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4454576
Case No: __________________ 5 July 2019
Date: _____________
Pauline A. Luna
Name: ___________________________________________ 35/F
Age/Gender: _______
MI mauling 1) soft tissue swelling
Impression: ____________________________________________________________
2) shoulder, 3) right chest area,
______________________________________________________
4) bruises in the neck
________________________________________________________________
________________________________________________________________
Duration of Treatment: ___________________________________________________
PIA GUANIO
UP-PGH Surgery
Lic. No. 0136931
__________________________________
Signature over Printed Name
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