Republic of the Philippines

PHILIPPINE HEALTH INSURANCE CORPORATION

Corporate Action Center Hotline - (02)441-7442
MDR
www.philhealth.gov.ph

MEMBER DATA RECORD

MEMBER INFORMATION
Philhealth Identification Number (PIN) : 020269820358
Member Category : INFORMAL ECONOMY NHTS Coverage :
Sub-Category : SELF-EARNING INDIVIDUAL Effectivity Period :

OGALESCO , KRISTINE CASSANDRA ABLAZA

1189 E JULIO NAKPIL STREET PACO MANILA
BGY 688, MALATE, NCR, CITY OF MANILA,
FIRST DISTRICT 1004

Foreign Address : N/A Sex : Female

Date of Birth : 12/19/1995
Place of Birth : PACO, NCR, CITY OF MANILA, FIRST DISTRICT

Contact No.(Foreign) : N/A Civil Status : SINGLE

(Local) : (353)230-5 Tax Identification Number :

EMPLOYER/ORGANIZED GROUP INFORMATION

PhilHealth Number (PEN/POGN) : N/A
Name of Employer/Organized Group : N/A
Business Address : N/A

Telephone Number : N/A

Tax Identification Number : N/A

DEPENDENT INFORMATION
PIN Surname Given Name Middle Name Sex Relation Date of Birth
*** NO DECLARED DEPENDENT/S ***

Paalala: Basahin ang nilalaman ng MDR. Kung may kulang o mali, dalhin agad ang kopya sa pinakamalapit na PhilHealth Office upang maiwasto. Ingatan ang inyong kopya ng MDR
at huwag ibigay kahit kanino.

Reminder: Read the contents of the MDR. Should there be discrepancies, bring your copy to the nearest PhilHealth Office to amend or rectify error. Take good care of the MDR
and do not hand it over to anybody.

This is a Member Inquiry System generated report.

7/25/2018 7:22:14 PM