johannesburg health district department of family medicine, wits phc outreach team / community practice family folde
JOHANNESBURG HEALTH DISTRICT
Department of Family Medicine, Wits
PHC Outreach Team / Community Practice
FAMILY FOLDER
Ward:…………… CHW:…………………………………Ref.No. ……………
Registered Doctor / Nurse:…………………………………………………….
Family Name: …………………………………………………………………..
Physical Address: ……………………………………………………………….
Postal Address: ………………………………………………………………….
……………………………………………………………….Code …………….
Home Telephone: ……………………………………………………………..
Most Useful Cell:…………………………………………………………………
Relevant Family Information:
…………………………………………………………………………………….