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MDR 070511267437

This document contains personal information and health insurance details for an individual named Lara Michaela Vasquez Reyes. It includes her PhilHealth identification number, member category, address, date of birth, and contact information. No dependent information is listed.

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Mary Elaine Golez
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43 views1 page

MDR 070511267437

This document contains personal information and health insurance details for an individual named Lara Michaela Vasquez Reyes. It includes her PhilHealth identification number, member category, address, date of birth, and contact information. No dependent information is listed.

Uploaded by

Mary Elaine Golez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION


Corporate Action Center Hotline - (02) 441-7442
www.philhealth.gov.ph

MEMBER DATA RECORD


MEMBER BASIC INFORMATION
PhilHealth Identification Number (PIN) : 07-051126743-7 PhilSys Number :
Member Category : DIRECT CONTRIBUTOR - SELF
Sub-Category EARNING INDIVIDUAL - NHTS Coverage : N/A
INDIVIDUAL Validity Period : N/A - N/A

REYES, LARA MICHAELA VASQUEZ


BLOCK 1 LOT 45 FOREST HILL STREET ROCKA VILLAGE 3 SANTA RITA, GUIGUINTO BULACAN

Foreign Address : N/A Sex : FEMALE


Date of Birth : 07/25/1997
Place of Birth : MAGALANG, PAMPANGA
Contact No. (Foreign) : N/A Civil Status : SINGLE
(Local) : +639162270782 Tax Identification Number : 347783519000

ENTITY INFORMATION
PhilHealth Number (PEN/POGN) : N/A
Name of Employer/Organized Group : N/A
hidden text
Business Address : N/A
hidden text
Telephone Number : N/A Employment Status :
Tax Identification Number : N/A Date : N/A

DEPENDENT INFORMATION
PIN Surname Given Name Middle Name Sex Relation Date of Birth
*** NOTHING FOLLOWS ***

ARLAN M. GRANALI
ACTING BRANCH MANAGER
PRO - III Branch B

Paalala: Basahin ang nilalaman ng MDR. Kung may kulang o mali, ibalik agad upang maiwasto. Ingatan ang orihinal na kopya at huwag ibigay kahit kanino. Kung
sakaling gagamit at makikinabang ng benepisyo, magbigay ng kopya sa ospital. (Reminder: Read the contents of the MDR. Should there be any data discrepancies,
return it back to amend or rectify the error. Take good care of MDR and do not hand it over to anybody. Provide photocopy to hospital in case of confinement and
availment of benefits.)
This is a Member Portal System generated report. Signature is not required.
Oct 08, 2022 02:37 PM

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