ActiveOne Health, Inc.

4F Williams Building, Williams St., Cor. Mayflower St.

Mandaluyong City
www.activeonehealth.com

QUARANTINE CLEARANCE

TO WHOM IT MAY CONCERN:

This is to certify that                         Bautista, Dolly                         who come from,

                            Blk 12 Lot 10 Community Model, Tondo Manila                                         may

return to work as per our medical assessment and due to the below reason/s:

      ✅ Completed Home Quarantine Period:  3/24/2021   to   4/6/2021  

      🔲 Negative PCR Result taken on     

      🔲 Infectious Disease Specialist (IDS) Clearance issued on     

      🔲 Medical Certificate/Clearance

      🔲 Others:     

Issued this       6th       day of       April 2021       for whatever purpose it may serve best.

Dr. Kristine Reyes

Telemedicine Physician
Lic. No. 103716