CS Form No.

212

PERSONAL DATA SHEET

Revised 2017

WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the person concerned.

READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No. (Do not fill up. For CSC use only)

I. PERSONAL INFORMATION
2. SURNAME Aseron
NAME EXTENSION (JR., SR)
FIRST NAME Kent Fhilip
MIDDLE NAME Ramirez
3. DATE OF BIRTH
(mm/dd/yyyy)
7/5/2003 16. CITIZENSHIP
Filipino Dual Citizenship

by birth by naturalization

4. PLACE OF BIRTH Calapan City, Oriental Mindoro If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female

Single Married 17. RESIDENTIAL ADDRESS Mezza 2 Residences Guirayan St.

6 CIVIL STATUS
Widowed Separated House/Block/Lot No. Street
N/A Brgy. Doña Imelda
Other/s:
Subdivision/Village Barangay
Quezon City Metro Manila
7. HEIGHT (m) 1.9 m
City/Municipality Province
8. WEIGHT (kg) 65kg ZIP CODE 1113

18. PERMANENT ADDRESS Aseron Residences Sitio Mayumi

9. BLOOD TYPE A
House/Block/Lot No. Street
N/A Brgy. Maluanluan
10. GSIS ID NO. N/A
Subdivision/Village Barangay
Pola Oriental Mindoro
11. PAG-IBIG ID NO. N/A
City/Municipality Province

12. PHILHEALTH NO. N/A ZIP CODE 5206

13. SSS NO. N/A 19. TELEPHONE NO. 0277570195

14. TIN NO. N/A 20. MOBILE NO. 09564785354

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) kentfhilip@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) N/A
FIRST NAME N/A

MIDDLE NAME N/A

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME Aseron

NAME EXTENSION (JR., SR)
FIRST NAME Kenneth
MIDDLE NAME Lagsac
25. MOTHER'S MAIDEN NAME Filipina Alda Ramirez
SURNAME Aseron
FIRST NAME Filipina
MIDDLE NAME Ramirez (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

SCHOLARSHIP/
26. PERIOD OF ATTENDANCE HIGHEST LEVEL/
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE YEAR ACADEMIC
LEVEL UNITS EARNED
(Write in full) (Write in full) (if not graduated)
GRADUATED HONORS
RECEIVED
 SCHOLARSHIP/
HIGHEST LEVEL/
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE YEAR ACADEMIC
LEVEL UNITS EARNED
(Write in full) (Write in full) (if not graduated)
GRADUATED HONORS
From To RECEIVED

2nd Honorable
ELEMENTARY MALUANLUAN ELEMENTARY SCHOOL Primary Education 2009 2015 2015 Mention

DOMINGO YU CHU NATIONAL HIGH Junior High School - Science With High
SECONDARY
SCHOOL Technology and Engineering Class
2015 2019 2019
Honors
VOCATIONAL / Senior High School - Health Allied
TRADE COURSE
UNIVERSITY OF SANTO TOMAS
Strand
2019 2021 2021 With Honors

Bachelor of Science in Physical

COLLEGE UNIVERSITY OF SANTO TOMAS
Theraphy
2021 2025 2025 Cum Laude

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE March 26, 2035

CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT Date of
(If Applicable) NUMBER
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT Validity

Licensed Physical Therapist 89.90% 8/30/2025 Metro Manila #PT81987 8/30/2037

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet.
28. INCLUSIVE DATES SALARY/ JOB/ PAY
GRADE (if GOV'T
(mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY MONTHLY STATUS OF
applicable)& STEP SERVICE
(Write in full/Do not abbreviate) (Write in full/Do not abbreviate) SALARY (Format "00-0")/ APPOINTMENT
(Y/ N)
From To INCREMENT

8/21/2033 Present Chief of Rehabilitation Department Philippine Children's Medical Center P47k Permanent Y

1/5/2028 8/5/2033 Physical Therapist II Philippine General Hospital P29K Contractual Y

10/20/2025 1/3/2028 Physical Therapist I Philippine Children's Medical Center P20k Contractual Y

(Continue on separate sheet if necessary)

SIGNATURE DATE March 26, 2035

CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29.
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

Philippine Doctors League 9/18/2031 11/20/2032 Volunteer PT

Gawad Kalinga 07/29/2027 07/29/2030 Volunteer

Red Cross Philippines 02/19/2028 02/19/2030 Volunteer

UNICEF Philippines 07/25/2025 05/17/2028 Voluteer

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start from the most recent L&D/training program and include only the relevant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)

INCLUSIVE DATES OF Type of LD

30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To
Treating Chronic Pain Patients with Knowledge and Confidence: A
08/21/2028 3 days Department of Health
Multidiscipinary Approach in the Managed Care Environment.
Epignosis: A Webinar on COVID-19, Vaccines, and Herd Immunity 3/18/2021 3 hours
University of Santo Tomas

EmpoweRED: An HIV Awareness Campaign 3/21/2021 1 hour

University of Santo Tomas

Walk the Talk: Speech Language Pathology in the New Normal 3/19/2021 2 hours
University of Santo Tomas

Eating 101: Staying Healthy in the New Normal 3/19/2021 3 hours

University of Santo Tomas

On the Job Training 10/20/2025 2 years

Philippine Children's Medical Center

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full) (Write in full)

Patient Assessment Mobility Award Red Cross Philippines

Creating Plan of Care Interpersonal Skills Award Gawad Kalinga

Pedriatic PT 5-star ratings on Healthgrades Philippine Association of Physical Therapist

Patient and Family Education Red Cross Volunteer Excellence Unicef Philippines

Performinng Therapy Intervention

Documentation

Interpersonal Skills

(Continue on separate sheet if necessary)

SIGNATURE DATE March 26, 2035

CS FORM 212 (Revised 2017), Page 3 of 4

 34. Are you related by consanguinity or affinity to the appointing or recommending authority, or to the
chief of bureau or office or to the person who has immediate supervision over you in the Office,
Bureau or Department where you will be apppointed,
a. within the third degree? YES NO

b. within the fourth degree (for Local Government Unit - Career Employees)? YES NO
If YES, give details:

35. a. Have you ever been found guilty of any administrative offense? YES NO
If YES, give details:
________________________________

b. Have you been criminally charged before any court? YES NO

If YES, give details:
________________________________
Date Filed:
Status of Case/s:
36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation YES NO
by any court or tribunal?
If YES, give details:
________________________________

37. Have you ever been separated from the service in any of the following modes: resignation, YES NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in the public or private sector?
38. a. Have you ever been a candidate in a national or local election held within the last year (except YES NO
Barangay election)? If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES NO
election to promote/actively campaign for a national or local candidate? If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country? YES NO
If YES, give details (country):

40. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA
7277); and (c) Solo Parents Welfare Act of 2000 (RA 8972), please answer the following items:
a. Are you a member of any indigenous group? YES NO
If YES, please specify:
b. Are you a person with disability? YES NO
If YES, please specify ID No:
c. Are you a solo parent? YES NO
If YES, please specify ID No:

41. REFERENCES (Person not related by consanguinity or affinity to applicant /appointee)

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
Therese Dianne Reyes, PTRP Metro Manila (02) 434549 3.5 cm. X 4.5 cm
(passport size)

Coleen Santos, RN Metro Manila (02) 163131 With full and handwritten
name tag and signature over
printed name
Kent Fhil Mae Aseron, RN Mezza 2 Residences, QC (02) 793903
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated herein.
I agree that any misrepresentation made in this document and its attachments shall cause the filing of PHOTO
administrative/criminal case/s against me.

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of Issuance
Government Issued ID: Passport

ID/License/Passport No.: P29156250D

Signature (Sign inside the box)

Date/Place of Issuance: 05/31/2020; Quezon City

Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this March 26, 2035 , affiant exhibiting his/her validly issued government ID as indicated above.

Person Administering Oath

CS FORM 212 (Revised 2017), Page 4 of 4