APPOINTMENT DATE: Sep 02, 2019 (11:00 AM TO 12:00 PM) - PRC Cebu - Main Office (Initial Registration, PIC

Renewal, Certifications)
REFERENCE NO: INK2JEGKTR23 | OR: - | AMOUNT: PHP -

NOT FOR SALE (REPRODUCTION IS ALLOWED)

Republic of the Philippines

Professional Regulation Commission
Manila Paste here
your recent
PASSPORT SIZE
colored picture in
white background
PANUNUMPA NG PROPESYONAL with complete
name tag

ELDEVINCEY ALAJAR MACABATA

Ako, si ______________________________________________________________________, ng
_____________________________________________________________________________________
BISLIG, SURIGAO DEL SUR
(Pook na Sinilangan, Bayan/Lungsod, Probinsya)
ay taimtim na nanunumpa na itataguyod ko at ipagtatanggol ang Saligang Batas ng Pilipinas, na ako ay
tunay na mananalig at tatalima rito; na susundin ko ang mga batas, mga utos na legal, at mga atas na
ipinahayag ng mga sadyang itinakdang may kapangyarihan ng Republika ng Pilipinas; at kusa kong
babalikatin ang pananagutang ito, na walang ano mang pasubali o hangaring umiwas.

Taimtim pa rin akong manunumpa na sa lahat ng panahon at pook na kinaroroonan ay mahigpit

akong manghahawakan sa mga etikal at tuntuning propesyonal ng mga
VETERINARIAN
____________________________ sa Pilipinas, at marapat kong gagampanan ng buong husay sa abot ng
(Propesyon)
aking makakaya ang mga tungkulin at pananagutang iniatang sa isang itinakdang
VETERINARIAN
________________________.
(Propesyon)

Kasihan Nawa ako ng Diyos.

______________________________________
( Lagda)
M213IEEY59-DT340370
A - ____________________________ ILIGAN CITY
_______________________ May 22, 2019
_________________________
(Blg. Ng Sedula) (Kinuha sa) (Petsa)

Nilagdaan at Pinanumpaan sa harap ko ngayong ika-____________ ng ________________________

taon ng ating Panginoon _____________________ sa ___________________________, Pilipinas.

FOR PRC PROCESSING

-
OK to Pay: __________________________________ __________________________________
Selyo -
OR No.: _____________________________________ (Pinunong Tagapanumpa)
Dokumentaryo -
Date Paid: ___________________________________
VETERINARIAN
Profession: __________________________________ __________________________________
Registration No.: ______________________________ (Katungkulang Opisyal)
Registration Date: _____________________________

PERSONAL DATA
Telephone/Contact Number: +639224464800 / 2216156 Date of Examination: Aug 01, 2019
Citizenship: FILIPINO Date of Birth: Sep 05, 1995
Civil Status: SINGLE Sex: MALE Spouse’s Name/Citizenship:
Father’s Name/Citizenship: AVERY FRANK L. MACABATA / FILIPINOMother’s Name/Citizenship: CHONA A. MACABATA / FILIPINO

PLEASE FILL OUT THIS CLAIM SLIP

CLAIM SLIP

ELDEVINCEY ALAJAR MACABATA

NAME: _______________________________________ VETERINARIAN
PROFESSION: _________________________________
REGISTRATION NO. ____________________________ REGISTRATION DATE: __________________________
Please present this slip at Issuance Window ____________________ to claim your professional identification card on
________________________.
(NOTE: REPRESENTATIVE WITH PROPER IDENTIFICATION SHOULD PRESENT SPECIAL POWER OF ATTORNEY/ AUTHORIZATION
LETTER FROM THE REGISTERED PROFESSIONAL). FOR CONFIRMATION PLEASE CALL UP (02) 736-22-48.

____________________________________________
(Registration Officer)

REG- 01
Rev. 00
February 25, 2015
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