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 a copy of fire safety inspection certificate;
That the Fire City Inspectors of General Santos has been reviewing our renewal due to some
compliance of fire exit that we are need to comply;
That as of this day, we are still on communication and processing for the renewal of fire
safety inspection certificate;
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 8th day April, 2024.

˜
Lourdes D. Auguis, MD
Affiant

SUBRCIBED AND SWORN TO BEFORE ME this 8th day April, 2024 at General Santos City.

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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 have 13 staff nurses;
That as of this time, I lack 2 registered nurses;
That my Human Resource Officer is still recruiting and hiring nurses;
That we lack of applicants and we cannot be able to submit yet the lack of 2 registered nurses;
That I will submit the credentials of both nurses within the next 30 days;
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 8th day April, 2024.

˜
Lourdes D. Auguis, MD
Affiant

SUBRCIBED AND SWORN TO BEFORE ME this 8th day April, 2024 at General Santos City.

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Page No. ___
Book No. ___
Series of 2024.