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Official MDR PDF

This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) for Mark Fritz Boongaling. It provides his PhilHealth Identification Number, member category as an informal economy migrant worker, personal details such as name, date and place of birth, and contact information. The MDR also notes he has no declared dependents under his coverage and provides reminders to check the accuracy of the information and keep the MDR secure.

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BesarioLouiseCassandra
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669 views1 page

Official MDR PDF

This document is a Member Data Record (MDR) from the Philippine Health Insurance Corporation (PhilHealth) for Mark Fritz Boongaling. It provides his PhilHealth Identification Number, member category as an informal economy migrant worker, personal details such as name, date and place of birth, and contact information. The MDR also notes he has no declared dependents under his coverage and provides reminders to check the accuracy of the information and keep the MDR secure.

Uploaded by

BesarioLouiseCassandra
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
MDR
www.philhealth.gov.ph

MEMBER DATA RECORD


MEMBER INFORMATION
Philhealth Identification Number (PIN) : 020255991907
Member Category : INFORMAL ECONOMY NHTS Coverage :
Sub-Category : MIGRANT WORKER Effectivity Period :

BACLAYON , MARK FRITZ BOONGALING


BOLOC BOLOC SANGAT, SAN FERNANDO,
CEBU 6018

Foreign Address :, Sex : Male


Date of Birth : 04/02/1987
Place of Birth : SAN FERNANDO, CEBU

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

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.


10/2/2018 3:17:07 AM

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