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 actual deliveries during his days of duty in this institution.

ACTUAL DELIVERIES
Supervised by:
No Case Diagnosis Name of Ag Date of Time Gende Name of Type of Name & Signature
. No. Mother e Delivery of r of Hospital Delivery of Qualified Clinical
Delive Baby Instructor
ry

1 Home Pregnancy
Delive Uterine 40 Virginia 21 February 27, 8:30 Female Tanqui Normal Charmaine S.
ry weeks Age of Pagaling 2007 AM Health Spontaneo Abenes
Gestation Cu Center us PRC #: 0266421
Cephalic in City of San Delivery PNA #:16309
Labor Fernando, with Right MAN units: 42 units
Gravida 1 La Union Medio-
Para 0 (G1P0) Lateral
Episiotom
y (RMLE)

2 Home Pregnancy
Delive Uterine 39 Asnairah 37 January 6, 10:46 Male Cabaroan Normal Charmaine S.
ry weeks Age of Moctar 2007 AM Health Spontaneo Abenes
Gestation Macapuna Center us PRC #: 0266421
Cephalic in g City of San Delivery PNA #:16309
Labor Fernando, (NSD) MAN units: 42 units
Gravida 4 La Union
Para 3 (G4P3)

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