SAMPLE AFFIDAVIT | AFFIDAVIT OF DOCTOR TO ESTABLISH THE BIRTH OF A PERSON FOR LATE REGISTRATION WITH THE CIVIL REGISTRAR

 REPUBLIC OF THE PHILIPPINES)

Quezon City, Philippines                       ) S.S.

AFFIDAVIT

I, Dra. Maria Ligaya, Filipino, of legal age, single and a resident of 123 Bagong Liwanag, Barangay Sinilangan, Quezon City, Philippines, having been duly sworn in accordance with law, hereby depose and state:

1. That I am a duly licensed medical doctor, practicing at the St. Lukes Medical Center with Professional License No. 123456 issued on February 28, 2015 at the City of Manila;

2. That on or about 8:00 o'clock in the morning of February 28, 2016, I personally attended to a patient named Mary Anne in giving birth by normal delivery to a baby girl whom they named as Mary Ann; and

3. That I am executing this affidavit to attest to the truthfulness of the facts mentioned above and for any other legal purposes that this Affidavit may serve.

IN WITNESS WHEREOF, I hereby set my hand this 28th day of February 2022, in the City of Quezon, Metro Manila, Philippines.

DRA. MARIA LIGAYA

Affiant

JURAT

(Please see sample my sample format of Jurat on this link: Sample Jurat)