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User Registration
*required fields
PERSONAL INFORMATION:
First Name
*
:
Middle Name :
Last Name
*
:
Date of Birth
*
:
year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
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2003
2002
2001
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1991
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1984
1983
1982
1981
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1978
1977
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1972
1971
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1969
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1967
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1932
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1930
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1927
1926
1925
/
month
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February
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June
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August
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October
November
December
/
day
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Sex
*
:
Please select below
Unknown
Male
Female
CONTACT INFORMATION :
Landline:
e.g: 020-0987909
Mobile Number
*
:
e.g: +63 904 391 1221
Email Address
*
:
HEALTH FACILITY INFORMATION :
Address :
Barangay :
City
Province :
This table show Health Facility Information depends on what you type below :
Health Facility
*
:
Please type facility name
DESIGNATION INFORMATION :
Designation :
*
Clinical Specialist
Derma Project
eHealth Nurse
Information Service Subscriber
Municipal Health Officer
National Telehealth Center Staff
UP PGH OB CS
UP PGH OB RP
Rural Health Physician
UPHS MD
UPHS Nurse
UPHS Patient
Admin
Derma Project
Executive
Information Service Subscriber
National Telehealth Center Staff
UP PGH OB CS
UP PGH OB RP
Software Developer
UPHS MD
UPHS Nurse
UPHS Patient
Clinical Speciality :
*
Please Select Below
Ophthalmology
Family Medicine
Dermatology
General Question
Psychiatry
Tele ECG
Pediatrics
Internal Medicine
Dermatology AMIGA
Radiology
Orthopedics
Obstetrics and Gynecology
MedicoLegal
Otorhinolaryngology
Neurology
Surgery
Emergency Medicine
Dentistry
Rehabilitation Medicine
Neuroscience
Laboratories
Cardiology
NCR
Anaesthesiology
Ears Nose Throat
Dermlink
Dermatology SPMC
PLM OB
PLM Derma
UPHS
Obstetrics and Gynecology Test
UP PGH OB DEPT
Clinical Sub-speciality :
DTTB:
*
Yes
No
DTTB Batch :
*
Please select below
DTTb
dttb test
DTTB-26
DTTB-27
DTTB-28
DTTB-29
DTTB-31
DTTB-32
DTTB-33
DTTB-35
DTTB-36
Remarks :
Date Started:
year
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
/
month
01
02
03
04
05
06
07
08
09
10
11
12
/
day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
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18
19
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21
22
23
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31
End of Contract:
year
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
/
month
01
02
03
04
05
06
07
08
09
10
11
12
/
day
01
02
03
04
05
06
07
08
09
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11
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USER INFORMATION :
Username
*
:
e.g: username.health
Password
*
:
e.g: Password123
Confirm Password
*
:
Secret Question:
*
Please select below
What was your favorite sport in high school?
In what county were you born?
How many bones have you broken?
What is the color of your eyes?
How many bones have you broken?
What is the color of your eyes?
Secret Answer:
*
Confirm Answer:
*
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