2. PHS Forms
  3. PHS Forms

PHS Forms

PHS Forms

words found on Pokagon Health Service froms
Pëgėgnenimshkëkiwgëmëk
Pokagon Health Services
Recording: 
nithë ė zhnëkazyen
patient name [what are you called?]
Recording: 
nithëwpi ga ndadzëyen
Date of birth [when were you born?]
Recording: 
nipithë ėthë dayen
address [where do you live at?]
Recording: 
nipithë ėthë miktthéwiyen
employer [where do you work at?]
Recording: 
wgetthda nė gdaw
are you a veteran?
Recording: 
wzhebyé’en gbiwapkogdaswen
phone number [write your phone number]
Recording: 
wénithë da shëgnongot
emergency contact [who should be called?]
Recording: 
yazhdéyakwpi’gén
signature of patient [make your mark]
Recording: 
maktthéwit wdazhdéyakwpi’gën
signature of PHS staff [signature of worker]
Recording: