Republic of the Philippines

DEPARTMENT OF HEALTH
ZAMBOANGA PENINSULA - CENTER FOR HEALTH DEVELOPMENT
Upper Calarian, Zamboanga City 7000
Phone : 062 983-0314, 062 983-0315, Fax : 062 983-3380
Email : dohchdzp@yahoo.com, Web : www.doh.gov.ph
PETTY CASH VOUCHER No. : __________________

Entity Name : DOH ZP CHD Date : _________________

Fund Cluster: _____________________________

Payee/Office : Responsibility Center Code:

Address : Zamboanga City ______________________

I. To be filled out upon request II. To be filled out upon liquidation

Particulars Amount
Wreath flower 1,000.00 Total Amount Granted 1,000.00

Total Amount Paid per

Amount Refunded/
(Reimbursed)
1,000.00
A Requested by: C

Received Refund
ENGR. DOMINGO E. LUSAYA/CAO
Name of Requestor Reimbursement Paid

Approved by:

EMILIA P. MONICIMPO, MD. MPH. CSEE ELMER G. DUCANES

Director IV Petty Cash Custodian

B Paid by: D
Liquidation Submitted
ELMER G. DUCANES
Petty Cash Custodian Reimbursement Received by:

Cash Received by:

_______________________________________ _________________________________
Payee Payee
Date: _______________ Date: _______________
2,301,600.00 767,200.00
462,000.00 767,200.00
2,763,600.00 1,534,400.00
4,298,000.00
Fund
Cluster :
 Republic of the Philippines
DEPARTMENT OF HEALTH
ZAMBOANGA PENINSULA - CENTER FOR HEALTH DEVELOPMENT
Upper Calarian, Zamboanga City 7000
Phone : 062 983-0314, 062 983-0315, Fax : 062 983-3380
Email : dohchdzp@yahoo.com, Web : www.doh.gov.ph
PETTY CASH VOUCHER No. : __________________

Entity Name : DOH ZP CHD Date : _________________

Fund Cluster: _____________________________

Payee/Office : MARIA LIZETTE C. GONGORA Responsibility Center Code:

Address : Zamboanga City ______________________

I. To be filled out upon request II. To be filled out upon liquidation

Particulars Amount
Wreath flower 3,000.00 Total Amount Granted ______________

Total Amount Paid per 3,000.00

Cash Invoice No. 3623 & 3624
01/15/2020
Amount Refunded/
(Reimbursed) 3,000.00
3,000.00
A Requested by: C

Received Refund
ENGR. DOMINGO E. LUSAYA/CAO
Name of Requestor Reimbursement Paid

Approved by:

EMILIA P. MONICIMPO, MD. MPH. CSEE ELMER G. DUCANES

Director IV Petty Cash Custodian

B Paid by: D
Liquidation Submitted
ELMER G. DUCANES
Petty Cash Custodian Reimbursement Received by:

Cash Received by:

MARIA LIZETTE C. GONGORA MARIA LIZETTE C. GONGORA

Payee Payee
Date: _______________ Date: _______________
 Republic of the Philippines
DEPARTMENT OF HEALTH
ZAMBOANGA PENINSULA - CENTER FOR HEALTH DEVELOPMENT
Upper Calarian, Zamboanga City 7000
Phone : 062 983-0314, 062 983-0315, Fax : 062 983-3380
Email : dohchdzp@yahoo.com, Web : www.doh.gov.ph
PETTY CASH VOUCHER No. : __________________

Entity Name : DOH ZP CHD Date : _________________

Fund Cluster: _____________________________

Payee/Office : MARIA LIZETTE C. GONGORA Responsibility Center Code:

Address : Zamboanga City ______________________

I. To be filled out upon request II. To be filled out upon liquidation

Particulars Amount
Wreath flower 3,000.00 Total Amount Granted ______________

Total Amount Paid per 3,000.00

Cash Invoice No. 23139
01/16/2020
Amount Refunded/
(Reimbursed) 3,000.00
3,000.00
A Requested by: C

Received Refund
ENGR. DOMINGO E. LUSAYA/CAO
Name of Requestor Reimbursement Paid

Approved by:

EMILIA P. MONICIMPO, MD. MPH. CSEE ELMER G. DUCANES

Director IV Petty Cash Custodian

B Paid by: D
Liquidation Submitted
ELMER G. DUCANES
Petty Cash Custodian Reimbursement Received by:

Cash Received by:

MARIA LIZETTE C. GONGORA MARIA LIZETTE C. GONGORA
Payee Payee
Date: _______________ Date: _______________
2,301,600.00 767,200.00
462,000.00 767,200.00
2,763,600.00 1,534,400.00
4,298,000.00
2,301,600.00 767,200.00
462,000.00 767,200.00
2,763,600.00 1,534,400.00
4,298,000.00
Fund
Cluster :
Fund
Cluster :
 Republic of the Philippines
DEPARTMENT OF HEALTH
ZAMBOANGA PENINSULA - CENTER FOR HEALTH DEVELOPMENT
Upper Calarian, Zamboanga City 7000
Phone : 062 983-0314, 062 983-0315, Fax : 062 983-3380
Email : dohchdzp@yahoo.com, Web : www.doh.gov.ph
PETTY CASH VOUCHER No. : __________________

Entity Name : DOH ZP CHD Date : _________ 1/30/2020

Fund Cluster: _____________________________

Payee/Office : HELEN S. ARANETA/COA Responsibility Center Code:

Address : Zamboanga City
______________________

I. To be filled out upon request II. To be filled out upon liquidation

Particulars Amount
MISC.EXP. 1,000.00 Total Amount Granted 1,000.00

Total Amount Paid per

Amount Refunded/
(Reimbursed)
Total : 1,000.00
A Requested by: C
Received Refund
NARCISA S. CABALLES
SA IV Reimbursement Paid

Approved by:

EMILIA P. MONICIMPO, MD. MPH. CSEE ELMER G. DUCANES

Director IV Petty Cash Custodian

B Paid by: D
/ Liquidation Submitted
ELMER G. DUCANES
Petty Cash Custodian Reimbursement Received by:

Cash Received by:

HELEN S. ARANETA HELEN S. ARANETA

Signature over printed name of payee Signature of payee
Date: 1/30/2020 Date: 1/30/2020
 Republic of the Philippines
DEPARTMENT OF HEALTH
ZAMBOANGA PENINSULA - CENTER FOR HEALTH DEVELOPMENT
Upper Calarian, Zamboanga City 7000
Phone : 062 983-0314, 062 983-0315, Fax : 062 983-3380
Email : dohchdzp@yahoo.com, Web : www.doh.gov.ph
PETTY CASH VOUCHER No. : __________________

Entity Name : DOH ZP CHD Date : _________ 3/2/2020

Fund Cluster: _____________________________

Payee/Office : HELEN S. ARANETA/COA Responsibility Center Code:

Address : Zamboanga City
______________________

I. To be filled out upon request II. To be filled out upon liquidation

Particulars Amount
Misc. Exp. 1,000.00 Total Amount Granted 1,000.00

Total Amount Paid per

Amount Refunded/
(Reimbursed)
Total : 1,000.00
A Requested by: C
Received Refund
NARCISA S. CABALLES
SA IV Reimbursement Paid

Approved by:

EMILIA P. MONICIMPO, MD. MPH. CSEE ELMER G. DUCANES

Director IV Petty Cash Custodian

B Paid by: D
/ Liquidation Submitted
ELMER G. DUCANES
Petty Cash Custodian Reimbursement Received by:

Cash Received by:

HELEN S. ARANETA HELEN S. ARANETA

Signature over printed name of payee Signature of payee
Date: 3/2/2020 Date: 3/2/2020