Republic of the Philippines

BUTUAN MEDICAL CENTER

Km. 5, Baan, Butuan City

Date: August 7, 2017

MEDICAL CERTIFICATE
To Whom It May Concern:

This is to certify that Mr./Mrs./Ms. CASERA, KIMSAR M. ,

28 y.o, Male , Single , a resident of Purok 7, Baan Riverside, Butuan City ,
(age) (sex) (status) (address)
has been examined by the undersigned and found him/her______________________________
PHYSICALLY FIT, NO PHYSICAL INJURIES AS OF TIME OF EXAMINATION .

This certification is being issued upon request by the interested party for:
Transfer to Department of Health- Drug Treatment Rehabilitation Center at Brgy. Anomar,
Surigao City.

DR. ANDRE C. MALBAS

Asst. Hospital Director