Republic of the Philippines

MUNICIPALITY OF _____________
Province of Pangasinan

BARANGAY ________________

APPOINTMENT

To: ___________________
______________________
______________________

By virtue of powers vested in me under RA No. 7160, Otherwise

known as the Local Government Code of 1991, and in consonance with
Sec. 394 & 395, Chapter 5, Title One, Book III thereof, you are hereby
appointed/re-appointed as Barangay Health Worker of Barangay
______________, ________________, Pangasinan effective
_____________.

The status of your appointment is co-terminus with the appointing

officer unless sooner terminated by resignation or withdrawal of
appointment by the Punong Barangay and shall be governed by the
provisions of this Code and other laws, with allowances prescribed by law.

Given this _____ day of ____________________ at Barangay

__________________, ________________, Pangasinan.

_________________
Punong Barangay

Noted by:

_________________
MLGOO