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Annex A: Baguio General Hospital and Medical Center

The document is a medicolegal certificate from Baguio General Hospital certifying that Maurice J. Domogzki, a 23 year old male from Baguio City, was examined and treated on September 10, 2019 for a punctured wound from a foreign body approximately 8cm in his left gluteal region. He was brought to the hospital by his uncle Barney Bulgaria at 12:40 PM and his treatment was estimated to take one to two days to heal without complications.

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Joward Palitayan
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3K views1 page

Annex A: Baguio General Hospital and Medical Center

The document is a medicolegal certificate from Baguio General Hospital certifying that Maurice J. Domogzki, a 23 year old male from Baguio City, was examined and treated on September 10, 2019 for a punctured wound from a foreign body approximately 8cm in his left gluteal region. He was brought to the hospital by his uncle Barney Bulgaria at 12:40 PM and his treatment was estimated to take one to two days to heal without complications.

Uploaded by

Joward Palitayan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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ANNEX A

Republic of the Philippines


Department of Health
BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER
Baguio City
Form no.: MS-HIM-004
Health information management office
Revision no.: 1
MEDICO-LEGAL CERTIFICATE
Effectivity date: July 1, 2015

___September 10, 2019 x


Date
TO WHOM IT MAY CONCERN:

This is to certify that MAURICE J. DOMOGZKI (Male__ Female__) _23_ of


age,
(Name of patient)

From No. 21 Pias, Brgy. Camp 7, Baguio City _______________ f


(Address)

Was examined and treated/confined in this hospital on/from ______September 10, 2019________
(Date admitted)
to ______September 10, 2019_______ for the following:
(Date discharged)

Punctured wound sec to trauma with_ z


f foreign body, (+/-) 8cm, left gluteal region s

TIME OF ARRIVAL: _______________________12:40______________ AM/PM


Brought by: __________BARNEY BULGARIA_____ /Relationship: ____Uncle_____________
Address: No. 21 Pias, Brgy. Camp 7, Baguio City_______________ x

Treatment will take from One (1) to Two (2) days for the above conditions/ injuries to
heal/recover unless complications will arise.

PROVISIONAL
FINAL
NED HABILOG, MD
Licence No. 214412
Department of ORL-HNS
Attending Physician / Medico-legal

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