IMPORTANT

This health certificate is non transferable. Always

Wear your certification in the upper left side front portion
of your garment while working
Valid only until the next date of examination, as
Indicated below
!"#I$ATI%& %' (!$TI'I(AT!
)AT! I**+!) )AT! !"#I$!)
)!(!,-!$ ./, 01 222
3A-%$AT%$4 !"A,I&ATI%&
)AT! 5I&) $!*+3T
'!(A34*I*
+$I&A34*I*
*#+T+,
I**+!)6#%*T!) -4
DANILO A. CANENCIA A
*A&ITATI%& I&*#!(T%$ IV

$epublic of the #hilippines
City Health Office
7eneral *antos (ity

HEALTH CERTIFICATE
Pursuant to the provision of P.D. 856 and City Ord.
No.______s_______, this certificate is issued to:
NAM ________________________________________________
OCC!PA"#ON _________________________________________
A$, _____ , %& _____ NA"#ONA'#"( _____________________
P'AC O) *O+, __________________________________
EDGARDO R. SANDIG MD, MHA
City -ea.th Officer
Paid: P ____________
O+ /: ____________
DA"D 2222222222