily detectable clinical
manifestations of NCDs: hypertension and diabetes. By accelerating case detection of
patients with risk factors, illnesses will most likely be found at an early stage, that is, before
the onset of any damage to target organs.
Campaigns are needed to detect as many patients as possible in the early stages of
hypertension and diabetes. Organizing patients into active Health Clubs is one of the
strategies to ensure continuity ofcare, raise the effectiveness oflifestyle changes and prevent
complications.

The following guidelines are hereby issued to strengthen the fight against NCDs at the
primary health facilities specifically, the health centers and barangay health stations. These
guidelines reiterate the policies and thrusts outlined in the'National Policy on Strengthening
the Prevention and Control of Chronic Lifestyle Related Non-Communicable Diseases
(NCD)" (DOH AO 2011- 003), and "Implementing Guidelines on the lnstitutionalization of
Philippine Package of Essential NCD lnterventions (PhilPEN) on the lntegrated Management
of Hypertension and Diabetes for Primary Health Care Facilities" (DOH AO 2012 - 0029).

II. OBJECTIVES

A.

General objectives

These guidelines aim

to gulde various stakeholders in health care in

sustaining Hypertension-Diabetes Health

creating and

Club s.

B.

Specific objectives

l.

Define the process of accelerating the identification of patients based on the PhilPEN
protocol, of creating a Patient Registry and of recruiting these patients into health
clubs.

Building

l,

San lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila o Trunk Line 651-78-00 Drect Line: 711-9501
Fax:743-1829;'143-1786 URL: httorl/www.doh.gov.ph; e-mail: osecG)doh.gov

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2.

J.

Define the services and activities of the health club that will ensure at least 90Yo
continuity of care to hypertensive and diabetic patients according to the PHIL PEN
guidelines on lifestyle changes and the DOH guidelines on conlmunity activities
especially patient education and motivation.
Promote better access to maintenance medications and management of

pharmaceutical supply chain.


4. Define the roles and responsibilities of the different DOH offices and agencies, the
LGUs and other stakeholders in organizing and sustaining health clubs.
5. Create a mechanism for conduct of patient clubs that can be applicable for other
diseases entities.

IIL SCOPE AND COVERAGE


This issuance applies to all DOH units including its attached agencies, local government units
(LGUs), non-govemment orgarizations, professional organizalions, the private sector and
other relevant partners in the health sector.
Chronic Lifestyle Related NCDs affect the vulnerable age groups in all economic levels. Case
finding and treatment shall no longer be limited to priority areas identified through the
Conditional Cash Transfer (CCT) program or to families under the National Household
Targeting System (NHTS) for Poverty Reduction.

IV. DEFINITION OF TERMS

A. PhilPEN Protocol - is the Philippine Package of Essential Non Communicable


Disease Interventions for low-resource settings adopted from WHO PEN. This
protocol consists of guidelines for the integrated management of hypertension and
diabetes through a total risk approach. The individual client/patient is assessed and
managed based on using the risk prediction chart. The prediction charts can estimate
the client/patients risk of having a cardiovascular event (CV risk) in the next ten
years. This will be applied to all patients screened for and found to have NCDs.
these are facilities that provide screening and management of
diseases like hypertension and diabetes. May include but not limited to city health
offices, rural health units (RHUs) and barangay health stations.

B. Health Facilities -

a registry of patients diagnosed with


hlpertension and diabetes in the health facilities, linked to iClinicSys of RHUs and
Integrated Chronic Non Communicable Disease Registry of hospitals.

C. DOH Hypertension and Diabetes Registry

D. DOH Health Clubs -

an organ izationthat consist of officers with rules and by-laws


and a common goal of improving the health and wellness of its members. lnitially,
these shall be organized in health facilities such as RHUs and expanded to barangays.

V. GENERAL GUIDELINES

A. ACCELERATED CASE FINDING.

Accelerated case finding

is applicable for

persons 40 years old and above.

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B. MANDATORY REGISTRY. All RHus/health centers shall have a registry of all


hypertensive and diabetic patients to closely monitor their health conditions and for
provision of medications.
C.

VOLUNTARY ENROLLMENT. All diagnosed patients with hypertension andlor


diabetes in all public and private health facilities shall be encouraged to enroll in
designated Hypertension-Diabetes Health Clubs in their health center but will remain
voluntary. The list of health clubs shall be submitted to DOH Central Office after
validation of the Provincial and Regional Offices.

D. SERVICE DELIVERY NETWORI(. Each health facility shall ensure that there is a
network of higher facilities and providers within the province or city-wide health
systems where referrals and other health care services can be provided.
E.

STANDARDIZING DIAGNOSTICS. Fasting Blood Sugar/Glucose (FBS) with 8 10 hours fasting shall be the standard of screening for diabetes instead of random
blood sugar to promote efficiency in use of resources and facilitate follow-up. This
shall be initially through the capillary method (glucometer) and confirmed using the
venous FBS.

F. FOLLOW - UP OF PATIENTS. A11 patients with diagnosed

hypertension and
diabetes, regardless of membership into a Health Club, shall be scheduled for regular
follow-up and re-evaluation by a physician based on philpEN.

G. ADOPTION OF PhilPEN PROTOCOL. The PhilPEN protocol shall be the basis


for further assessment, screening, management and follow-up of patients seen in the
facilities. Risk assessment of persons betw een 25 and 39 years old apparently healthy,
with risk factors or with early manifestation of disease shall continue as defined in
this protocol.

VI. SPECIFIC GUIDELINES


STAGE 1: Accelerated case finding among the highest risk group

A. Identifying

1.

patients with hypertension and diabetes

Case Finding shall be done during:


a. Community campaign, or

b. Household visits

2.

Case Finding shall be done through:

a. Blood pressure (BP) measurement of all persons 40 years old and above measured
twice, 15-30 minutes apart, by a Barangay Health Worker (BHW).
b. Risk assessment of clients 25 years old and above who visit the health center for
other clinical complaints, based on philpEN.

3.

Those found to have BP >140190 on both readings shall be referred to the local
government staff (midwife or nurse) who shall verify the elevated BP reading one
week later

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4. All those verified

to have elevated BP >140/90 by the health center midwife or nurse

shall be:
Referred to the physician/Municipal Health Officer (MHO) to confirm diagnosis
of hypertension and examined for any sign or symptom of underlying causes (eg.
renal disease) and target organ damage. Using PhilPEN, risk prediction can be
done to estimate the cardiovascular risk of the patient.
b. Have their fasting blood sugar/glucose (FBS) tested
c. Started on the first line antihypertensive medicine as prescribed by the doctor and

a.

contraindicated based on the available drugs provided by DOH


(Amlodipine 5 mg, 1 tablet, daily) and test blood cholesterol if available
Registered in the health center Hypertensive Patient Registry
Strongly encouraged to enroll in the Hypertension-Diabetes Health Club,
Assessed for secondary hypertension andl or signs and symptoms of some target
organ damage and then referred to a hospital for fuither evaluation

if not

d.
e.
f.
5. All

other persons without hypertension but have a family history of diabetes, are

obese and with signs and symptoms of possible diabetes shall also have their fasting
blood sugar/glucose (FBS) tested.

6. All patients found to have high capillary FBS (>7.0 mmol/l or 126 mg/dl)

shall have

their FBS retested using venous blood done by a medical technologist either in the
health center laboratory, local hospital laboratory or a private laboratory and shall be:

a.

b.
c.
d.
e.

Referred to the physician/MHO to confirm diagnosis of diabetes and examined for


any sign or symptom of target organ damage. Using PhilPEN, risk prediction can
be done to estimate the cardiovascular risk of the patient.
Started on the first line anti-diabetic drug as prescribed by the doctor and if not
contraindicated (Metformin 500 mg daily).
Registered in the health center Diabetic Patient Registry
Strohgly encouraged to enroll in the Hypertension-Diabetes Health Club
Assessed for signs and symptoms of target organ damage and then referred to a
hospital for further evaluation

B. Enrollment to the NCD Registries


1. Newly diagnosed patients shall be registered in the specific Chronic Disease Registry.
2. A patient who has both hypertension and diabetes shall be registered in both the

3.
4.

Hypertension and Diabetes registries.


Deaths and geographic ffansfers in and out of their specific health facility shall now
be recorded in the Chronic Disease Registries and reported to the DOH Regional
Offices through the appropriate LGUs.
National Chronic Disease registries shall also be maintained by DOH through the
Knowledge Management and Information Technology Service (KMITS).

C. Health Education
1.

All

patients registered in the hypertensive and diabetic patient registries shall have
their first health education session given by the health facility nurse or midwife.

2. Topics on first health education session shall be composed of but not limited to the
following:

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3.

a.

Diet changes needed for their specific condition (e.g. increase intake of fruits and

b.
c.

vegetables)
Increased physical activity (at least 30 minutes brisk walking three times a week),
Cessation of smoking and reduction of alcohol intake, when relevant, and

d.

Prevention of common infections

Subsequent health education sessions to reinforce the health messages may be given
by the midwife or a BHW specially trained for this task.

D. Follow-up
1. All patients with hypertension shall have their BP taken by the BHW

at least once a
week to verify that their BP is under control. Follow-up of these patients with the
physician shall be monthly until BP is controlled and 3 - 6 months thereafter. Those
found to still have BP >T40190 shall be referred back to the physician who may decide
to:
a. Increase the dose of the current medication, OR
b. Shift medication to the second line drug if not contraindicated (Losartan 50 mg
daily), OR
c. Add Losartan on top of Amlodipine

2. All patients with diabetes shall have repeat capillary FBS testing every three (3)
months. Those found to still have FBS >7.0 mmolll or 126 mg/dl shall be re-evaluated
by the health center physician or any physician who may decide to:
a. Increase the dose of the current medication, OR
b. Shift to the second line drug (Gliclazide 80 mg daily), OR
c. Refer the patient to a hospital for further evaluation
3. Patient treatment booklet shall be given to the patient and shall be used to monitor the
dispensing of medications and health promotion activities. The booklet shall contain
all the essential clinical information that should be assessed and monitored on a
regular basis.

4. Clients who are 40 years old and above who still do not manifest any signs of
hypertension or diabetes but are known smokers, have a family history of diabetes
and/or are obese should continue to be followed up at least every 3 to 6 months since
they are still considered low to moderate risk or with <20yo CV risk.
5. Summary of above-listed procedures (Annex A)

STAGE 2: THE ORGANIZATION AND MAINTENANCE OF HEALTH CLUBS


1.

Enrollment
a. All patients with Chronic Lifestyle Related NCDs shall be encouraged to enroll in
an appropriate health club in their respective health centers.
b. Patients who agree to enroll in the club shall fill- up the application form (Annex
B) and will be issued an ID and patient booklet.
c. The club member shall be informed of scheduled activities from which incentives
can be provided if attended (e.g. 1 activity - 1 raffle ticket; total of 3 raffle tickets
can be equivalent to a discount voucher for diagnostics/gift

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items)

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d.

There shall be only one club for hypertensive and diabetic patients since many
diabetics are also hypertensive and the activities to promote lifestyle changes are
the same for both types of patients.

2. Establishing Other Health Clubs


a. Other health clubs for other types of chronic diseases such as Arthritis Health
Club or Cancer Survivor Health Club may also be established as deemed
necessary by the health facility.
b. Each health club shall elect their own officers and they are encouraged to meet at
least once a month and election every year.
3. Core Activities of the Hypertension and Diabetes Health Club shall include:
a.Lifestyle improvement activities such as changes of diet, increased physical
activities, cessation of smoking, reduction of alcohol intake;
b. Health education especially on prevention of common infections and proper
use of medications, among othersi
c.Periodic measurement of BP and FBS including reminders when these have to be
repeated, eg. through mobile phones;
d. Replenishment of free medications; and
e.Mental health improvement activities to encourage bonding among members and
to relieve stress.
4. Membership Number
a. Each club member shall be given a unique chronological Club membership
number in the following format:
i. DOH Heath Facility Code (FC) of the National Health Facility Registry
System - Year of enrollment in the club -particular health club and
chronological number of patient
ii. Example for the first club member who is registered in Payatas B Health
Center, #I7 Bulacan St.,2nd District, Quezon City. Enrolled in the
Hypertension and Diabetes Health Club, year 2016: FC102 - 2016 - H/D

Club -

5. ID

a.

Each patient shall receive a unique identification (ID) card color-coded according
to their clinical classification as follows:
i. YELLOW: (<20% risk score) the patient has hypertension OR diabetes only
(no signs or symptoms of target organ damage).
ii. ORANGE: (20-30% risk score) the patient has hypertension AND diabetes
without any sign or symptom of target organ damage.
11i. RED: (>30% risk score) the patient has hypertension and I or diabetes AND
signs of target organ damage.

b.

When the clinical condition of the patient improves or deteriorates, he/she shall be
given an adjusted color ID.

c. Red coded patients shall also be enrolled in hospital-based

health clubs but they


will retain their unique facility-based Club membership number. They can be
active in either clubs but shall claim their free medications only from their
respective RHUs.

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6. Medications
a. Newly diagnosed hypertensive and diabetic patients shall:
i. Receive a prescription good for 3 months from the City/Municipal Health

ii.

Officer
Receive maintenance medications in the Rural Health Units where they are
registered on a monthly basis.

b. Previously diagnosed hypertensive and/or diabetic patients who come to the


health facility just to ask for free medications shall be:
i. Thoroughly evaluated: measure BP, test capillary FBS (glucometer), assess
clinical signs and symptoms for target organ damage and underlying causes
(eg. renal disease for hypertensive patients) based on PhilPEN
ii. Registered in the appropriate Chronic Disease Registry in the health facility.
iii. Strongly encouraged to enroll in a Hypertension-Diabetes Health Club.
iv. Given health education reiterating the lifestyle messages mentioned in First
Health Education
v. Maintained on their current medications until the next follow-up
c. Claiming of DOH maintenance medications
i. Patients shall personally claim their medicines in their respective RHUs.
Altematively, other people may claim for them as long as with authorization
letter and patient booklet.
ii. Club members may collect their free medications from another
RHU/Hypertension - Diabetes Health Club within the same region provided:
a. Both clubs are informed and agree to the modified arrangement.
b. The drug allocation for these selected patients shall be transferred to the
RHU where the patient will obtain his/her medicines to respond to the
needs of the patient and at the same time avoid duplication of drug
dispensing.
c. Inter-regional arrangements will only be possible at a later time when the
national electronic registry system is in place.
7. DOII flealth Clubs may engage in other activities, such as:
a. Peer group engagement in health education, regular activities like exercises and
sustained medication to ensure continuity of care leading to better health
outcomes.
b. Social activities like get-togethers to further raise the understanding of health
messages (eg. the meals served should be diabetic-friendly or hypertensive-

c.
d.

friendly)
Own fund raising activities to get free or discounted laboratory tests such as
cholesterol test and ECG, among others.
Involvement of family members to encourage participation especially health
promotion activities.

8. Affiliations
a. Patient-initiated health clubs, such as those organized in schools, workplace or
churches, may be recognized as affiliated chapters in the Barangay where the
school, workplace or church is located.

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b.

c.

The health club may start with a few members that is health center/RHU - based
and over time, with additional members, health promotion activities could be
organizedthrough a club in each Barangay.
The Barangay-based club shall maintain its links with the Main RHU-based Club
through specific activities that need the presence of physicians (e.g. during followup health assessment).

VII. MONITORING AND EVALUATION

1. The Task Force for Health Clubs shall develop a monitoring and evaluation
mechanism to measure the inputs, processes and outcomes expected from the

2.

implementation of this issuance. The monitoring will be based on existing mechanism


that is currently used for PhilPEN implementation and for inventorylutilization reports
of medications.
The DOH Hypertension and Diabetes Club shall be measured in terms of:
a. Performance indicators to measure attainment of targets in terms of patients
identified and treated, health clubs organized and functional, and NCD drug
utilization
b. Indicators of the effectiveness of health clubs in preventing adverse health
outcomes.

3.

4.

Periodic reports on the performance of various DOH offices and agencies shall be
written and disseminated through quarterly monitoring and performance evaluation
meetings with appropriate DOH offices and stakeholders.
Guidelines for monitoring of drug reactions at the RHU level will be developed by the
Pharmaceutical Division in collaboration with the Food and Drug Administration.

VIII. ROLES AND FUNCTIONS


l.

Disease Prevention and Control Bureau (DPCB) shall:


a. Provide technical assistance to various stakeholders in clarifuing the integration of
this guideline with the policies/guideline mentioned above (AO 2012-0029 and

b.

c.
2.

AO 2011-0003).
Assist the DOH Regional Offices in translating the national DOH guidelines into
simple, locally useful field implementers' manuals and tools by providing samples
and models of patient manuals for adaptation to field conditions.
Oversee the development of a practical mechanism to harmonize and monitor
inputs, processes and outcomes related to these chronic diseases

Bureau of Local Health System Development (BLHSD) shall:


with DPCB and PD, provide technical assistance to the LGUs,
through the DOH Regional Offices, on the formation and maintenance of
Hypertension-Diabetes Health Clubs and other health clubs especially in
clarifying the role of BHWs and LGUS and translating the national DOH
guidelines into simple, locally useful field implementers' manuals and tools
through samples and models of well-organizedhealth clubs.
b. Facilitate the organization of health clubs by assisting the DOH Regional Offices
in advocating for support for health clubs among the Local Chief Executives and
through the BHW Federation, and various NGOs working in the communities,

a. In collaboration

amons others.

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c.

J.

4.

Collaborate with DPCB and other DOH units in developing a practical mechanism
to harmonize and monitor inputs, processes and outcomes related to the
organization and maintenance of health clubs.

Knowledge Management and Information Technology Service (KMITS) shall:


a. Maintain the National Chronic Disease Registry based on data from the various
sources especially the LGUs.
b. Facilitate the submission of timely Chronic Disease Registry reports by the DOH
Regional Offices by assisting them develop their recording system through
capability building.
c. Through the Logistics Managernent Division, ensure the timely and secure
distribution and accounting of essential drugs and medicines purchased by DOH
for NCDs and assist in developing efficient and secure mechanisms for drug
distribution and monitoring.

Health Promotion and Communication Service (HPCS) shall:


a. Provide technical support in the development of promotion and IEC materials and
the conduct of advocacy and health education activities for Hypertension-Diabetes
Health Clubs.

b.

Advocate among other govemment agencies, non-govemment organizations,


private sector, development partners and other relevant stakeholder towards a
supportive environment for health clubs.

5.

DOH Regional Offices shall:

a. Provide

technical assistance to LGUs and various stakeholders within their Region


by disseminating and clariffing the
i. Integration of this guideline with the policies/guidelines mentioned above
(AO 2012-0029 and AO 2011-0003).
ii. Updating and maintenance of Chronic Disease Registries and the importance
of compliance with the Phil PEN protocol.
iii. Role of BHWs and LGUS.
iv. Adapting nationally-developed field implanenters' manuals and tools into
local manuals and tools.
b. Facilitate the formation of Hypertension-Diabetes Health Clubs among the LGUs

withintheirRegionbyassistingtheminidentif,zingmethods'interventionsand
resources and by providing a responsive and supportive health system
c. Oversee the monitoring of the inputs, processes and outcomes of the activities of
Hypertension-Diabetes Health Clubs within their Region based on the monitoring,
feedback and evaluation mechanism developed for health clubs.

6.

Development Management Officer (DMOyDOII Representatives shall:


a. Be the overall coordinator of the Hypertension and Diabetes Health Club within
his/her catchment ar ealLGU
b. Ensure that guidelines and procedures for the club are understood by the LCE and
health facility staff/providers
c. Solicit the active participation of the LCE especially provision of support to the
club
d. Assist in monitoring and evaluation of the activities and operations of the club

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Pharmaceutical Division shall :


Collaborate with the KMITS-LMD and the Procurement Service to ensure the
timely purchase and distribution of essential medicines for NCDs.
b. Collaborate with DPCB and BLHSD in developing an efficient and secure drug
distribution and monitoring system for drugs and medicines purchased by the PD
for NCDs and distributed through Hypertension-Diabetes Health Clubs.
c. Assist the DOH Regional Offrces in disseminating important information on the
proper use, handling and utilization of drugs and medicines.
d. In collaboration with FDA, develop guidelines for monitoring drug reactions at the
RHU level (pharmacovigilance).

a.

8.

Philippine Health Insurance Corporation (PHIC or PhilHealth) shall:


a. Incorporate the NCD medicines that are not yet covered by DOH in the primary
care package that would be reimbursed to the Health Care Provider through
PhilHealth financing

b.

c.

9.

Develop other Diagnostic Services

in the primary

care package that will

complement the programs of DOH through Health Clubs


Facilitate/Assist the enrollment of patients in the Chronic Disease Registry in the
PhilHealth programs e.g. Sponsored Program, Informal Sector and orient in their
rights, privileges and how to avail of PhilHealth benefits

City Health Offices/Rural Health Units shall:

a.
b.

c.
d.
e.

Develop their facility-based Hypertension and Diabetes Club using this guideline
Identify a point person within the facility (e.g. MHN) who will oversee the plans
and activities of the club. To guide club officers and members in ensuring that
plans are carried out and provide assistance in coordinating with other RHU staff
or stakeholders ifresource persons are needed during activities.
Ensure sustainability of health clubs through regular follow-up of patients and
registry and conduct of activities that promote education/awareness
Submit monitoring and evaluation reports on a regular basis
Ensure close coordination with the Regional and Provincial Health Offices, LGUs
and other stakeholders

10. Local Government Units shall:

a.

b.

Implement and support the formation of the club per primary health care facility
within their area.
Provide support to PHOs/CHOs/MHOs in the logistics needed by the club.

IX. FUNDING
The Department of Health Central Office through DPCB, BLHSD and HPCS shall provide
funds for technical assistance, commodities such as glucose strips, monitoring, capacity
building and health promotion campaigns to ensure that the above-mentioned activities are
implemented. Likewise, the Regional Offices through counterpart departments/divisions of
central office shall allocate funds for the same strategies.

The Pharmaceutical Division shall allocate funds and procure maintenance medications
needed for chronic diseases.

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Local government units shall provide funds for health facility activities in their respective
communities. Other goveflrment agencies, non-government organizations and other
stakeholders and partners in health shall provide funds as appropriate to ensure the
implementation of this guideline.
X. REPEALING CLAUSE
The provisions of Department of Health Administrative Order 2011-0013 (Implementing
Guidelines on the DOH Treatment Pack) limiting the distribution of ComPack medicines to
CCT priority areas and NHTS families are hereby repealed. A11 other previous Orders and
other ielated issuances inconsistent or contrary to the provisions of this Administrative Order
are also hereby repealed, amended or modified accordingly. A11 other provision of existing
issuances which are not affected bv this Order shall remain valid and in effect.

XI. EFFECTIVITY
This Order takes effect immediatelv.

ARIN, MD, MBA.H

JANETTE

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ANNEX A

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HIGH RISK GROUP (> 40 years old)


a. Those

with BP 2 140/90 taken

twice by BHW shall be referred to


RHUs for further assessment
b. In the RHU, the nurse/midwife will

confirm if the patient has BP

>- 140190

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BP >140/90 - referred to
physician/MHO for diagnosis and
further management

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Initial: capillary FBS by
nurse/midwife

Confirm: venous blood FBS

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cholesterol.

if available)

by medical technologist

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a. Health lifestyle

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'b. Monitor BP
Every3-6months

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The physician/MHO will further evaluate the patient (for target organ damage, secondary
hlpertension, etc.) and start appropriate medications:
First line anti-hypertensive.' Amlodipine (based on drugs provided by DOH)
First line anti-diab etic.' Metformin
Monitor BP and capillary FBS monthly until target goals are met

Diagnosed patients with Hypertension and/or Diabetes will be registered in the


specific chronic disease registry ofthe health facility

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Uypertensive and Diabetic patients will be strongly encourased


join the Health Ctub

to

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ANNEX B
a. Sample application form

APPLICATION F'ORM
DOH ITYPERTENSION AND DIABNTES CLUB
Date:
Name of patient:

FIRSTNAME

LASTNAME
Age:

Birthdate:

No.

MIDDLE NAME

Sex:

Street Brgy./City,Municipality

Contact number:

Email (if any):

PhilHealth Number:

b. Sample ID

DOH
DIABETES CLUB
AND
HYPERTENSION
Patient No.:
Name:
Address:
RHU:
Birthdate:
Contact number:

Sex:

FRONT

ln case of emergency:
Name:
Address:
Contact number:

Signature of member

BACK

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