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Republic of the Philippines

DEPARTMENT OF EDUCATION
Region V
DIVISION OF CAMARINES SUR
NABUA DISTRICT
MALAWAG NATIONAL HIGH SCHOOL
I hereby returned the amount of 40.00 for the Student Insurance.

GRADE 9-
NAME OF STUDENT AMOUNT NAME OF PARENT SIGNATURE
1. 40.00
2. 40.00
3. 40.00
4. 40.00
5. 40.00
6. 40.00
7. 40.00
8. 40.00
9. 40.00
10. 40.00
11. 40.00
12. 40.00
13. 40.00
14. 40.00
15. 40.00
16. 40.00
17. 40.00
18. 40.00
19. 40.00
20. 40.00
21. 40.00

Prepared & Submitted: Noted:

JUDITH P. ARMILLOS IRENIA L. SAYSON


SPTA Treasurer Principal

Attested: Approved:

LOURDES R. NOPRE FERNANDO C. MACARAIG JR.


PSDS ASDS
Republic of the Philippines

DEPARTMENT OF EDUCATION
Region V
DIVISION OF CAMARINES SUR
NABUA DISTRICT
MALAWAG NATIONAL HIGH SCHOOL

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