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Republic of the Philippines

Department of Education
REGION VIII
SCHOOLS DIVISION OFFICE OF MAASIN CITY
MEDICAL CERTIFICATE

To Whom It May Concern:

This is to certify that ___________________________ was seen on _____________.


Thorough examination reveals:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Recommendations:
__________________________________________________________________________
__________________________________________________________________________

Medical certificate issued upon request at________________________________________


for the purpose of ___________________________________________________________.

Medical Officer/ Physician Examining Nurse


License No.: ______________ License No.: ______________
Date of Examination: ___________

Government Center, Combado, Maasin City


Tel No. (053) 570-8066
maasin.city@deped.gov.ph
SGOD/HNU-SD/FO-05Rev#00 07/02/21

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