Republic of the Philippines

Department of Education
Region IV-A CALABARZON
Division of Province of Batangas
District of Nasugbu West
SHS WITHIN PANTALAN ES
Barangay Pantalan, Nasugbu, Batangas

MEDICAL CERTIFICATE
______________________
Date

TO WHOM IT MAY CONCERN:

This is to certify that _____________________________________, ______________ student of Pantalan

(Name) (Strand)
Senior High School was examined and treated at Municipal Health Center Office of Municipality of Nasugbu on

________________, 20__ with the following diagnosis:

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

And would need medical attention for ________________________________________ days barring

complication. (Attending Physician)

______________________
(Attending Physician)
 Republic of the Philippines
Department of Education
Region IV-A CALABARZON
Division of Province of Batangas
District of Nasugbu West
SHS WITHIN PANTALAN ES
Barangay Pantalan, Nasugbu, Batangas

MEDICAL CERTIFICATE
______________________
Date

TO WHOM IT MAY CONCERN:

This is to certify that _____________________________________, ______________ student of Pantalan

(Name) (Strand)
Senior High School was examined and treated at Municipal Health Center Office of Municipality of Nasugbu on

________________, 20__ with the following diagnosis:

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

And would need medical attention for ________________________________________ days barring

complication. (Attending Physician)

______________________
(Attending Physician)