Certificate of Indigency (Medical Assistance)

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Republic of the Philippines

Province of Sorsogon
Municipality of Bulan
Barangay San Francisco

OFFICE OF THE PUNONG BARANGAY


________________________________________________________________

CERTIFICATE OF INDIGENCY
TO WHOM IT MAY CONCERN:

This is to certify that GINA ESPINOSA MERCA Filipino of


legal age is a bonafide resident of Barangay San Francisco Bulan,
Sorsogon.

This further certifies that the above-mentioned resident


belongs to indigent family considering that he/she is unemployed
and has no source of regular income.

PURPOSE: MEDICAL ASSISTANCE

Issued this certificate of indigency for whatever purposes


this may legally serve.

Given this 11th day of August, 2021 at Barangay San


Francisco Bulan, Sorsogon.

Approved by:

HON. GEMMA E. CAINGAT


Punong Barangay

Note: This Certification is not valid without dry seal of this barangay.

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