Republic of the Philippines

Office of the Punong Barangay

Barangay Calaocan, Municipality of Bambang
Province of Nueva Vizcaya
~~oOo~~
RECORD OF BARANGAY INHABITANTS BY HOUSEHOLD
REGION II
PROVINCE NUEVAVIZCAYA
MUNICIPALITY BAMBANG
BARANGAY CALAOCAN
HOUSEHOLD NO.

NAME ADDRESS
DATE OF SEX CIVIL HIGHEST EDUCATIONAL
SUBDIVISION/ PLACE OF BIRTH CITIZENSHIP OCCUPATION TRIBE if IP
LAST NAME FIRST NAME MIDDLE NAME EXT NO. STREET NAME SITIO/ PUROK
BIRTH (F/M) STATUS ATTAINMENT

Prepared by: Certified Correct: Validated by:

RUBY JOY G. BUGTONG HON. CHRISTOPHER C. MADERA

(Name of Household Head/Member and Signature) Barangay Secrectary Punong Barangay