REPUBLIC OF THE PHILIPPINES

CITY OF DIGOS
x-------------------------------------------x

PROMISSORY NOTE

I, JUAN DELA CRUZ, Filipino citizen of legal age, single, and a resident of Estrada
5th, Brgy. Zone 3, Digos City, Davao del Sur, after being duly sworn to in accordance
with law, depose and say THAT:

1. I am indebted in the sum of SIXTEEN THOUSAND EIGHT HUNDRED THIRTY

EIGHT AND 36/100 PESOS (P16,838.36) to the order of DIGOS DOCTORS’
HOSPITAL, INC. at Mc Arthur Highway, Digos City, Davao del Sur, the
principal amount of SIXTEEN THOUSAND EIGHT HUNDRED THIRTY EIGHT
AND 36/100 PESOS (P16,838.36); AND

2. I hereby promise and undertake to pay the said indebtedness unto the said
hospital within a period of six (6) months from today.

October 10, 2019, Digos City, Philippines.

MAKER

SUBSCRIBED AND SWORN TO before me this October 10, 2019 in Digos City,
Philippines, affiant exhibiting to me his competent evidence of identity by way of (ID)
with ID No. XXXXXX issued at Digos City on November 10, 2017.

ATTY. XYZ
NOTARY PUBLIC

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 2019.