PARENTS CONSENT

TO WHOM IT MAY CONCERN:

This is to allow my child ________________________________ to undergo deworming
next week by the Division Medical Personnel.

__________________________________
Parents Signature Over Printed Name

PARENTS CONSENT

TO WHOM IT MAY CONCERN:

This is to allow my child ________________________________ to undergo deworming
next week by the Division Medical Personnel.

__________________________________
Parents Signature Over Printed Name