Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

Corporate Action Center Hotline - (02)441-7442
MDR
www.philhealth.gov.ph

MEMBER DATA RECORD

MEMBER INFORMATION
Philhealth Identification Number (PIN) : 080513622981
Member Category : FORMAL ECONOMY NHTS Coverage :
Sub-Category : PRIVATE Effectivity Period :

IGNACIO , JEAMHAR MAGNO

BLOCK I A7 LOT 7 STA CRISTINA II BLOCK I A7
LOT 7 STA CRISTINA II SANTA CRISTINA II,
DASMARIÑAS, CAVITE 4115

Foreign Address : N/A Sex : Male

Date of Birth : 09/05/1995
Place of Birth : DASMARIÑAS, CAVITE

Contact No.(Foreign) : N/A Civil Status : SINGLE

(Local) : Tax Identification Number :

EMPLOYER/ORGANIZED GROUP INFORMATION

PhilHealth Number (PEN/POGN) : 001000002979
Name of Employer/Organized Group : IQOR PHILIPPINES INC(INTELLIRISK PHILIPPINES INCORPORATED)
Business Address : BLDG 36 AND 37 BERTHAPHIL II CMPD JOSE ABAD SANTOS AVE , CLARK FREEPORT ZONE, PAMPANGA

Telephone Number : 8897180

Tax Identification Number : 234988175

DEPENDENT INFORMATION
PIN Surname Given Name Middle Name Sex Relation Date of Birth
*** NO DECLARED DEPENDENT/S ***

Paalala: Basahin ang nilalaman ng MDR. Kung may kulang o mali, dalhin agad ang kopya sa pinakamalapit na PhilHealth Office upang maiwasto. Ingatan ang inyong kopya ng MDR
at huwag ibigay kahit kanino.

Reminder: Read the contents of the MDR. Should there be discrepancies, bring your copy to the nearest PhilHealth Office to amend or rectify error. Take good care of the MDR
and do not hand it over to anybody.

This is a Member Inquiry System generated report.

7/15/2019 2:13:35 PM