PhilHealth Annex B.3 Checklist of PhilHealth Konsulta Laboratories
Fill PhilHealth Annex B.3 Checklist of PhilHealth Konsulta Laboratories online and download the official form as a PDF, ready to print. Every input is mapped to its printed box, so IDs, dates and amounts land digit by digit in the right cells, and a value the form cannot hold is refused with the reason instead of being printed wrong.
What you will need: Name of Facility, Address, Name of Referral Facility (if applicable), License Number, Type of Health Facilities, Ownership of Health Facility, CBC w/ platelet count, Remarks, Urinalysis, Fecalysis, Sputum Microscopy, Fecal Occult Blood.
The form is the agency's own, from philhealth.gov.ph (checked 2026-10-14): the PDF you download is that form with your values printed in its boxes.
The free clean PDF is that pack’s shortest form. A later form in the same pack needs the Starter plan (₱499) or above. Preview, check, and verify stay free. Not affiliated with BIR, SSS, PhilHealth, Pag-IBIG or any government agency.
Fill PhilHealth Annex B.3 Checklist of PhilHealth Konsulta Laboratories now