REFERENCE NO: CEO1FKGYRWHC | OR: E2024-12-10333123 | Amount: PHP 225.
00
Jan 02, 2025 (02:00 PM TO 03:00 PM) - PRC Cagayan de Oro
NOTE: This appointment date might be different to the date of claiming of the requested authenticated documents
Professional Regulation Commission
ACTION SHEET FOR AUTHENTICATION
DATE FILED: Dec 28, 2024 Please underline: MALE/FEMALE
NAME: OBSIOMA, ZYRAH MAE DE MESA
Last Name First Name Middle Name Married Name
PROFESSION:MIDWIFE REGISTRATION NO.: 0163813 REGISTRATION DATE: 05/23/2013
(For Professional Teacher, please tick [ ] Elementary [ ] Secondary)
VALIDITY DATE OF PROFESSIONAL IDENTIFICATION CARD (PIC): 07/23/2026 TEL./CP NO.: 0888283339 / 09687170610
PLEASE CHECK BOX FOR TYPE OF DOCUMENT TO BE AUTHENTICATED:
CERTIFICATE OF REGISTRATION (COR) NO. OF COPIES PURPOSE:
CERTIFICATION OF BOARD RATING NO. OF COPIES LOCAL
CERTIFICATION OF GOOD STANDING NO. OF COPIES ABROAD
CERTIFICATION OF PASSING NO. OF COPIES LEGAL
X PROFESSIONAL IDENTIFICATION CARD NO. OF COPIES 3 STATEBOARD
REPORT OF RATINGS NO. OF COPIES OTHERS
OTHERS NO. OF COPIES
FOR PRC PROCESSING
Amount: 225.00 Processed by: Prepared by:
. R. E2024-12-10333123
No.: Date: 12/28/2024
Signature over printed name Signature over printed name
maya-wallet
Issued Date: Date:
-
by: Date
due:
NOTE: AUTHENTICATION REQUIRES A VALID PROFESSIONAL IDENTIFICATION CARD.
AUTHENTICATION CLAIM SLIP
PLEASE FILL OUT THIS CLAIM SLIP
NAME: OBSIOMA, ZYRAH MAE DE MESA MIDWIFE
PROFESSION:
REGISTRATION 0163813 REGISTRATION DATE: 05/23/2013
NO.: DATE FILED: Dec 28, 2024 -
DATE DUE:
PLEASE PRESENT THIS SLIP TO CLAIM DOCUMENTS AT ON . PRC
REGISTERED REPRESENTATIVE SHOULD PRESENT ANY VALID GOVERNMENT-ISSUED ID AND AUTHORIZATION LETTER; IF NOT
REGISTERED PROFESSIONAL, PRESENT SPECIAL POWER OF ATTORNEY(SPA)AND ANY VALID GOVERNMENT-ISSUED ID.
REGISTRATION OFFICER
IMPORTANT NOTES:
1. PLEASE ENSURE THAT YOU BRING THE ORIGINAL DOCUMENT
YOU WISH TO HAVE AUTHENTICATED.
2. ADDITIONALLY, PLEASE REMEMBER TO BRING THE
CORRESPONDING NUMBER OF PHOTOCOPIES OF THE SAME
DOCUMENT THAT REQUIRE AUTHENTICATION.
PRD-07
Rev. 00
October 16, 2020
Page 1 of 2
