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Student’s Copy

Republic of the Philippines


CAVITE STATE UNIVERSITY
Imus Campus
Cavite Civic Center, Palico IV, City of Imus, Cavite 4103
cvsuimus.clinic@cvsu.edu.ph

Sequence No.: 511


Student Control No: 20428

MEDICAL CLEARANCE
Academic Year 2022-2023

This is to certify that I have personally seen/examined LAMA, MALACHI and found him/her to be
physically and medically FIT to enroll on the BSIT program.

JASPER T. LEGASPI, RN, MAN


Campus Nurse
License No. 0673199

Registrar’s Copy

Republic of the Philippines


CAVITE STATE UNIVERSITY
Imus Campus
Cavite Civic Center, Palico IV, City of Imus, Cavite 4103
cvsuimus.clinic@cvsu.edu.ph

Sequence No.: 511


Student Control No: 20428

MEDICAL CLEARANCE
Academic Year 2022-2023

This is to certify that I have personally seen/examined LAMA, MALACHI and found him/her to be
physically and medically FIT to enroll on the BSIT program.

JASPER T. LEGASPI, RN, MAN


Campus Nurse
License No. 0673199

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