ENDORSEMENT OF TASK

Employee Name: Aiza S. Gutkowski Date: November 30, 2019

Designation: HRH Nurse II
Official Station: RHU-Pilar, Sorsogon / Brgy. Calongay
Office Agency: PDO Sorsogon City
Reason for Endorsement of task: Resignation

No. Tasks Status

1. Endorsement of Duties in Barangay ( NIP, Prenatal care, Accepted
HPN & DM Club and other activities) to Ma'am Joanne C.
Nocedo, Catchment nurse supervisor.

2. Endorsement of ALL TCL 2018 and 2019 and other Received

reports to Ma'am Joanne C. Nocedo, Catchment nurse
supervisor

3. Endorsement of Schedule of HRH Bayanihan for Dengue

to Ma'am Maricel L. Ebuenga, NCD Coordinator and HRH
Coordinator.

3. Endorsement of Weekly Dengue Reports Tool to PHA Sir. Received

Ramil Ramos

4. Endorsement of Non Phil-health members per Barangay Received

to Sir. Ramil Ramos, PHA

5. Endorsement of Barangay Calongay Household profiling Received

to Sir. Ramil R. Ramos, PHA

6. Endorsement of all forms from DOH Office ( Leave form, Received

Clearance form and etc.) to PHA Sir. Ramil R. Ramos

Prepared by:

AIZA S. GUTKOWSKI, RN
HRH Nurse-II

Received by:

DAVID R. DAZA, MD
Municipal Health Officer

Noted by:

GINA D. BONGON, RN
DMO IV