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  • Medical Certificate: Name of Patient Age Sex Mental Status Complete Address

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    Jhun Figarola
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    SPO1 Rizman Bacariza y Agustin, a 35-year old married male from Brgy. San Vicente, City of Ilagan, Isabela, was examined as an outpatient at the Gov. Faustino Dy. Memorial Hospital in Calamagui 2nd City, Ilagan, Isabela on June 13, 2017 and was found to be physically and mentally fit. This medical certificate was issued at the request of SPO1 Bacariza for any legitimate purposes and was signed by Dr. Iza T. Tabao on June 6, 2017.

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    Medical certificate

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    Medical

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    SPO1 Rizman Bacariza y Agustin, a 35-year old married male from Brgy. San Vicente, City of Ilagan, Isabela, was examined as an outpatient at the Gov. Faustino Dy. Memorial Hospital in Calamagui 2nd City, Ilagan, Isabela on June 13, 2017 and was found to be physically and mentally fit. This medical certificate was issued at the request of SPO1 Bacariza for any legitimate purposes and was signed by Dr. Iza T. Tabao on June 6, 2017.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    38 views1 page

    Medical Certificate: Name of Patient Age Sex Mental Status Complete Address

    Uploaded by

    Jhun Figarola
    SPO1 Rizman Bacariza y Agustin, a 35-year old married male from Brgy. San Vicente, City of Ilagan, Isabela, was examined as an outpatient at the Gov. Faustino Dy. Memorial Hospital in Calamagui 2nd City, Ilagan, Isabela on June 13, 2017 and was found to be physically and mentally fit. This medical certificate was issued at the request of SPO1 Bacariza for any legitimate purposes and was signed by Dr. Iza T. Tabao on June 6, 2017.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    Province of Isabela

    Gov. Faustino Dy. Memorial Hospital


    Calamagui 2nd City of Ilagan, Isabela
    Tel. no. (078)652-7777
    PHILHEALTH ACCREDITED

    MEDICAL CERTIFICATE
    This is to certify that SPO1 RIZMAN BACARIZA Y AGUSTIN, 35 years old, male,
    Name of Patient Age Sex
    Married with stated residence of Brgy. San Vicente, City of Ilagan, Isabela
    mental status Complete address

    was examined and treated in this hospital as OUT PATIENT on

    June 13, 2017 with the following impressions/diagnosis/findings:


    Date of Examination

    Physically and Mentally fit


    This certification is issued upon request of the interested party for whatever legal and
    legitimate purposes/s it may served him/her

    Given this 6th day of June 2017at Gov. Faustino Sy. Memorial Hospital, Calamagui 2nd, City
    of Ilagan, Isabela.

    IZA T. TABAO M.D


    Medical officer III
    License No. :123456

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