Physical Medical Examination

PNP sample request form for physical medical examination

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Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
_________________________________________
___________________________
MEMORANDUM
FOR

:

FROM

:

SUBJECT

:

DATE

Director, PNP Crime Laboratory

:

Request for Physical/Medical Examination

1. Request conducts Physical/Medical Examination
____________________ residing at ________________________.

of

the

person

2. In connection with para 1 above, request furnish this office a copy of the initial
result thereof for reference purposes.
3. For consideration.

____________________________
(CHIEF OF OFFICE)