[RESTART Taba eapRST Ray oo) | croveos argent 2016) Bapubiclhe Pruer cn ees OFFICE OF THE CIILREGISTRAR GENERAL | CERTIFICATE OF DEATH a = Registry No, Province CAVITE, - "2021-700 [Civatunicioaity ___TAGAYTAY CITY RAMON CATALAN MANTALAC. MAL E TONEOr Rom er BNEGRRIRTH Gy) WOOT pews [SAGEAT TIE 22 NOVEMBER 2021 31 AUGUST 1963 | a * - ‘Harrt OSPITAL NG TAGAYTAY TAGAYTAY CITY CAVITE 1 TaRSONRRIGUseECT ee ROMAN CATHOLIC FILIPINO BAYPHGYAN MENDEZ CAVITE oT TERRECER pas SC*Y REMI COMIN rac ssa ew 'BRGY. KAGAWAD JULIO M. MANALAG PRESCILA R. CATALN | 155: CAUSES OF DEATH 1 | iececeremee 25 na ergRy omcRENATORY AORTAL BARK. PATUTONG MALAKI TAGAYTAY crx | BceRnnToNorrromaee |S RREPSRED BY ~ Sionatue sonata ox) aun ‘S. HOJICA name pons HERLINDA /R. OCAMPO ES ine ovement BE RECENED EY 5 1 2 REGISTEREDAT THE OFFICE OF THE GSR REGETIAR Setar 68000 | sonst IMS cAROLTWAE.TOLENTINO ———soserHt T-DE CASTRO ‘ADMIN-AIDE-E— en ‘ee or Poston 2 _ | Tee. Poston ba 23 NOVEMBER 2021 ifs REMARKS/ANNOTATIONS (For LCROIOGRG Use Oni HEDICAL CERTIFICATE i (For ages 0 9 7 Gays, Aesomplsh lms 14-189 atthe back) AGuiE WiocAnprat. tsearcrron— » ISCHEMIC HEART DISEASE on 4 None ean Sos BBEST Ty icectelowes yesiise™ : org SRP ty’ EZ_MD OICICITY.HEALTH-OFEICE | ae \ 28-NOVENDER 2021 = igi AW peeeerane| EN TAN tas or Poston RECORD SECTION STAFF | bwe23_ NOVEMBER 02. TOUE FILLEO-UPAT THE OFFICE OF THE CIVIL REGITRAR Scanned with CamScannerJE AGE OF MOTHER [75 TYPE OFSIRTH a Tain Tate ee) MEDICAL CERTIFICATE 3, CAUSES OF OEATH coNTHVETORKL UPEM 29 POSTHORTEM CERTIFICATE OF DEATH ony oft cecaased and ormad an autopsy ven @ owen sratre Name in Prat _ CeRTREAGONCFEVSALIER —— | HEREBY CERTIFY tat have eosined oN Co MARALAC a the egulatons presertod by te Deparment of HOS TiveiDesrznation (rs Signature 1 That was attenaea by | | 3. That ne cause of aeatn of the ceceased was 4. Tnatine reason lr tne layin eegstenna ts death was cue to ‘5 Thal am executing this aidavi to atest to tho wumvuiness of he foregoing stsaents Rr athe tents a pu, | | Inu where have asad my signature below hs ayo! = | SUBSCRIBED AND SWORN 10 botove mo this ay of _ Pippin, atant who evndtes toma he her CTCVINS 1D re Scanned with CamScanner