Republic of the Philippines

Province of Zamboanga del Sur

MUNICIPALITY OF TABINA
Municipality Health Office

POST-MORTEM REPORT
Name
Age
Sex
Citizenship
Date of Death
Time of Death
Place of Death
Time of Examination
Date of Examination
Place of Examination
Requesting Party

POST MORTEM FINDINGS

1.
HEAD AND NECK
1.
THORAX AND ABDOMEN
1.
EXTREMITIES
1.
CONCLUSION

JESSA MAE F. PANGANDIAN, RPH, MD

Municipal Health Officer- OIC

OR #:
Amount Paid:
Date Paid:
NOT VALID WITHOUT DRY SEAL