CERTIFICATE OF ELIGIBILITY

This is to certify that ANABEL GULENG residing at Brgy. ALCALA

Maria Aurora, Aurora, has been found eligible for MEDICAL Assistance after interview and the
case study had been made.

Record of the Case Study for Assistance in the amount of TWO THOUSAND
PESOS ONLY (Php.2,000.00).

Prepared by:
Noted by:
NIKKI S. JACINTO
ELENA D. GONZALES Admin. Aide
MSWDO
 SOCIAL CASE STUDY
December 1, 2020
Date
I. IDENTIFYING INFORMATION:

Name : Anabel D. Guleng

Age : 28 Civil Status Married 4P's (YES) (NO) /
Address : Brgy. Alcala, Maria Aurora, Aurora
Occupation : H/K

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 Vener Guleng Husband 38 M H/S GRADUATE subject of the case
2 Valerie daughter 8 F Grade 3 ISY

III. PROBLEM PRESENTED:

Educational ASSISTANCE Php 2,000.00

IV. DIAGNOSIS OF THE SITUATION:

Client came personally innthis office (MSWD) asking Medical assistance for her husband ( VENER) who is
suffering from FRACTURE OF THE RIGHT ANKLE secondary to vehicular accident as diagnosed by the Physician.
Client claimed that the family could not afford to support all medical expenses needed hence, MSWD assistance
is very much needed under AICS program.

V. RECOMMENDATION:

Client is highly recommended to avail Medical Assistance amounting to TWO THOUSAND PESOS ONLY (
Php 2,000.00 ).

Prepared:

Noted: NIKKI S. JACINTO

Administrative Aide
ELENA D. GONZALES
MSWDO APPROVED:

AMADO M. GENETA
Municipal Mayor
 SOCIAL CASE STUDY
March 26, 2019
Date
I. IDENTIFYING INFORMATION:

Name : ELEONOR Q. NATAN

Age : 48 Civil Status MARRIED 4P's (YES) (NO) /
Address : Brgy. San Joaquin, Maria Aurora, Aurora
Occupation : House Wife / Subject of the case

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 Abelardo Natan Husband 38 M Elem. Under Grad. Job Order
2 Dwiyght Allen Natan Son 14 M Grade 8 ISY
3 Annie Natan Daughter 12 F Grade 7 ISY
4 Amelia Natan Daughter 12 F Grade 5 ISY
5 Erwin Natan Son 9 M Grade 2 ISY
6 Ezer Chain Natan son 4 M Kinder ISY

III. PROBLEM PRESENTED:

MEDICAL ASSISTANCE Php 5,000.00

IV. DIAGNOSIS OF THE SITUATION:

Client came personally in this office ( MSWD ) asking Medical Assistance for herself who is suffering from
Acute Cystitis, Pleural Effusion, Right probably secondary to Infectious in Nature as diagnosed by the Physician.
Client claimed that the family could not afford to support all medical expenses needed,Hence, MSWD assistance
is really needed under AICS program .

V. RECOMMENDATION:

Client is highly recommended to avail medical assistance amounting FIVE THOUSAND FIVE PESOS ONLY
(Php 5,000.00).

Prepared by:

MAYNARD F. MIANA
Noted: Administrative Aide

ELENA D. GONZALES APPROVED:

MSWDO
AMADO M. GENETA
Municipal Mayor
 SOCIAL CASE STUDY
September 11, 2020
Date
I. IDENTIFYING INFORMATION:

Name : Evelyn Pajela Orpia

Age : 67 Civil Status Widow 4P's (YES) (NO)
Address : Brgy. San Jose, Maria Aurora, Aurora
Occupation : None

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 Estefanio B. Pajela Father 98 M Elem. Grad Subject of the case

III. PROBLEM PRESENTED:

BURIAL ASSISTANCE Php 10,000.00

IV. DIAGNOSIS OF THE SITUATION:

Client approached the undersigned aksing Burial Assistance for her father ( Estefanio) who died last
September 3, 2020 due to INTRACRANIAL HEMORRHAGE due to vehicular accident client claimed that the
family could not afford to support all funeral expenses needed, hence mswd assistance is really needed under
AICS program.

V. RECOMMENDATION:

Client is highly recommended to avail medical assistance amounting to TEN THOUSAND PESOS ONLY
(Php. 10,000.00).

Prepared by:

NIKKI S. JACINTO
Noted: Admin. Aide

ELENA D. GONZALES APPROVED:

MSWDO
AMADO M. GENETA
Municipal Mayor
 SOCIAL CASE STUDY
April 30, 2019
Date
I. IDENTIFYING INFORMATION:

Name : MILA C. DONGGOY

Age : 40 Civil Status Solo Parent 4P's (YES) (NO) /
Address : Brgy. Galintuja, Maria Aurora, Aurora
Occupation : Fruits Vendor

II. FAMILY COMPOSITION:

NAME Relationship Age Sex Educational Attainment Occupation

1 Hilario Caycayen Uncle 52 M HS.Grad. Farm Laborer
2 Jay-Ar Donggoy son 19 M HS.Grad. ISY
3
4
5

III. PROBLEM PRESENTED:

EMERGENCY SHELTER ASSISTANCE Php 10,000.00

IV. DIAGNOSIS OF THE SITUATION:

Client came personally in this office ( MSWD ) asking Emergency Shelter Assistance for herself because
she is the victim of destructived fire that transpired last March 22, 2019 around 10:39pm at Public Market Maria
Aurora. Client claimed that they dont have enough money to support all the necessary expenditures. ,Hence,
MSWD assistance is really needed under AICS program .

V. RECOMMENDATION:

Client is highly recommended to avail medical assistance amounting to TEN THOUSAND PESOS ONLY
(Php 10,000.00).

Prepared by:

MAYNARD F. MIANA
Noted: Administrative Aide

ELENA D. GONZALES APPROVED:

MSWDO
AMADO M. GENETA
Municipal Mayor