Scribd
Upload
76 views1 page

Member Data Record: Philippine Health Insurance Corporation

This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) that contains personal information about Bryan Solis Ferrancullo. It lists his PhilHealth Identification Number, member category as an informal economy migrant worker, full name, date of birth, place of birth, civil status as single, and contact information. It also indicates a one-year period of health insurance coverage from August 8, 2014 to August 7, 2015 for which a payment of 2,400 Philippine pesos was made on August 8, 2014. There is a reminder to check the MDR for accuracy and maintain security of the document.

Uploaded by

nath
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
76 views1 page

Member Data Record: Philippine Health Insurance Corporation

This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) that contains personal information about Bryan Solis Ferrancullo. It lists his PhilHealth Identification Number, member category as an informal economy migrant worker, full name, date of birth, place of birth, civil status as single, and contact information. It also indicates a one-year period of health insurance coverage from August 8, 2014 to August 7, 2015 for which a payment of 2,400 Philippine pesos was made on August 8, 2014. There is a reminder to check the MDR for accuracy and maintain security of the document.

Uploaded by

nath
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
You are on page 1/ 1

Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION


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

MEMBER DATA RECORD


MEMBER INFORMATION
Philhealth Identification Number (PIN) : 090502350330
Member Category : INFORMAL ECONOMY NHTS Coverage :
Sub-Category : MIGRANT WORKER Effectivity Period :

FERRANCULLO , BRYAN SOLIS


TABOBO-AN, ODIONGAN, ROMBLON 5505

Foreign Address : N/A Sex : Male


Date of Birth : 12/04/1988
Place of Birth : ODIONGAN, ROMBLON

Contact No.(Foreign) : N/A Civil Status : SINGLE


(Local) : Tax Identification Number :

EMPLOYER/ORGANIZED GROUP INFORMATION


PhilHealth Number (PEN/POGN) : N/A
Name of Employer/Organized Group : N/A
Business Address : N/A

Telephone Number : N/A


Tax Identification Number : N/A

DEPENDENT INFORMATION
PIN Surname Given Name Middle Name Sex Relation Date of Birth
*** NO DECLARED DEPENDENT/S ***

PAYMENT INFORMATION
Coverage OR Number Amount Date of Payment
8/8/2014 to 8/7/2015 10934018L 2400.00 8/8/2014

Paalala: Basahin ang nilalaman ng MDR. Kung may kulang o mali, dalhin agad ang kopya sa pinakamalapit na PhilHealth Office upang maiwasto. Ingatan ang inyong
kopya ng MDR at huwag ibigay kahit kanino.
Reminder: Read the contents of the MDR. Should there be discrepancies, bring your copy to the nearest PhilHealth Office to amend or rectify error. Take good care
of the MDR and do not hand it over to anybody.

This is a Member Inquiry System generated report.


12/7/2017 8:35:21 PM

You might also like