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    Cindy Dollente Villafuerte
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    This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) providing key information about member Edelberto Sicad Villafluerte Jr. and his dependents. It lists Villafluerte's PhilHealth identification number, member category, personal details, employer information, and details for his four dependents - his wife, Cinderella Dollente Villafluerte, and three daughters. The MDR reminds the member to check for any errors or missing information and to keep the original copy safe while providing hospitals with a photocopy if availing any benefits.

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    This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) providing key information about member Edelberto Sicad Villafluerte Jr. and his dependents. It lists Villafluerte's PhilHealth identification number, member category, personal details, employer information, and details for his four dependents - his wife, Cinderella Dollente Villafluerte, and three daughters. The MDR reminds the member to check for any errors or missing information and to keep the original copy safe while providing hospitals with a photocopy if availing any benefits.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views1 page

    MDR PDF

    Uploaded by

    Cindy Dollente Villafuerte
    This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) providing key information about member Edelberto Sicad Villafluerte Jr. and his dependents. It lists Villafluerte's PhilHealth identification number, member category, personal details, employer information, and details for his four dependents - his wife, Cinderella Dollente Villafluerte, and three daughters. The MDR reminds the member to check for any errors or missing information and to keep the original copy safe while providing hospitals with a photocopy if availing any benefits.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Republic of the Philippines

    PHILIPPINE HEALTH INSURANCE CORPORATION


    Citystate Centre, Barangay Oranbo, Pasig City 1600
    637-9999 Local 1116,1118,1131
    www.philhealth.gov.ph MDR
    MEMBER DATA RECORD
    MEMBER INFORMATION

    PhilHealth Identification Number (PIN) : 190896327325


    Member Category : FORMAL ECONOMY NHTS Coverage :
    Sub-Category : PRIVATE Effectivity Period :

    VILLAFUERTE JR, EDELBERTO SICAD


    BLK 21 LOT 6 PHASE 2 VICTORIA HOMES,
    DARASA, TANAUAN CITY, BATANGAS
    4232

    Foreign Address : N/A Sex : Male


    Date of Birth : 09/18/1979
    Place of Birth : CASTILLA, SORSOGON

    Contact No. (Foreign) : N/A Civil Status : MARRIED


    (Local) : Tax Identification Number : 223729258
    EMPLOYER/ORGANIZED GROUP INFORMATION
    Philhealth Number (PEN/POGN) : 009070000165
    Name of Employer/Organized Group : PMFTC INC
    Business Address : PLANT C AND D CHAMPACA ST, FORTUNE, MARIKINA CITY, SECOND DISTRICT

    Telephone Number : 02 8879600


    Tax Identification Number : 007515588000
    DEPENDENT INFORMATION
    PIN Surname Given Name Middle Name Sex Relation Date of Birth
    092526570636 VILLAFUERTE EDCIN MHAE DOLLENTE Female Daughter 9/11/2003
    082511764048 VILLAFUERTE JHELLIAN MAE DOLLENTE Female Daughter 10/5/2006
    190902702052 VILLAFUERTE CINDERELLA DOLLENTE Female Wife 7/2/1980
    092537607175 VILLAFUERTE JECE MHAEY DOLLENTE Female Daughter 12/21/2017

    *** NOTHING FOLLOWS ***

    HENRY V. ALMANON
    Branch Manager
    NCR South Las Piñas

    Paalala : Basahin ang nilalaman ng MDR. Kung may kulang o mali, ibalik agad upang maidagdag o maiwasto. Ingatan ang orihinal na
    kopya at huwag ibigay kahit kanino. Kung sakaling gagamit at makikinabang ng benepisyo, magbigay ng kopya sa ospital.
    (Reminder: Read the
    contents of the MDR. Should there be any data discrepancies, return it back to amend or rectify the error. Take good care of the MDR and do not hand it over to anybody.
    Provide photocopy to hospital in case of confinement and availment of benefits.)

    This is a system generated report. Signature is not required.


    6/11/2020 12:15:56 AM 30469013 20245200 / 30469013 / 5/17/2003 6/10/2020

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