Republic of the Philippines

Province of Leyte
Provincial Health Office
ORMOC DISTRICT HOSPITAL

MEDICAL CERTIFICATE

____October 27, 2019____

Date

This is to certify that ____LAURENTE, ANA LUISA CASTRO____ ____20 y.o.,

female, single____ of ____Doña Feliza Mejia Subd., Ormoc City, Leyte___ was
examined and treated/confined in this hospital __on/from ___October 27, 2019___
with the following findings and/or diagnosis:

ACUTE TONSILLOPHARYNGITIS
INTERMITTENT FEVER

And would need medical attendance for __3__ days barring complications.

EVELYN P. MEJIA, M.D.

Medical Officer
License No. 93480

CASE NO. 01-25-74-21

O.R. NO.