Out-patient Pharmacy

Online Order Form

(Please complete the fields for successful transaction)

Delivery Guidelines:
1. 1. Minimum delivery purchase amount is P250
3. 2. Delivery fee is P50
5. 3. Free delivery for purchases P1000 and above
7. 4. Delivery fee of P50 will be charged to deliveries to SC/PWD patients regardless of amount of purchase
8. 
   For follow up of orders beyond 4PM, you may contact the official hotline numbers: CALL DDH (225-5334 ) or through SMART - 0920 9183333; SUN - 0923 7165515; GLOBE 0917 8953333.
   
   
   

Customers Name:

Complete Mailling Address

Contact numbers:

Email Address:

Birthday:

Gender

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Civil Status:

SingleMarriedWidowed

Recipient of Order

Name of Patient

Address of Patient:

Contact numbers:

Medicine Order

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