BARANGAY HEALTH OFFICE

Bulusukan, San Ildefonso, Bulacan

SANITARY PERMIT TO OPERATE

Issued to ____________Bulusukan Elementary School_____________
(Registered Name)

_________________________School Canteen___________________
(Types of Establishment)

Address ___Bulusukan, San Ildefonso, Bulacan___________________

Sanitary Permit No. 003

Date Issued _______________ Date of Expiration____________

This permit is not transferable and will be revoked for violation of the
Sanitary Rules. Laws or Regulation of P.D. 522 & P.D. 856 and
Pertinent Local Ordinances.

Recommending Approval:___________________________________
Committee on Health
CORAZON C. DE OCAMPO

Approved: ALVIN N. INDUCIL

Barangay Captain