Request Details	Reference No.	Request Date
Type: Cash Charge TPL PHIC PAY CHARITY MAP MISSION LINGAP EP DSWD PCSO POPCOM NSC-M FOR MAP OP WALK-IN (MAP) SCPF WALK-IN (LINGAP) LPM/PCSO PHS APPROVED To pay later Name: Address: Patient type: WALK-IN HRN: Location: WALK-IN PHIC no: None Category:		January 17, 2026 2:08pm
	Discounts	Request options
	Classification: None Senior citizen	Priority Routine Stat Notes

PHIC Coverage:

	Item No.	Item Description	Area	Consigned	Quantity	Dosage	Frequency	Route	Price(Orig)	Price(Adj)	Total
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