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Republic of the Philippines

Province of Albay
CITY OF TABACO
BARANGAY _________________

DATE: _______________

APPOINTMENT
(Barangay Health Worker)

TO: ______________________

Pursuant to Section 387 of the Republic Act No. 7160 otherwise known as the
Local Government Code of 1991 and RA 11223 known as the Universal Health Care Act,
you are hereby appointed Barangay Health Worker of Barangay ___________________________,
Tabaco City effective upon taking your oath of office and to serve in such capacity with
all the rights, privileges and responsibilities appurtenant thereto until the end of the
term of the appointing authority unless sooner replaced.

________________________
Punong Barangay

In concurrence:

__________________________________________
Signature Above Printed Name of Appointed BHW