CLOSE CONTACT LINE List FORM

NATURE OF
DATE OF BIRTH CONTACT (HH, DATE of LAST ASYMPTOMATIC
LAST NAME FIRST NAME MIDDLE INITIAL ADDRESS AGE SEX (M/F) CONTACT NO.
(mm/dd/year) WS, S, T, A, HCW, EXPOSURE (Y/N)
Others)
1 Amilao Roy A 11/07/1971 48 M 9751862566
2 Alentajan Neilmar V M 9652473521
3 Bayotas Ray H 10/16/1991 28 M 9156277513
4 Beliganio Cyrus John L 02/18/1985 35 M 9553365884
Daraug Danilo P 11/02/1973 46 M 9388836858
Decipulo Necitas S 08/07/1977 43 M 9363381261
Dela Cruz Sonny P 10/14/1977 42 M 9477862900
Esmade Jubert P 09/15/1987 32 M 9512541042
Jaleco John Rey B 01/19/1993 27 M 9125368066
Janson Bernard R 08/06/1976 44 M 9503613843
Jayme John S 1/1/1985 35 M
Macalong Augustine S M 9776240997
Mier Mark P 07/23/1979 41 M
Mondejar Maxwell M 03/09/1980 40 M
Panares Efren A 04/02/1985 35 M
Panes Rhean G 12/28/1987 37 M
Tabios Rey P 10/01/1977 42 M 9169364746
Torreon Ranie E 02/05/1987 33 M
Taustumban Elsie J M
Santiago Jessie G 01/15/1974 46 M 9305842233