Republic of the Philippines
Province of Surigao del Norte
OFFICE OF THE PUNONG BARANGAY
Barangay Lipata
Surigao City
CERTIFICATION
TO WHOM IT MAY CONCERN:
NAME : TERESITA MATURAN VITOR
AGE : 78 YEARS OLD
DATE OF BIRTH : NOVEMBER 7, 1942
DATE OF DEATH : APRIL 17, 2021
TIME : @ 6:45 A.M.
PLACE OF DEATH : PUROK 2, BRGY. LIPATA, SURIGAO CITY
Has been reported and validated to be dead by persons whose signature appears below.
This certification is issued upon request of the interested party for the death certificate.
Issued this 17th day of April, 2021.
DINO M. VITOR MARGIE B. EVILLA
Informant RHM II
GELITA S. BRUA HON. ALLAN L. CASIÑERO
BHW Kagawad
HON. LOEL JOY O. MESIAS
Punong Barangay