Republic of Philippines

DEPARTMENT OF HEALTH
Region – 10
Province of Lanao del Norte
Municipality of Kapatagan

________________________________________
Name of Hospital/Health Center/Station

HEALTH CENTER/STATION REGISTRATION CERTIFICATE

This is to certify that the following Pantawid Pamilya beneficiaries are registered in this hospital/health
center/station for health/medical check-ups/consultation:

REMARKS (Please
indicate if the beneficiary
NO HOUSEHOLD ID NUMBER NAME OF BENEFICIARIES
is 0-5 years old or
pregnant)
1
2
3

Given this ______ day of FEBRUARY, 2023.

____________________________
MHO/OIC/HN

Republic of Philippines
DEPARTMENT OF HEALTH
Region – 10
Province of Lanao del Norte
Municipality of Kapatagan

________________________________________
Name of Hospital/Health Center/Station

HEALTH CENTER/STATION REGISTRATION CERTIFICATE

This is to certify that the following Pantawid Pamilya beneficiaries are registered in this hospital/health
center/station for health/medical check-ups/consultation:

REMARKS (Please
indicate if the beneficiary
NO HOUSEHOLD ID NUMBER NAME OF BENEFICIARIES
is 0-5 years old or
pregnant)
1
2
3

Given this ______ day of FEBRUARY, 2023.

____________________________
MHO/OIC/HN