PGH Form No.
Q-550099 PHILIPPINE GENERAL HOSPITAL
The National University Hospital
University of the Philippines Manila
Taft Avenue, Manila
PHIC-Accredited Health Care Provider
ISO 9001:2008 Certified
Section of Infectious Disease
MEDICAL CERTIFICATE
Date:
TO WHOM IT MAY CONCERN:
This is to certify that I have seen and examined
Residing at .
She/He was diagnosed to
And the following are the recommendations:
BY:
License No.