PR REG Fam No 0 Pe. Sep 2 a apache Bylppces © Professions! Regulation Commission Mails REGISTRATION DIVISION ACTION SHEET FOR CERTIFICATION Date fed: nave, 241RA_ Mona BARES PROFESSION,__ NURSE LUcense no_ 941322 ave reaisreren:_MAKCH $2012 PURPOSE (lease chet) : Lice star [toca emrloyrent Jot foe AW RecPea) Cl corns [_Joverseas Employment [_] Legal No. of copies:_! (P75lcopy ae rE Amount OR. No. Proaessed by. Ea AMEFLLOUTTOOGAMELP CERTIFICATION CLAIM SLIP No, of copies: NAME: PROFESSION LUCENE No. DATE REGISTERED: tne sd “an Feb Mar igray hm Ag Sepk Oct Nov Dee 42245678 90 2S 4% MoM We Ad A D2 6 a 28 29 30 3 ahs Jan Feb Mar doe ay ing Sept Oct Not Dec 12345676 910M 12 TS WS 1617 18 19 HO Zk U4 2 26-27 2 2 30H Please present this slp to claim documents at Window REPRESENTATIVE WITH PROPER IDENTIFICATION SHOULI PRESENT AUTHORIZATION LETTER FROM THE REGISTERED PROFESSIONAL, REGISTRATION OFFICER