Republic of the Philippines

DEPARTMENT OF EDUCATION
REGION III
(Region)
TARLAC PROVINCE
(Division)
CORAZON C. AQUINO HIGH SCHOOL
(School)
POB. 3 GERONA, TARLAC
(School Address)

MEDICAL CERTIFICATE

October 12, 2018

(Date)

To Whom It May Concern:

This is to certify that I have personally examined ROLAN D. GALAMAY

Name
age 28 sex M born on JANUARY 28, 1992 and have found that he/she is

physically fit, during the time of examination, to join and compete in the lower meets and

Palarong Pambansa.

Event: ATHLETICS SECONDARY BOYS

Physical Examination

Date examined: _______________

Height Weight: Blood Pressure
Pulse, Resting Respiratory Rate
Other Remarks:

____________________________
Physician/Medical Officer
(Signature over printed name)

License No. __________________

PTR.: ____________________
Date: ____________________

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
DEPARTMENT OF EDUCATION
REGION III
(Region)
TARLAC PROVINCE
(Division)
CORAZON C. AQUINO HIGH SCHOOL
(School)
POB. 3 GERONA, TARLAC
(School Address)

MEDICAL CERTIFICATE

October 12, 2018

(Date)

To Whom It May Concern:

This is to certify that I have personally examined LEA ANN B. PALACIOS

Name
age 26 sex F born on JUNE 20, 1990 and have found that he/she is physically

fit, during the time of examination, to join and compete in the lower meets and Palarong

Pambansa.

Event: ATHLETICS SECONDARY BOYS

Physical Examination

Date examined: _______________

Height Weight: Blood Pressure
Pulse, Resting Respiratory Rate
Other Remarks:

____________________________
Physician/Medical Officer
(Signature over printed name)

License No. __________________

PTR.: ____________________
Date: ____________________

FOR PALARONG PAMBANSA ONLY