Republic of the Philippines

Province of Leyte
Municipality of Palo
Barangay Sta. Cruz

OFFICE OF THE PUNONG BARANGAY

C E R T I F I C A T I O N

TO WHOM IT MAY CONCERN:

THIS IS TO CERTIFY that LUCILA P. CHAVERO, of legal age, female, married and a
bona fide resident of Barangay Sta. Cruz, Palo, Leyte, that on July 3, 2019 she was diagnosed
with Diabetes Mellitus Type 2, Non-insulin requiring at Palo Municipal Health Office, Palo,
Leyte.
This certification is being issued upon the request of the aforementioned for
application of DSWD Medical Assistance Program.

SIGNED this 4th day of July 2019, at Barangay Sta. Cruz, Palo, Leyte, Philippines.

GEMMA M. GASPANG
Punong Barangay