(Front) (Back)

Republic of the Philippines

CITY HEALTH OFFICE IMPORTANT
Doc. Stamp
Tacloban City This health certificate is non-transferable.
Paid
OR. No. Always wear your certificate in the upper
HEALTH CERTIFICATE left front portion of your garment while
Reg.No. 2024 - 15260 8485048 working.
Valid only until the next date of
examination, as indicated below.

Pursuant to the provision of

PD 522 & PD 856, this LABORATORY EXAMINATION
certificate issued to
LAB EXAM DATE RESULT VERIFIED BY
SPUTUM

Name MAR CARLO VILLALINO BALILA STOOL

Age 38 Sex MALE Nationality FILIPINO C-XRAY Feb-12-24 NORMAL

Occupation MANAGEMENT TRAINEE HBSAg
Place of Work PUREGOLD ABUCAY
HBSAb

SEMINAR/TRAINING ATTENDED
Attach your
(1X1) Signature FHS/ HACCP/ WRSOS Date
Picture ID
here Feb-12-24 Dec-31-24
DANILO S. ECARMA
OIC-City Health Officer Date of Issue Date of Expiration

Reminders:

Reminders:

1. Falsification of documents is punishable by law.

2. This document has encryted QR Code for security reasons to prevent from data tampering.
3.When printing please use white paper/sheet/card only and a colored printer.
4. Before laminating, please print and cut according to the size and color of the template and attach (1x1) picture ID.
5. This health certificate is non-transferable. Always wear your certificate in the upper left front portion of your garment
while working.

From Tacloban City Health Office