Medical Certificate: Department of Education

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Republic of the Philippines

Department of Education
REGION III
SCHOOLS DIVISION OFFICE OF BATAAN

MEDICAL CERTIFICATE
Date: __________________

TO WHOM IT MAY CONCERN:

This is certify that


Mr/Ms/Mrs_____________________________________________
Was personally examined/ treated by the undersigned for the following medical
problem.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
______

Impression/Diagnosis:
_____________________________________________________________
_____________________________________________________________

This certificate is issued upon request of___________________________________


____________________________________ for whatever purpose it may serve, except
for MEDICO LEGAL.

DR. ROBERTO B. LUNETA


MEDICAL OFFICER III
Lic. #
Republic of the Philippines
Department of Education
REGION III

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