Republic of the Philippines

Department of Health
BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER
Baguio City
Form No. : HS-HIM-005
Revision NO.:
Health Information Management Section Effective Date: August 1,
MEDICO-LEGAL CERTIFICATE 2014

October 13, 2014

Date
TO WHOM IT MAY CONCERN:

This is to certify that Christian Alvar Galag _____________________

(Name of Patient)
(Male___Female___) 19, of age, from No.13 MRR Queen of Peace, Baguio City______
(Address)
was examined and treated/confined in this hospital on/from October 13, 2014
(Date Admitted)
to _______________________________for the following injuries.
(Date Discharged)

Essentially Normal Findings at the Time of Examination (No External Signs of

Physical Injury)

TIME OF ARRIVAL: 1:27 AM/PM

Brought by: PO1 Julius Paul Diaz
Address: Police Station 1
Treatment will take from to days from above injuries to
heal unless complications will arise.

(PROVISIONAL)
(FINAL)

JENNIFFER R ROSALES,MD
MEDICO-LEGAL OFFICER

Baguio City Tel. No. (074) 442-4216 loc 219; Fax No. (074) 442-3809