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Get PH PMRF 2013

_____ Others (Please specify): _____________________________________ 3.5 Lifetime Member Retiree / Pensioner With 120 months contribution and has reached retirement age Date/Effectivity of Retirement: mm dd yyyy Filipino with Dual Citizenship Naturalized Filipino Citizen Citizen of other countries working/residing/studying in the Philippines Organized Group (Please specify): _________________________ Please do not write on this portion. For filling-out by PhilHealth Officer: Under the pe.

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