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PhilHealth Claim Form Philhealth Gov 2018
APPROPRIATE BOXES. For local availment this form together with other PhilHealth claim forms and other supporting documents should be filed within 60 days from date of discharge. PhilHealth Employer No. PEN 2. Contact No. 3. Business Name 4. CERTIFICATION OF EMPLOYER This is to certify that all monthly premium contributions for and in behalf of the member while employed in this company including the applicable three 3 monthly premium contributions within the past six 6 months period prior to the...
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