REPUBLIC OF THE PHILIPPINES

PROVINCE OF CAVITE
CITY OF DASMARINAS

CERTIFICATION
This is to certify that. EARTH YABA .is a resident of
(Name of Patient)

. Blk. 73 Lot 7 Barangay San Juan, City of Dasmariñas, Cavite .

(Complete Address of Patient)

He/She is not included in the suspect/probable/confirmed COVID-19 cases listed in our

barangay.

Further, he/she didn’t manifest any of the following signs and symptoms of COVID-19 at the
time of certification such as fever, cough, colds, sore throat, diarrhea and loss of appetite.

This certification is issued upon the request of the above named person purpose going back
to work.

Issued this. 8th day of April 2021 .at Barangay. SAN JUAN , City of Dasmariñas, Cavite.
(Date Issued)

Certified by: Attested by:

Ms. Leah B. Arribe Hon. Atanacio G. Cantimbuhan Jr.

(Signature over Printed Name) (Signature over Printed Name)
BHERT Nurse/Midwife Barangay Captain

Note: Certification is issued for record purposes and not for legal use

LIGTAS ANG PAMILYA

LIGTAS ANG BAYAN
#STAYHOMESTAYSAFE