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DE LA SALLE

DR. RODOLFO POBLETE MEMORIAL HOSPITAL


BURGOS STREET, ALFONSO, CAVITE 4123 PHILIPPINES
TEL. NOS. (046) 4150190* (046) 4151286

Date:____10/01/18_____

MEDICAL CERTIFICATE

TO WHOM IT MAY CONCERN:

THIS IS CERTIFY THAT _____________AQUINO CLYDE_25/M_____________________________


_________________________________________________________________ CONSULTED AT
THE DE LA SALLE –DR. RODOLFO POBLETE MEMORIAL, HOSPITAL, ALFONSO, CAVITE ON
____10/01/2018____ AS OUTPATIENT UNDER THE MEDICAL CARE OF THE UNDERSIGNED WITH
THE DIAGNOSIS OF __________________HEADACHE AND MOUTH SORE __________________
_____________MAY RETURN TO WORK_____________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

THIS CERTIFICATION IS ISSUED UPON THE REQUEST OF THE PATIENT EMPLOYER


PURPOSE ONLY.

CARLO A.O. PASCO. MD. DPCP


ATTENDING PHYSICIAN

LICENSE NO.___112491____
PTR NO_____6997815_____

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