Republic of the Philippines

Department of Education
Region VII, Central Visayas
DIVISION OF BOHOL
FERMIN TAYABAS NATIONAL HIGH SCHOOL
Cabayugan, Calape, Bohol

MEDICAL CERTIFICATE
________________
Date

To Whom It May Concern:

This is to certify that I have personally examined

_____________________________________ _, __________
____________
(Name of the Student) ( Age) (Gender)

and have found that he / she is physically fit during the time of examination, to join

and compete in the Intramurals Meet on December 3, 2022, Saturday at Fermin

Tayabas National High School, Cabayugan, Calape, Bohol.

Event: __________________

Height:_________
Weight:________
Temperature:_______
Blood Pressure:_________
Pulse: _________
Remarks:______________________________

DR. MANUEL N. RELAMAPAGOS, II

Physician/Medical Officer
(Signature Over Printed Name)

License No. _______________

PTR: _______________
Date: _______________
 Republic of the Philippines
Department of Education
Region VII, Central Visayas
DIVISION OF BOHOL
FERMIN TAYABAS NATIONAL HIGH SCHOOL
Cabayugan, Calape, Bohol

PARENT’S CONSENT/PERMISSION SLIP

I/WE _________________________________________________________permits/s my

son / daughter __________________________________________________to join the

____________________FERMIN TAYABAS NATIONAL HIGH SCHOOL____________

(Name of School)

__________________________TEACHER’S DAY______________________________

(Name of Activity)

_________________________OCTOBER 5, 2023______________________________

(Date of Activity)

I/WE confirm that the signature below is our true and genuine signature as our consent in

permitting our son/ daughter in the said activity.

_________________________________________

Parent /guardian

(Signature Over Printed Name)