AECIT

Republic of the Philippines

DIPOLOG CITY
OFFICE OF THE CITY HEALTH WE LOVE
DIPOLOG
OFFICER
Tel. No.: (065) 212-3400
Circumferential Road, Brgy. Biasong Email: chodipologcity2019@gmail.com
Dipolog City, Zamboanga del Norte

MEDICAL CERTIFICATE

TOWHOM IT MAY CONCERN:

MARIE FAITH E. DUMPA 21years old of
THIS IS TOCERTIFY that
SERGIO OSMENA,ZDN
Lis physically and mentally healthy.

DUMPA for
Issued upon request of Mr./Ms./Mrs.
FIELD STUDY

25th AUGUST
,20
23
at City Health Office,
Given this "day of
Dipolog City, Philippines.

ROWEL J. MATA,M.D
City Health Officer
License No. 69255

1970*

' iEAL THA)F-4

Paid under OR# 25Aug-23
Date:
 Republic Philippines
of the
DIPOLOG CITY
OFFICE OF THE CITY HEALTH WE LOVE
OFFICER DIPOLOG
Circumferential Road, Brgy, Biasong Tel. No.,: (065) 212-3400
Dpolog City, Zamboanga del Norte Email: chodipologcity2019@gmail.com

MEDICAL CERTIFICATE

TOWHOM IT MAY CONCERN:

THIS IS TOCERTIFY that MARIE FAITH E. DUMPA 2'years old of

SERGIO OSMEÑA,ZDN
is physically and mentally healthy.

Issued upon request of Mr./Ms./Mrs. DUMPA for

FIELD STUDY

Given this 25thday of AUGUST

,20
23 at City Health Office,

Dipolog City, Philippines.

CATY OF
oPa, ROWELJ. MATA,M.D
City Health Officer
License No. 69255

1970

Paid under OR#

Date: 5-Aug-3