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Republic of the Philippines

Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA

MEDICAL CERTIFICATE
FOR EDUCATIONAL TOUR

DISTRICT: TALAVERA NORTH


SCHOOL: SAN JOSE ELEMENTARY SCHOOL
GRADE & SECTION: III-ACACIA
DATE: MARCH 12, 2024

THIS IS TO CERTIFY THAT THE FOLLOWING LEARNERS HAVE BEEN FOUND TO BE:

A. PHYSICALLY FIT TO TRAVEL

NAME
1. JARED LAGATUZ
2. JOANNA MARIE ESTRELLA
3.
4.
5.
6.

B. PHYSICALLY FIT TO TRAVEL BUT WITH MEDICAL OR HEALTH RESERVATION (e.g. allergy, bronchial
asthma, fainting, dizziness during travel, heart problems, etc.)
NOTE: Learner with FEVER is discouraged from joining the tour.
NAME AILMENTS
1.
2.
3.
4.
CERTIFICATION IS ISSUED FOR TRAVEL PURPOSES ONLY.

Prepared by: Noted and Verified by:

JOAN A. DAGDAG MARILYN M. SUAREZ


Health Coordinator District Nurse
Approved by:

ANTONIO U. FELIX
Division Medical Officer

Address: Brgy. Rizal, Santa Rosa, Nueva Ecija 3101


Telephone No.: (044) 940 3121
Email: nueva.ecija@deped.gov.ph
Facebook Page: DepEd SDO Nueva Ecija
Webpage: https://sites.google.com/deped.gov.ph/depednuevaecija/

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