Republic of the Philippines

DEPARTMENT OF EDUCATION

(REGION)

LA UNION

(DIVISION)

DON EULOGIO DE GUZMAN MEMORIAL NATIONAL HIGH SCHOOL

(SCHOOL)

CALUMBAYA BAUANG, LA UNION

SCHOOL ADDRESS

MEDICAL CERTIFICATE
November 2018

(Date)

To Whom It May Concern:

This is to certify that I have personally examined

age of ____ sex , born on and have found that he/she is

physically fit, during the time of examination.

Physical Examination

Date examined: __________________

Height _____ Weight _____ Blood Pressure________

Pulse, resting ______________ Respiratory Rate __________________

Other remarks __________________________________________

 ________________________

Physical Medical Officer

(Signature over printed name)

License no.____________

PTR: _________________

Date __________________
 ON EULOGIO GUZMAN MEMORIAL NATIONAL HIGH SCHOOL

(School)

CALUMBAYA BAUANG, LA UNION

(School Address)

MEDICAL CERTIFICATE
November 9, 2018

(Date)

To whom It May Concern:

This is to certify that I have personally examined Gian Paolo R. Corpuz

age 17 sex Male born on March 19, 2001, and have that found that he is physically fit, during the time

of examination.