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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) : 140502341169
Member Category : FORMAL ECONOMY NHTS Coverage :
Sub-Category : PRIVATE Effectivity Period :

BADEO , LYKA JANE DEPOSITARIO


LOT 1 BLOCK 3 TUMAGA-LUNZURAN RD
VILLA PATRICIO HOMES SUBD LUNZURAN,
ZAMBOANGA CITY, ZAMBOANGA DEL SUR
7000

Foreign Address : N/A Sex : Female


Date of Birth : 04/06/1996
Place of Birth : ZAMBOANGA CITY, ZAMBOANGA DEL SUR

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


(Local) : 063 9935507 Tax Identification Number :

EMPLOYER/ORGANIZED GROUP INFORMATION


PhilHealth Number (PEN/POGN) : 014000002212
Name of Employer/Organized Group : SUREQUICK MARKETING INC
Business Address : ALESON COMPOUND GOV CAMINS AVE SANTA MARIA, ZAMBOANGA CITY, ZAMBOANGA DEL SUR

Telephone Number : 062 9925514


Tax Identification Number : 283466963001

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.


1/17/2020 10:07:18 PM

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