Philippine Pediatric Society, Inc.
63rd PPS PRE-CONVENTION Registration
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HAB Accredited Hospital Representatives Registration (4 representatives per hospital)
Individual registration for those who are not representatives of the HAB hospital
Contact Details
Name
*
First
Middle
Last
(as it appears on your PRC Card)
PRC Number
*
Put N/A if foreign delegate
Email
*
Position
*
Chair
Training Officer
Consultant
Resident
Other
Select one (1) Pre-convention Module that you will attend
*
Session Topic 1 – Abdominal Pain in Children: Beyond Functional
Session Topic 2 – The Febrile Child with Cytopenias
Session Topic 3 – The Adolescent with Puberty and Growth Concerns
Session Topic 4 – Cyanosis and Hypoxemia in Infants and Children
1st Representative
Which HAB Training Institution do you represent?
*
Adventist Medical Center Manila
Amang Rodriguez Memorial Medical Center
Asian Hospital & Medical Center
Capitol Medical Center
Cardinal Santos Medical Center
Chinese General Hospital and Medical Center
De Los Santos Medical Center
Dr. Jesus Delgado Memorial Hospital
Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium
East Avenue Medical Center
Fatima University Medical Center
Fe Del Mundo Medical Center
FEU-NRMF
Hospital of the Infant Jesus
Jose Fabella Memorial Hospital
Jose Reyes Medical Center
Las Piñas Doctors Hospital
Las Piñas General Hospital & Satellite Trauma Center
Makati Medical Center
Mandaluyong City Medical Center
Manila Doctors Hospital
Mary Chiles General Hospital
Mary Johnston Hospital
MCU-FDTMF
Medical Center Manila
Medical Center Parañaque
Medical Center Muntinlupa, Inc.
Metro Antipolo Hospital and Medical center
Metropolitan Medical Center
National Children’s Hospital
Ospital ng Makati
Ospital ng Muntinlupa
Our Lady of Lourdes Hospital
Pasay City General Hospital
Pasig City General Hospital
Perpetual Help Medical Center – Las Piñas
Philippine Children’s Medical Center
PLM-Ospital ng Maynila Medical Center
Quezon City General Hospital
Quirino Memorial Medical Center
Rizal Medical Center
San Juan De Dios Hospital
San Juan Medical Center
St. Luke’s Medical Center- Global City
St. Luke’s Medical Center-Quezon City
The Medical City
Tondo Medical Center
UERM- Medical Center
UP-PGH Hospital
UST Hospital
Veterans Memo Medical Center
VRP Medical Center
Valenzuela Medical Center
Victoriano Luna Medical Center
World Citi Medical Center
Philippine Heart Center
Research Institute for Tropical Medicine
Cagayan Valley Medical Center
Region II Trauma and Medical Center
Southern Isabela Medical Center
Mariano Marcos Memorial Hospital & Medical Center
Ilocos Training & Regional Medical Center
Baguio General Hospital & Medical Center
Sacred Heart Medical Center
Region I Medical Center
Angeles University Foundation & Medical Center
James L. Gordon Memorial Medical Center
Jose B. Lingad Memorial General Hospital
Tarlac Provincial Hospital
Dr. Paulino J. Garcia Memorial Research & Medical Center
Bulacan Medical Center
Central Luzon Doctors Hospital
Bataan General Hospital and Medical Center
Jecsons Medical Center
De La Salle University Medical Center
Gen. Emilio Aguinaldo Memorial Hospital
Perpetual Help Medical Center-Biñan
Batangas Medical Center
Mary Mediatrix Medical Center
Bicol Medical Center
Bicol Regional Training & Teaching Hospital
Cebu City Medical Center
Cebu Doctor’s University Hospital
Cebu South Medical Center
Cebu Velez General Hospital
Chong Hua Hospital
Chong Hua Hospital-Mandaue
VisayasMed Hospital
Perpetual Succour Hospital
Southwestern University Medical Center
Vicente Sotto Memorial Medical Center
Silliman University Medical Center
Gov. Celestino Gallares Hospital
University of Cebu Medical Center
Allied Care Expert (ACE) Medical Ceenter-Tacloban
Divine Word Hospital
Eastern Visayas Medical Center
Remedios Trinidad Romualdez Hospital
Adventist Med. Ctr. – Bacolod
Corazon Locsin Montelibano Memorial Hospital
Dr. Pablo O. Torre Sr. Memo Hospital
The Doctor’s Hospital
Iloilo Doctor’s Hospital
Iloilo Mission Hospital
St. Paul’s Hospital
West Visayas State University Medical Center
Western Visayas Medical Center
Brokenshire Integrated Health Ministries
Cotabato Regional & Medical Center
Davao Doctor’s Hospital
Davao Medical School Foundation Hospital
Davao Regional Medical Center
Metro Davao Medical and Research Center, Inc.
San Pedro Hospital
St. Elizabeth Hospital, Inc.
Southern Philippines Medical Center
Adventist Medical Center-Iligan
Ma. Reyna Xavier University Hospital
Mayor Hilarion A. Ramiro Sr. Medical Center
Northern Mindanao Medical Center
Amai Pakpak Medical Center
Zamboanga City Medical Center
Select one (1) Pre-convention Module that you will attend
*
Session Topic 1 – Abdominal Pain in Children: Beyond Functional
Session Topic 2 – The Febrile Child with Cytopenias
Session Topic 3 – The Adolescent with Puberty and Growth Concerns
Session Topic 4 – Cyanosis and Hypoxemia in Infants and Children
Name of 1st Representative
*
(as it appears on your PRC Card)
First
Middle
Last
PRC Number
*
Put N/A if foreign delegate
Email
*
Position
*
Chair
Training Officer
Consultant
Resident
Other
2nd Representative
Select one (1) Pre-convention Module that you will attend
*
Session Topic 1 – Abdominal Pain in Children: Beyond Functional
Session Topic 2 – The Febrile Child with Cytopenias
Session Topic 3 – The Adolescent with Puberty and Growth Concerns
Session Topic 4 – Cyanosis and Hypoxemia in Infants and Children
Name of 2nd Representative
*
(as it appears on your PRC Card)
First
Middle
Last
PRC Number
*
Put N/A if foreign delegate
Email
*
Position
*
Chair
Training Officer
Consultant
Resident
Other
3rd Representative
Select one (1) Pre-convention Module that you will attend
Session Topic 1 – Abdominal Pain in Children: Beyond Functional
Session Topic 2 – The Febrile Child with Cytopenias
Session Topic 3 – The Adolescent with Puberty and Growth Concerns
Session Topic 4 – Cyanosis and Hypoxemia in Infants and Children
Name of 3rd Representative
(as it appears on your PRC Card)
First
Middle
Last
PRC Number
Put N/A if foreign delegate
Email
Position
Chair
Training Officer
Consultant
Resident
Other
Position
*
Chair
Training Officer
Consultant
Resident
Other
4th Representative
Select one (1) Pre-convention Module that you will attend
Session Topic 1 – Abdominal Pain in Children: Beyond Functional
Session Topic 2 – The Febrile Child with Cytopenias
Session Topic 3 – The Adolescent with Puberty and Growth Concerns
Session Topic 4 – Cyanosis and Hypoxemia in Infants and Children
Name of 4th Representative
(as it appears on your PRC Card)
First
Middle
Last
PRC Number
Put N/A if foreign delegate
Email
Position
Chair
Training Officer
Consultant
Resident
Other
Transaction Details
Pre-Convention Fee
Price:
Pre-Convention Fee x4
Price:
Total
Payment Option
*
Please choose your payment option
Paid at the PPS Office
Paid thru Paymongo
Paid thru Bank
Transaction Number
*
Amount Paid
*
Transaction Date
*
MM slash DD slash YYYY
Proof of payment
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Attach your official receipt or deposit slip
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PAYMENT VERIFICATION
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DATE VERIFIED
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MM slash DD slash YYYY
