MIRANDA POLYCLINIC

CAMPOSANO-MIRANDA & SONS BLDG.

TRES FUENTES RIZAL ST.,
SILAY CITY, NEGROS OCCIDENTAL

July 27, 2015

CERTIFICATION
To whom it may concern:
This is to certify that Ms. ALLEYAH ANICA NENE, 13 years
old/female of Silay City, Negros Occidental, Philippines had received
the following immunizations on the following dates:
01/26/05

H. Influenza Type B

01/26/05

Hepatitis B1

03/08/05

Hepatitis B2

This certificate is being issued upon the request of MS. ALLEYAH

ANICA NENE for whatever purpose it may serve him/her (excluding
legal matters).

RHODORA CAMPOSANO-MIRANDA, M.D.

PTR No. 1663697
License No. 0061749