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lor OCRG)

lrunispsl Form No, 103 $o br r..ompllrhrd kl +Ednfllcat l FEMAFKS/AI'INOTATIOH


(khrd Janusy 19Sl)
Republlc ol the Pt{tlPdnes
OFFICE OF THE CIVIL REGISTRAfl GENEFAL
CERTIFIGATE OF LIVE BIRTH
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08043-89- 1 45PMP-001 60-8100 1


BReN
BEST POSSIBLE IMAGE 07604-803XE06-B CLAIRE DENNIS S. MAPA, Ph, D
National $tatistician and Civil Registrar General
lll Documentary Ph,ippine tlftX?ii:fi
il Ill ll Illlllll
I I I I I I ll llll ll I I ll ll I I I I II ll I ll I ll ll I II I
ffifftl{Y rn rtl r,ii
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Page 1 of 2, 1 Copy

lor OCRG)

ttuoispel Fom iro. 102 $o be r.compllshgd kl qfrd{ulllcate} FEMAFKS/ANNOTATIOH


(ftrl€.d Jmtry 19€3)
Republlc ol the PtiltlPPlnes
OFFICE OF THE SIVIL REGISTRAN GENERAL
CERTIFICATE OF LIVE BIRTH
IFitrI EeEtct {rd hglbly UE ir* s( t ptrnb{.
out @nehtdy,
ptico I tcio{, ,!. srDrorthit M lt llffi! ?' 5e. 55 rnd 19r)
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18. DATE AND PI-ACE OF MAftSIAGE OF PAFEf'{J3 {il rlot tnE tfcd; scoompllBh Afid;vil o{
Aclrnowledgrnent lAdmi8rim ol Fatrrnllyel lh. bio&-)
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20. INFORMAfiff
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21. PREPAHED BY 22" REf,EI\EO
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08043-89- 1 45PMP-001 60-8100 1


__l BReN
BEST POSSIBLE IMAGE 07604-803XE06-8 CLAIRE OENNIS S. MAPA, Ph, D
National Statistician and Civil Registrar General
ill lll Documentary Ph,ippine tt$l?liifi.tfFftl{,.
il I il il I lllllll II II II ll llll ll I I ll ll I I I II I ll I ll I I II I
ffi rsffi646fd500 1 600 1 08202200'1 Stamp Tax Paid rn, rru rii,

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