Republic of the Philippines

Department of Health
CENTER FOR HEALTH DEVELOPMENT
CaLaBaRZon
QMMC Compound, Project 4, Quezon City
Trunkline: (02)990.4016
Email Add: chd4a_doh_calabarzon@yahoo.com

MEDICAL ASSISTANCE TO INDIGENT PATIENTS PROGRAM

___________________________________________________________________
MAHMC-RACMJD20230911-360

GUARANTEE LETTER
SEPTEMBER 11, 2023

Respectfully referred to, METRO ANTIPOLO HOSPITAL AND MEDICAL

CENTER, the herein attached approved request of BENJAMIN POLICARPIO 65 y/o,
from STA. ANA TAYTAY, RIZAL for the assistance below:

TYPE OF ASSISTANCE AMOUNT

MEDS/LAB/PROCEDURES/HB/PF 50,000.00
Total Amount: 50,000.00

Amount in words: FIFTY THOUSAND PESOS

Non-convertible to cash
Valid with attached hospital bill

RACMJD2023-360

“Ang paninigarilyo o paglanghap ng usok nito ay agad na nagdudulot ng paglapot ng dugo at pagkipot ng mga ugat,
na maaaring magdulot ng atake sa puso.” - U.S. Department of Health and Human Services, 2011