Civil Service Form No. 48 Civil Service Form No.

48
Department of Health Department of Health
Cordillera Administrative Region Cordillera Administrative Region
Provincial DOH Office Apayao Provincial DOH Office Apayao
DAILY TIME RECORD DAILY TIME RECORD

SALES LADY MARIE M. SALES LADY MARIE M.

LASTNAME FIRST NAME M.I. LASTNAME FIRST NAME M.I.
For the month of OCTOBER 2022 For the month of OCTOBER 2022
Official Hours for arrival and departure 8AM to 5PM Official Hours for arrival and departure 8AM to 5PM
D MORNING AFTERNOON UNDERTIME D MORNING AFTERNOON UNDERTIME
A A
Y Arrival Departure Arrival Departure Hrs Mins Y Arrival Departure Arrival Departure Hrs Mins

1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
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15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
TOTAL TOTAL
I CERTIFY ON MY HONOR that the above is a true & I CERTIFY ON MY HONOR that the above is a true &
correct report of the hours of work performed, record of correct report of the hours of work performed, record of
which was made daily as the time of arrival at and which was made daily as the time of arrival at and departure
departure from office. from office.

Signature Signature
Verified to the prescribed office hours. Verified to the prescribed office hours.

CHARLYN B. TAGABING, RMT, MPH CHARLYN B. TAGABING, RMT, MPH

DMO V DMO V
 Republic of the Philippines
DEPARTMENT OF HEALTH
Cordillera Administrative Region
Provincial DOH Apayao

MONTHLY ITINERARY
For the month of ______________________

Name:
Designation:

DATE WHEREABOUTS
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Submitted by:
 Republic of the Philippines
DEPARTMENT OF HEALTH
Cordillera Administrative Region
Provincial DOH Apayao

MONTHLY ITINERARY
For the month of ______________________

Official station:
Area of Assignment:

PURPOSE
Approved by: Concurred by:
 Republic of the Philippines
Department of Health
CORDILLERA ADMINISRATIVE REGIONAL OFFICE
Provincial DOH Office-Apayao

HIGHLIGHTS OF ACTIVITIES FOR THE MONTH OF ________________ 2018

ACTVITIES:

LEARNING INSIGHTS:

ISSUES AND CONCERNS:

RECOMMENDATIONS:
Prepared by: Recommending approval/noted:

___________________________ ___________________________
DOH HRH PHN

Recommending approval/noted: Recommending approval/noted:

___________________________ ___________________________
MHO DMO IV
 CERTIFICATE OF APPEARANCE

This is to certify that that Ms. LADY MARIE M. SALES a PHYSICAL THERAPIST has appeared in this
office/clinic/house/establishment on the date stated therein
NAME & POSITION OF THE
DATE PLACE PURPOSE CERTIFYER SIGNATURE