REFERENCE NO: CEBO7MWSIMM9 | OR: E2023-02-04095836 | Amount: PHP 75.
00
Feb 21, 2023 (11:00 AM TO 12:00 PM) - MIMAROPA (Quezon City)
Professional Regulation Commission
STATEBOARD VERIFICATION SLIP
Feb 17, 2023
DATE FILED: _________________
NAME: RIMAN, KRISTIA GRACE FELICIANO
____________________________________________________________________________________________________________________________
LAST NAME FIRST NAME MIDDLE NAME MARRIED NAME
NURSE
PROFESSION: __________________________________ 0636527
LICENSE NUMBER: ____________________ 09/27/2010
DATE OF REGISTRATION: ___________________________
(Month/Date/Year)
FILIPINO
CITIZENSHIP:___________________________________ PASSPORT
PROOF OF CITIZENSHIP: _____________________________________________ ___________________________
JULY 2010
DATE/PLACE OF EXAMINATION: __________________________________________________________________________________________________________
05505148
EXAMINATION NUMBER: ___________________________ 76.80%
GENERAL AVERAGE: ________________ 06/11/2025
PRC ID CARD EXPIRATION DATE:______________________
(Month/Date/Year)
TEL. /CELLPHONE NO./E-MAIL ADDRESS:_____________________________________________
0549086936 /
[email protected] DATE OF BIRTH: ___________________________________
06/11/1989
(Month/Date/Year)
OUR LADY OF FATIMA UNIVERSITY-QC
NAME OF SCHOOL: __________________________________________________________________________________________________________________________________
(Complete Name)
FAIRVIEW, QUEZON CITY
SCHOOL ADDRESS: __________________________________________________________________________________________________________________________________
(City/ Municipality/ Province)
BS IN NURSING
DEGREE COURSE: ______________________________________ Mar 25, 2010
DATE OF GRADUATION: ___________________________________________________________________
FOR PRC PROCESSING
ACTION TAKEN BY THE RECEIVER: _____________________ACTION TAKEN BY THE VERIFIER: _____________________O.R. NO.:____________________________
COURIER/IEMS: DESTINATION: ___________________________________DATE: _________ AMOUNT:__________________________________
NAME OF COURIER: _______________________________ ACTION TAKEN BY THE LEGAL AND INVESTIGATION DIVISION:
TRACKING NO.:______________________________________ CL NCL
DATE OF PICK-UP:____________________________________
ORDINARY/ REGISTERED MAIL
Verified by PDFfiller
CONFORME: 02/19/2023 22:24
I agree to the PRC Privacy Notice and give my consent to the collection and processing of my personal data in accordance thereto:
KRISTIA GRACE FELICIANO RIMAN
________________________________________________________________
Signature over printed name
ARD-10
/ Rev. 02
January 3, 2019
Page 1 of 2
Professional Regulation Commission
STATEBOARD VERIFICATION SLIP
Feb 17, 2023
DATE FILED: ____________________
NAME: RIMAN, KRISTIA GRACE FELICIANO
____________________________________________________________________________________________________________________________
LAST NAME FIRST NAME MIDDLE NAME MARRIED NAME
NURSE
PROFESSION: __________________________________ 0636527
LICENSE NUMBER: ____________________ 09/27/2010
DATE OF REGISTRATION: ___________________________
(Month/Date/Year)
FILIPINO
CITIZENSHIP:___________________________________ PASSPORT
PROOF OF CITIZENSHIP: ________________________________________________________________________
JULY 2010
DATE/PLACE OF EXAMINATION: __________________________________________________________________________________________________________
05505148
EXAMINATION NUMBER: ___________________________ 76.80%
GENERAL AVERAGE: ________________ 06/11/2025
PRC ID CARD EXPIRATION DATE:______________________
(Month/Date/Year)
TEL. /CELLPHONE NO./E-MAIL ADDRESS:_____________________________________________
0549086936 /
[email protected] DATE OF BIRTH: __________________________________
06/11/1989
(Month/Date/Year)
OUR LADY OF FATIMA UNIVERSITY-QC
NAME OF SCHOOL: __________________________________________________________________________________________________________________________________
(Complete Name)
FAIRVIEW, QUEZON CITY
SCHOOL ADDRESS: _________________________________________________________________________________________________________________________________
(City/ Municipality/ Province)
BS IN NURSING
DEGREE COURSE: ________________________________________________ Mar 25, 2010
DATE OF GRADUATION: ___________________________________________________________
FOR PRC PROCESSING
ACTION TAKEN BY THE RECEIVER: _____________________ACTION TAKEN BY THE VERIFIER: _____________________O.R. NO.:_______________________
COURIER/IEMS: DESTINATION: _____________________________________DATE: _____ ______ ___ AMOUNT: ___________________________
NAME OF COURIER: _______________________________ ACTION TAKEN BY THE LEGAL AND INVESTIGATION DIVISION:
TRACKING NO.:______________________________________ CL NCL
DATE OF PICK-UP:____________________________________
ORDINARY/ REGISTERED MAIL
Verified by PDFfiller
CONFORME: 02/19/2023 22:25
I agree to the PRC Privacy Notice and give my consent to the collection and processing of my personal data in accordance thereto:
KRISTIA GRACE FELICIANO RIMAN
_______________________________________________________________________
Signature over printed name
ARD-10
Rev. 02
January 3, 2019
NOTE: Please make sure that you have the original copy of the document/s to be authenticated. Page 1 of 2
