SUPERCARE MEDICAL SERVICES, INC.

573 Patria Bldg. Ma. Orosa Cor. Engracia Reyes Sts.

Ermita, Manila 1000 521-0024 to 35

APPLICANT'S INFORMATION SHEET

POSITION APPLIED FOR: DATE: August 20, 2020
PLEASE LAST NAME FIRST NAME MIDDLE NAME SEX : Male

PRINT Señerers Ana Maria Mercedita Sumera Female

PRESENT 2541 Coral St. San Andres Manila Telephone No.:
ADDRESS 5644421
PERMANENT 2541 Coral St. San Andres Manila Telephone No.:
ADDRESS
HEIGHT WEIGHT MARITAL S X W DATE OF BIRTH
NO. OF CHILDREN AND/OR
152 cm 53 kg STATUS M SEP OTHER DEPENDENTS 07/08/1987
SSS No. PhilHealth No. 02-051177619-9 RELIGION
TIN No. Pag-IBIG No. Roman Catholic
329140189 1211-7411-2872
School Attended Address/Telephone Year Graduated
Primary 2560 Leon Guinto St, Malate, Manila, 1004 Metro Manila 2001
St. Scholastica’s College Manila
Secondary 2560 Leon Guinto St, Malate, Manila, 1004 Metro Manila 2005
St. Scholastica’s College Manila
Tertiary Albertus Magnus Building, Ruaño Dr, Sampaloc, Manila, 2010
University of 1008 Metro Manila
Santo Tomas
Course: BS
Biology
Vocational

What extra-curricular activities did you participate in (athletics, organizations, publications, offices) : UST College of Science Football Team

What hobbies and outside interests do you have (including civic activity) :Baking

Do you have any present or past medical condition which will present special consideration as to job assignments? If so, please
indicate the condition. None
Have you had any illnesses, hospitalization or accidents in the past 2 years? If yes, please explain. None

Check any of these conditions you have or have had:

Allergic disorders (asthma, hay fever, hives, ect.)
Cardiovascular conditions (elevated blood pressures, anemia, heart abnormalities
Gastrointestinal problems (ulcers, liver diseases, bowel problems)
Muscoloskeletal (fractured bone, disc or joint problems, ect.)
Vision problems (glasses, defects or diseases)

Name and Address Telephone Inclusive Monthly Reason for

Nature of Work
of Employer Number Date Salary Leaving
s
Present or Last Job (02) 8521 5353 April 2016- Dec Re- evaluation Physician 45,000 Apply for Residency
Arguelles Medical Center 2018

Second Last

Third Last

Which job did you enjoy most and why? Listening to patients concerns and problems and being able to help and assist them.

Was there anything you particularly disliked about any of the job? Why? Heavy bulk of patients because of limited manpower.

Please give us any further information which may be helpful in considering your qualifications and interests. I have experience working in an pre-
employment clinic for overseas and can adapt very well to the working environment.

Minimum monthly salary desired: Do you have any relative at SuperCare? Have you applied in SuperCare before?
60,000 None No
Any government examination taken? If yes, when? State rating obtained. Can you drive?
Physician’s Licensure Exam (March 2016) with a rating of 76 % No
Where did you learn Advertisement Walk-in X Referral
about our vacancy? Employment Agency College Placement Office Other
s

August 20, 2020

Signature Of Applicant Date

SS HRD 02 - Aug. 04, 2015