DENNIS M. TUDTUD, M.D.

, FPCP, FPSMO, FPSO, FMOSP

DIPLOMATE IN INTERNAL MEDICINE
DIPLOMATE IN MEDICAL ONCOLOGY

February 28, 2017

MEDICAL ABSTRACT
Name : Mira, Jessielyn B.
Age/Sex : 53 years old / Female
Address : Barangay I Poblacion Tubay, Agusan del Norte

DIAGNOSIS : Breast CA, Right, invasive ductal carcinoma, ERA(+), PRA (-), Her2Nue(-)
(T2N0Mx)

I. History of Present Illness:

Diagnosed case of Breast CA, right, S/P(11/19, 2016). Advise chemotherapy with
regimen Docetaxel/Cyclophosphamide protocol. Cycle 1 treatment was done last
20 December 2016 to be repeated every 21 days for 6 cycles.

II. Chemotherapeutic Drugs/Cost

Chemotherapy Dose per vial Actual Dose Cost per Vial Total Cost
Drugs (Php) (Php)
80 mg 29,000.00 29,000.00
Docetaxel
100 mg.
(taxotere)
20 mg. 7,500.00 7,500.00
Cyclophosphamide 1000 mg. 852 mg. 750.00 750.00
Tropisetron 5 mg. 5 mg. 1,300.00 1,300.00
ESTIMATED COST PER CYCLE 38,550.00
ESTIMATED COST for 6 CYCLES 231.300.00

DENNIS M. TUDTUD, M.D.

Medical Oncologist
License No. 51279
PTR No: 67326613
 DENNIS M. TUDTUD, M.D., FPCP, FPSMO, FPSO, FMOSP
DIPLOMATE IN INTERNAL MEDICINE
DIPLOMATE IN MEDICAL ONCOLOGY

February 28, 2017

MEDICAL CERTIFICATE
This is to certificate that patient Ms. Jessielyn B. Mira , 53 years old lady from Barangay I
Poblacion Tubay, Agusan del Norte had been diagnosed with Breast CA, Right, invasive ductal
carcinoma, right status-post mastectomy (11/19/2106). ERA positive, PRA negative, Her2Neu
negative and is receiving treatment under my care.

TREATMENT PROCOL/RECOMMENDATION

She will receive Docetaxel-Cyclophosphamide every 21 days for 6 cycles chemotherapy.

This certification is given to Ms. Mira for whatever legal purposes this may server her best.

DENNIS M. TUDTUD, M.D.

Medical Oncologist
License No. 51279
PTR No: 67326613
 Gorordo Avenue, Kamputhaw, Cebu City Philippines 6000
PERPETUAL SUCCOR Trunkline: (63-32) 2338620
Facsimile: (63-62) 2312362
H O S P I T A L PSH Customer Care E-mail: sphcares@pshcebu.ph
Compassionate & World Class: Website: www.pshcebu.ph
The Sisters of St. Paul of Chartres Difference

February 28, 2017

Hon, Jose George Corpuz

Chairman
Sun Plaza Building, 1507 Princeton St.
Corner Shaw Boulevard, Mandaluyong City

Thru:

Engr. Federico A. Damole

Department Manager
Visayas

Dear Hon. Corpuz,

Peace be with you!

Respectfully referring to your good office service patient, Mrs. Jessielyn Mira, 53 years old, female,
married from Brgy. 1 Poblacion Tubay, Agusan del Norte. She is an out-patient who was diagnosed of
Breast CA, Right, invasive ductal carcinoma, ERA(+), PRA(-), Her2Neu(-) (T2N0Mx). She is advised of
chemotherapy with regimen Decetazel/Cyclophosphamide protocol for 6 cycles every 21 days.

Patient is a BEED graduate and currently working as a Public Teacher receiving monthly net pay of Php.
6,200.00 only due to incurred loans and salary deductions. Her husband, 53 years old is a GSIS employee
in Surigao City with monthly income of Php. 12,000.00. The couple has two children; eldest daughter is
27 years old, single and employed as a Nurse under job order with minimal monthly wage; the 2 nd child is
20 years old and a 5th year college student. Living with the family is the mother of the patient, 84 years
old and the two other siblings of the patient (one is working in a Cooperative and one is jobless and the
one taking care of the aged and sickly mother). Patient was diagnosed of her illness in October 2016. She
underwent MRM last November 19, 2016 and has started her 1st chemo therapy on December 20, 2016.
Due to very expensive surgery and other medical procedures, resources of the family had been depleted.
Health Insurance is likewise exhausted. Relatives accordingly are trying to extend help, yet, it is not really
sufficient to sustain patients medication and continuous treatment procedures. Hence, they are appealing
to your good office for assistance particularly for her Chemotherapy.

Hoping for your favorable response on this request.

Thank you very much and God Bless.

Very truly yours,

Darleen M. Lim, RSW

Medical Social Worker