Princess Marie Loius Childrens Hospital Ghan | Covid19 Case Investigation Form

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PML HOSPITAL STAFF AND DEPENDANT DATA

Staff ID

Name of Staff

Name of Spouse

Dependant1 (Below 18 or23 if in School)

Dependant2 (Below 18 or23 if in School)

Dependant3 (Below 18 or23 if in School)

Dependant4 (Below 18 or23 if in School)

Phone Number

Emergency Contact

Thanks for submitting!

Contacts:

Post Office Box, GP 122, Accra.

GA-182-5729

Tel: +233 53 109 7694

Email: pmlhosp@outlook.com

Emergency Contacts:

+233 53 109 7694

Quick Links:

Ministry of Health

Ghana Health Service

National Health Insurance Scheme

World Health Organization

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