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Member Data Record: Philippine Health Insurance Corporation

This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) for Kristine Cassandra Ablaza. It provides her PhilHealth Identification Number, member category, personal details such as name, address, contact information, and confirms she has no declared dependents. The MDR serves to record an individual's health insurance enrollment and reminds the member to check for accuracy and protect the confidentiality of the document.

Uploaded by

Kristine Ogalesco
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© © All Rights Reserved
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166 views1 page

Member Data Record: Philippine Health Insurance Corporation

This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) for Kristine Cassandra Ablaza. It provides her PhilHealth Identification Number, member category, personal details such as name, address, contact information, and confirms she has no declared dependents. The MDR serves to record an individual's health insurance enrollment and reminds the member to check for accuracy and protect the confidentiality of the document.

Uploaded by

Kristine Ogalesco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION


Corporate Action Center Hotline - (02)441-7442
MDR
www.philhealth.gov.ph

MEMBER DATA RECORD


MEMBER INFORMATION
Philhealth Identification Number (PIN) : 020269820358
Member Category : INFORMAL ECONOMY NHTS Coverage :
Sub-Category : SELF-EARNING INDIVIDUAL Effectivity Period :

OGALESCO , KRISTINE CASSANDRA ABLAZA


1189 E JULIO NAKPIL STREET PACO MANILA
BGY 688, MALATE, NCR, CITY OF MANILA,
FIRST DISTRICT 1004

Foreign Address : N/A Sex : Female


Date of Birth : 12/19/1995
Place of Birth : PACO, NCR, CITY OF MANILA, FIRST DISTRICT

Contact No.(Foreign) : N/A Civil Status : SINGLE


(Local) : (353)230-5 Tax Identification Number :

EMPLOYER/ORGANIZED GROUP INFORMATION


PhilHealth Number (PEN/POGN) : N/A
Name of Employer/Organized Group : N/A
Business Address : N/A

Telephone Number : N/A


Tax Identification Number : N/A

DEPENDENT INFORMATION
PIN Surname Given Name Middle Name Sex Relation Date of Birth
*** NO DECLARED DEPENDENT/S ***

Paalala: Basahin ang nilalaman ng MDR. Kung may kulang o mali, dalhin agad ang kopya sa pinakamalapit na PhilHealth Office upang maiwasto. Ingatan ang inyong kopya ng MDR
at huwag ibigay kahit kanino.

Reminder: Read the contents of the MDR. Should there be discrepancies, bring your copy to the nearest PhilHealth Office to amend or rectify error. Take good care of the MDR
and do not hand it over to anybody.

This is a Member Inquiry System generated report.


7/25/2018 7:22:14 PM

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