Certificate For 4PS

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REPUBLIC OF THE PHILIPPINES

REGION XII
MUNICIPALITY OF PIGCAWAYAN
OFFICE OF THE MUNICIPAL HEALTH SERVICES
TEL NO. (064) 229-3357

HEALTH CERTIFICATE

This is to certify that _______________________________, __________, _____ year/s old


a resident of Pigcawayan, North Cotabato, has record in our facility and had been immunized with
the following vaccines:

NAME OF VACCINE DATE GIVEN

Other services received:


Pls. specify: _________________________
______________________________________
______________________________________

This certification is being issued for whatever legal purpose/s it may serve her/him best.

Given this ________ day of _____________________ 20____, at Pigcawayan, North Cotabato.

EDRHEYL L. BIADNES, RN
DOH – HRH NURSE
Brgy. Poblacion II

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