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Republic of the Philippines

Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL
CATEEL 2 DISTRICT
PAGLUSNGAN INTEGRATED SCHOOL

DEWORMING PARENTAL/GUARDIAN CONSENT

(Date)

TO WHOM IT MAY CONCERN:

I, do hereby permit
my
(Name of Parent/Guardian)

son/daughter - to
take
(Name of Son/ Daughter) (Year/Section)

deworming tablet.

Signature over Printed Name

Address: Paglusngan, Taytayan, Cateel, Davao Oriental Contact number: 09556111862


Email Address: 501418@deped.gov.ph

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