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This is to certify that AGUSTIN VIBER, 43 years of age, of Purok 2, Cogon, Tagbilaran
City, Philippines was examined and treated as out-patient/confined last December 26, 2016
with the following findings and/or diagnosis/es:
Hyperthermia, grinding and clenching of the teeth, lock jaw, loss of appetite, dehydration, and
increased dilation of the Iris
Remarks:
Possible chemical intoxication. Need to conduct chemical analysis of hair, blood and urine
to determine toxic agent. Admission is recommended.