(Rovised January 1993) . : Repulc ofthe Phippnes OFFICE’ ‘OF THE CIV REGISTRAR GENERAL CERTIFICATE OF LIVE BIRTH REMARKS ANNOTATION Eg som, cry an i, Un ino yet, ot Province —__Bamgue't RogitryNo ly /Municipalty. Baguio Ohty Apree Oe 1. NAME en ie ny Ta ons use Om Sostah Casta aoe Popaton Metron No. 2 Sex [s. DATE OF BIRTH way) front) Gee) gf} Eatin a are $3 Devonbar 2001, Tonerineoueay te 4 PLACE OF — (WamectHospital/Cinie/nsttuton/ —(Ciy/Municpatiy) (Province) eenstnan 4 BIRTH ‘House No,, Stroat, Barangay) Leconte 4 Baguio General Hospital & Medical Genter Baguio Oity “ Vga. TYPE OF BIRTH ° 1 Sihgle 2 Twin Se nile © BIRTH ORDER tive bithe ana ia denne] WEIGHT AT BIRTH Booond_fintesconstiated 3210 game & MAIDEN eno waoe) tet oo ae Virginia dustin Casts 7. CINZENSHIP 3. RELIGION ™ HAlspino Bonen Ontholto s 0 [Ga Tourrumberot wb, Novetehiaren ah Te No.otehilaren 7 nectar SE targincusing omaive at” og hf ae tebia [¥o, OCCUPATION oe Re é TE RESIDENCE Howse fie, Set Barangay, (OVMAMEDR Tee | | 310 Puntwos Komen Ras; t 7] NAME ee) waa A Benita. x oo oo + [ta CInZENSHIP 76 i Wiping fie. OCCUPATION = 7 Marat hese aye Gasoline Boy 25 yeas | 70 m m Te. DATE AND PLACE OF MARRIAGE OF PARENTS (ret marin examen Aidt ot ctnaniedgmont/Aamisionotaterny atthe 4)> 24 April 2000 Ben Caplos, Poagasinan a = Ga ATTENDANT : zs 1 Phyician ha 3 Midnite EN GrcationalMiawie) | 8 Oars Soest) 5) “Ya CERTIFICATION OF BIRTH : 1 ; trey ct tet strand tere Sid whwisbon aneat_ 8456 aa) ca {_ amfomen ow dus sed som. LZ fron xyes Pogusbo Generel. Resytal 4 i Medical Genter Frguie Gity | % #7 5 FilaorPositog Off4ear IIT ate-23 Deoaaber 2004 ____ +p. INFORMANT | connee —_FeACA aoe 380 Paldvon Kormnon BA'y| 1 » Name in Print Bondte Baoan’ ___ Baguio ity |; (Relationship othe child Father __ ate 23 Deoamber_ 2004 __ | 21. PREPARED BY @. RECEIVED AT TwE OFFICE OF | 2 } THE CIVIL REGISTRAR Sonat a er Soke : tarein Pit | are in \, tucerPemon—_———uree Tar aah ele DER ONM AS. ¢ BS Dagan 2004 tome /rvee | 5 Te imciay C. BACGANT See oes