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Republic of the Philippines

Department of Health
CARAGA REGIONAL HOSPITAL
Surigao City ACT-07
Rev. No. 0
Effectivity: 02/01/18

ITINERARY OF TRAVEL

Entity Name : _____________________


Fund Cluster: ____________________ No.: ___11-756 s. 2018____________

Name : BIOL, EARLBARR C Date of Travel : NOVEMBER 29-30, 2018


Position : Nurse -I Purpose of TravelLong Distance

Places to be visited TIME Means of Transpor- Per


Date Others
(Destination) Departure Arrival Transportation station Diem Total Amount

11/29 CRH Surigao City 4:00 PM City 160.00 160.00


Ambulance
Dinner 7:30 PM 80.00 80.00
SPMC, Davao City 2:00 AM
Accomodation 400.00 400.00

11/30/2018 SPMC, Davao City 6:00 AM 160.00 160.00


Breakfast 6:30 AM 80.00 80.00
Lunch 12:00 PM 80.00 80.00
Surigao City 2:00 PM

TOTAL: - 960.00 960.00

TOTAL AMOUNT: 960.00

TOTAL AMOUNT OF 960.00


Prepared by :

I certify that : (1) I have reviewed the foregoing BIOL, EARLBARR C.


itinerary, (2) the travel is necessary to the service, Signature over Printed Name
(3) the period covered is reasonable and (4) the
expenses claimed are proper.
Approved by:

MERCY A. YANDRA, RN, MAN DR. PONCIANO S. LIMCANGCO, FPSP, MBA, CEO VI
Signature over Printed Name MEDICAL CENTER CHIEF I
Chief Nurse