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EMVIC GENERAL MEDICINE CLINIC

#107 FILINVEST, ROAD 1 BATASAN HILLS, QUEZON CITY


TEL#: 8659-1040 CP#: 09669051035

Patients Name:______________________________ Age:_____ Sex:___

Address:____________________________________ Date: __________

Rx

_EP ALIORDE M.D___


Your next appointment is on: Lic. No. 0095575____
_____________________________ PTR. No:__________
S2 No:____________

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