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(Front) (Back)

Republic of the Philippines


CITY HEALTH OFFICE IMPORTANT
Doc. Stamp
Tacloban City This health certificate is non-transferable.
Paid
Always wear your certificate in the upper
OR. No.
HEALTH CERTIFICATE left front portion of your garment while
Reg.No. 2023 - 5144 8337032 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 JUNE CARLO MANANSALA CASTAÑEDA STOOL

Age 34 Sex MALE Nationality FILIPINO C-XRAY Jan-25-23 NORMAL


Occupation COLLECTOR HBSAg
Place of WorkGOODMOOD GENERAL MERCHANDISING
HBSAb

SEMINAR/TRAINING ATTENDED
Attach your
(1X1) Signature FHS/ HACCP/ WRSOS Date
Picture ID
here Jan-30-23 Dec-31-23
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

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