ACCIDENT REPORT
To Whom It May Concern:
On the 7th of April, 2011 around 4:00 oclock in the afternoon, John Rhaisser D. Baluyut, an eight-year old boy, a resident of this barangay, and a pupil of Sto. Domingo Elementary School, had an accident. He went out of balanced, resulting a fracture in his arm. This accident report is issued upon request by his parents for records, and insurance claim purposes.