REPUBLIC OF THE PHLIPPINES }

CITY OF GENERAL SANTOS }S.S.

AFFIDAVIT OF UNDERTAKING

I, Lourdes D, Auguis, of legal age, Filipino, presently residing at #32 North Osmena Avenue,
General Santos City, after having been duly sworn to in accordance to the law, do hereby depose and
say;
That I am the owner and the hospital administrator of Auguis Clinic and Hospital, an
infirmary hospital duly accredited with the Department of Health (DOH);
That the Department of Health (DOH) requires a submission of deficiency noted;
That I am required to submit the credential of Marlon A. Allecer, a nurse supervisor;
That his credential for his ongoing Masters of Arts in Nursing is yet to be released at the end
of this semester;
That attachment for his proofs of enrollment is hereby attached in the next following pages;
That I am executing this affidavit to attest to all of the above facts are true and correct;
IN WITNESS WHEREOF, I have hereunto affixed my signature this 4th day April, 2024.

˜
Lourdes D. Auguis, MD
Affiant

SUBRCIBED AND SWORN TO BEFORE ME this 4th day April, 2024 at General Santos City.

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