September 11, 2001
Dr. Rose Marie R. Medina
Mary Hill Clinic
Balanga City, Bataan
Dear Dr. Medina:
I, Analyn M. Santos, would like to authorize my sister, Kimberly M. Santos to get my personal medical records from your clinic. These records include CT scans, X-ray, and MRI scans. I will be using these records for employment purposes.
My sister will present her ID cards for identification.
Thank you very much!
Sincerely yours,
Analyn M. Santos