Office of the City Health Officer

City of San Fernando, La Union

CERTIFICATION
This is to certify that MR. JEFFERSON GOMEZ AGUILA of Union Christian
College had two cord dressings during his days of duty in this institution.

CORD DRESSING
Supervised by:
No Case Date Name of Gend Name of Age Name of Hospital Name & Signature
. No. Performed Baby er of Mother of Qualified Clinical
Baby Instructor

1 Home July 9, 2006 Marc Benz Male Betty Peralta 26 Santiago Norte Health Jennifer Alice G.
Delive Vinluan Olano Center Abaga
ry City of San Fernando, PRC #: 0216745
La Union PNA #:17944
MAN units: 33 units

2 Home November 15, Raiza Mae Femal Amalia 36 Ilocanos Sur Health Jennifer Alice G.
Delive 2006 Casil e Asuncion Casil Center Abaga
ry City of San Fernando, PRC #: 0216745
La Union PNA #:17944
MAN units: 33 units

This certification is issued to MR. JEFFERSON GOMEZ AGUILA this 19th of March
2007 for all good intents and purposes it may serve.

_____________________________________________ _________________________________
ELVIRA P. ORDINARIO, RM EMILY LAROYA, RN
Date Signed: _________ Date Signed: _________
Midwife II Nurse III
License No. 0062347 a. License No. 0164680
Valid Until: August 18, 2008 Valid Until: December 22, 2008
b. PNA No.: 16293
Valid Until: December 2007
c. ANSAP No.: 09241
Valid Until: December 2007

____________________________________
EDUARDO S. POSADAS, MD
Date Signed: _________
City Health Officer II