CESD9O58W2BH: Professional Regulation Commission Order of Payment Archives and Records Division

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APPOINTMENT DATE: January 18, 2021 (09:00 AM TO 10:00 AM) - Robinsons Place Naga

OR: 100603958360 | AMOUNT: PHP 300.00

Professional Regulation Commission

ORDER OF PAYMENT

Archives and Records Division


DATE FILED: ____________________
Jan 06, 2021

NAME: ________________________________________________________________________________________________________________________________________
DOMINGO, CLARIBEL TAN

NURSE 125855
NAME OF BOARD EXAM TAKEN: ______________________________________ APPLICATION NO: ______________________________________________
Official Receipt No: _____________________
100603958360 Date: ______________________________________
01/06/2021 Requested by: ____________________________
Received by: _____________________________ Due Date/Time: __________________________

No. of Copies: Reference Number:


4 CERTIFICATION OF RATING
CESD9O58W2BH

CLAIM SLIP
APPOINTMENT DATE: January 18, 2021 (09:00 AM TO 10:00 AM) - Robinsons Place Naga
REFERENCE NO: CESD9O58W2BH | OR: 100603958360 | AMOUNT: PHP 300.00

DATE FILED: _____________________


Jan 06, 2021 NO OF COPIES: ___________________________
4 DUE DATE/TIME: _________________________
NAME: ________________________________________________________________________________________________________________________________________
DOMINGO, CLARIBEL TAN

PROFESSION: ______________________________________
NURSE DATE OF EXAM: ____________________________________________
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ARD-01
Rev.01
November 3, 2017
Page 1 of 2

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