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Republic of the Philippines

NATIONAL POLICE COMMISSION


PHILIPPINE NATIONAL POLICE
Pagalungan Municipal Police Station
Poblacion, Pagalungan, Maguindanao
mpspagalungan@yahoo.com

September 24, 2022

Request for Medical Examination of Arrested Suspect/s

The Duty Physician


USM Hospital
Kabacan, North Cotabato

Sir/Madam:

Respectfully request for the Medical and Physical Examination of the following
suspects who were arrested by personnel of this Office on ___________ at
______________:

a. SEX
b. SEX
c. SEX

Please furnish the arresting/escort officer, (Rank/Name) ________________


a copy of the result of the Medical Examination for our reference.

Rest assured of our continuous support on matters of mutual concern. Thank


you.

PLT JHON DELA CRUX


Officer-In-Charge

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