Republic of the Philippines)

City of Tacloban ) s.c.

Province of Leyte )

AFFIDAVIT
OF LOSS

I, MARY JOY ANTONIETTE ABORQUE EDEP, of legal age, single and a

resident of Pastrana, Leyte, after having been duly sworn to in accordance with law do
hereby depose and say that:

1. I am a medical doctor by profession as such I was issued Yellow Prescriptions

by the Philippine Drug Enforcement Agency (PDEA) allowing me to prescribe
regulated drugs;

2. On the occasion and by reason of occurrence on November 8, 2013 of

Supertyphoon Yolanda which directly hit Eastern Visayas, our quarters located
at St. Paul’s Hospital was struck by strong winds and heavy rains. Further, it
was inundated with water due to the said storm causing irreparable damage to
the said Yellow Prescription and my other belongings;

3. I am executing this affidavit freely and voluntarily in order to establish the truth
of the foregoing facts for whatever legal purpose this may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 10th day of February
2017, at Tacloban City, Leyte, Philippines.

MARY JOY ANTONIETTE ABORQUE EDEP

(Affiant)

SUBSCRIBED AND SWORN to before me this 10th day of February 2017 at

Tacloban City, affiant exhibiting to me her PRC ID No. 0119600 issued on/valid until
2/24/2020, as competent proof of her identity.

Doc No. ___

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Book No. ___
Series of 2017
Republic of the Philippines)
City of Tacloban ) s.c.
Province of Leyte )

AFFIDAVIT
OF LOSS

I, MARY JOY ANTONIETTE ABORQUE EDEP, of legal age, single and a

resident of Pastrana, Leyte, after having been duly sworn to in accordance with law do
hereby depose and say that:

1. I am a medical doctor by profession as such I was issued an S2 ID or a special

license for regulated medications by the Philippine Drug Enforcement Agency
(PDEA) allowing me to prescribe regulated drugs;

2. On the occasion and by reason of occurrence on November 8, 2013 of

Supertyphoon Yolanda which directly hit Eastern Visayas, our quarters located at
St. Paul’s Hospital was struck by strong winds and heavy rains. Further, it was
inundated with water due to the said storm causing irreparable damage to the said
S2 ID and my other belongings;

3. I am executing this affidavit freely and voluntarily in order to establish the truth
of the foregoing facts for whatever legal purpose this may serve;

IN WITNESS WHEREOF, I have hereunto set my hand this 10th day of February
2017, at Tacloban City, Leyte, Philippines.

MARY JOY ANTONIETTE ABORQUE EDEP

(Affiant)

SUBSCRIBED AND SWORN to before me this 10th day of February 2017 at

Tacloban City, affiant exhibiting to me her PRC ID No. 0119600 issued on/valid until
2/24/2020, as competent proof of her identity.

Doc No. ___

Page No. ___
Book No. ___
Series of 2017