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Republic of the Philippines

HOUSE OF REPRESENTATIVES
Quezon City, Metro Manila

Hon. Elizaldy S. Co
Hon. Raul Angelo “Jil” D. Bongalon
Representatives, Ako Bicol Partylist Code Number: GL-2437

Date: September 20, 2023

DR. PATRICIA IRIS TANCHULING


Medical Director Tanchuling General Hospital
Legazpi City
09-20-2023
AKB-6638
Dear Dr. Tanchuling,

May we respectfully refer this patient who is seeking medical assistance to defray the cost of his/her
hospitalization at TANCHULING GENERAL HOSPITAL

Name Joylanie Daseco Monforte


Age 32 years old
Sex Female
Birthdate 6/30/1991
Contact Number 09094402591
Diagnosis T/C Nephrolithiasis
Purpose LABORATORY & ULTRASOUND
Monthly Household Income 3,000.00
Amount 4,135.00

Issued this 20th day of September 2023.

Thank you!

Sincerely,

CONGRESSMAN ELIZALDY S. CO

CONGRESSMAN RAUL ANGELO “JIL” D. BONGALON

Rm. SW416, House of Representatives, Batasan Hills, Quezon City


Trunkline: (632) 8931-5001 loc. 7978 / Direct line: (632) 8442-4044

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