PENRO LAGUNA HRMIS

Human Resource Management Information System

Daily Time Record

Enter any username and password.

Username

Password

Date:

Temperature:

Name:

Sex:

Male Female

Age:

Residence &
Contact No.:

Email:

	Yes	No
1. Are you experiencing any of the following? (Nakararanas ka ba ng alinman sa sumusunod?)
* Fever for the past 3 days (Lagnat ano mang oras sa nakalipas 3 araw) Fever = 37.5'c above. If yes please specify date when fever was experienced:
* Dry cough / Cough with phlegm (Tuyong ubo / Ubo na may plema)
* Fatigue (Pagkapagod)
* Body pains or Muscle pains (Pananakit ng katawan o kalamnan)
* Runny nose / Colds (Sipon)
* Shortness of breath (Hirap sa paghinga)
* Diarrhea (Pagtatae)
* Headache (Pananakit ng ulo)
* Loss of smell (Pagkawala ng pang amoy)
* Loss of taste (Pagkawala ng panlasa)
* Loss of appetite (Pagkawala ng ganang kumain)
* Sore throat (Pananakit ng lalamunan)
* Difficulty of breathing (Hirap sa paghinga)
* Body malaise or feeling discomfort due to flu like symptoms (panghihina ng katawan dahil sa trankaso)
2. Have you worked together or stayed in the same close environment of a confirmed COVID-19 case? (May nakasama ka ba o nakatrabahong tao na kumpirmadong may COVID-19/may impeksyon ng corona virus?)
3. Have you had any contact with anyone with fever, cough, colds and sore throat in the past 2 weeks? (Mayroon ka bang nakasama na may lagnat, ubo, sipon o sakit ng lalamunan sa nakalipas na dalawang linggo?)
4. Have you travelled outside the Philippines in the last 14 days? (Ikaw ba ay nagbyahe sa labas ng Pilipinas sa nakalipas na 14 na araw?)
5. Have you travelled to any area in NCR aside from your home? (Ikaw ba ay nagpunta sa iba pang parte ng NCR or Metro Manila bukod sa iyong bahay?) Specify (Sabihin kung saan):
6. Have you been asked to self-isolate or quarantine by a doctor or local public health official? (Napagpayuhan o napakiusapan ka na ba ng isang doctor o isang local na opisyal pangkalusugan na ihiwalay ang sarili of self quarantine?) If yes, specify dates covered. (Kung ang sagot ay oo, para sa anong petsa?):

I hereby authorize the Department of Science and Technology to collect and process the data indicated herein for the purpose of effecting control of the COVID-19 infection. I understand that my personal information is protected by RA 10173, Data Privacy Act of 2012, and I am required by RA 11469, Bayanihan to Heal as One Act, to provide truthful information.

Note: The DATE and TIME of this Daily Time Record is sychronized with the HRMIS server.