REPUBLIC OF THE PHILIPPINES

PHILIPPINE HEALTH INSURANCE CORPORATION

Regional Health Insurance Office I
APPENDIX "A"
ITINERARY OF TRAVEL Date: February 11, 2008
Name JEAN P. TOLENTINO Position CLERK II
Official Station:MANGATAREM SERVICE DESK Monthly Salary
Residence
Purpose of Travel: To remit collections and forward membership forms for printing.

Place Visited Time Means of Trans. Per Total

Date
(Destination) Departure Arrival Transportation Expenses Diems Amount

2/8/2008 Mangatarem Service Desk

7:50am 8:30am bus 57.00 57.00
to Alaminos Town Proper

Alaminos Town Proper

8:30am 8:40am tricycle 10.00 10.00
to Alaminos Service Office

Alaminos Service Office

5:00pm 6:30pm bus 60.00 60.00
to Mangatarem

2/19/2008 Mangatarem Service Desk

7:50am 8:40am bus 57.00 57.00
to Alaminos Service Office

Alaminos Town Proper

8:30am 8:40am tricycle 10.00 10.00
to Alaminos Service Office

Alaminos Service Office

5:00pm 6:30pm bus 60.00 60.00
to Mangatarem

TOTAL 254.00
I certify that ( 1 ) I have reviewed the foregoing itinerary,( 2 ) the Prepared by:
travel is necessary to the service, ( 3 ) the period covered is Cecilia T. Dela Cruz
reasonable and the expenses claimed are proper
Approved by:
 ABRAHAM A. BALLARES LEO DOUGLAS V. CARDONA JR.M.D.
CSIO / S.O. Head AVP - PRO I

PHILIPPINE HEALTH INSURANCE CORPORATION

Regional Health Insurance Office I
Dagupan City

CERTIFICATE OF TRAVEL COMPLETED

I CERTIFY THAT I have completed the tavel authorized in the Travel Order / Authority No.obs # 00308
series 2008, dated February 8, 2008 under conditions indicated below.

Strictly in accordance with the approved order.

Cut short as explained below. Excess payment in the amount of P _______ was refunded
under O.R. No. _____________, dated ____________.
Extended as explained below. Additional itinerary was submitted.
Other deviations as explained below.

Explanation or justifications:

Evidences of travel:

Used Tickets
Certificate of Appearance
Others ( specify ) ________________________

Respectfully submitted:

Cecilia T. Dela Cruz

On the evidence and information of which I have knowledge, the travel was actually undertaken.

LEO DOUGLAS V. CARDONA JR.M.D.

AVP - PRO I
 REPUBLIC OF THE PHILIPPINES
PHILIPPINE HEALTH INSURANCE CORPORATION
Regional Health Insurance Office I
APPENDIX "A"
ITINERARY OF TRAVEL Date: March 03, 2008
Name JEAN P. TOLENTINO Position Clerk II
Official Station:MANGATAREM SERVICE DESK Monthly Salary
Residence
Purpose of Travel: To render demonstration and printing of rf1 reports version 2.

Place Visited Time Means of Trans. Per Total

Date
(Destination) Departure Arrival Transportation Expenses Diems Amount

2/28/2008 Mangatarem Service Desk

9:00am 9:30am tricycle 30.00 30.00
to LGU-Urbiztondo

LGU-Urbiztondo to
12:00pm 12:30pm tricycle 30.00 30.00
Mangatarem Service Desk

TOTAL 60.00
I certify that ( 1 ) I have reviewed the foregoing itinerary,( 2 ) the Prepared by:
travel is necessary to the service, ( 3 ) the period covered is Jean P. Tolentino
reasonable and the expenses claimed are proper
Approved by:

ABRAHAM A. BALLARES LEO DOUGLAS V. CARDONA JR.M.D.

CSIO / S.O. Head AVP - PRO I
 PHILIPPINE HEALTH INSURANCE CORPORATION
Regional Health Insurance Office I
Dagupan City

CERTIFICATE OF TRAVEL COMPLETED

I CERTIFY THAT I have completed the tavel authorized in the Travel Order / Authority No.____
series 2008, dated _________________ under conditions indicated below.

Strictly in accordance with the approved order.

Cut short as explained below. Excess payment in the amount of P _______ was refunded
under O.R. No. _____________, dated ____________.
Extended as explained below. Additional itinerary was submitted.
Other deviations as explained below.

Explanation or justifications:

Evidences of travel:

Used Tickets
Certificate of Appearance
Others ( specify ) ________________________

Respectfully submitted:

JEAN P. TOLENTINO

On the evidence and information of which I have knowledge, the travel was actually undertaken.
LEO DOUGLAS V. CARDONA JR.M.D.
AVP - PRO I