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Republic of the Philippines
Department of the Interior and Local Government
PHILIPPINE NATIONAL POLICE POLICE REGIONAL OFFICE 9 KATIPUNAN MUNICIPAL POLICE STATION Katipunan Zamboanga Del Norte
PNP ARREST AND BOOKING SHEET
(To be accomplished by the Arresting Officer)
BLOTTER ENTRY NR: ________0241
MARCH 20, 2014 DATE: _____________________ PERSONAL INFORMATION: REYES JUAN LAURO N/A (Last Name) (First Name) (Middle Name) (Qualifier)
ADDRESS :BRGY UNO, KATIPUNAN ZAMBOANGA DEL NORTE
TEL NO: ______ NONEPOB:_______________________ DOB: _________________ MARITAL STATUS: SINGLE WIDOW/ER SEX: MALE MARRIED SEPARATED FEMALE AGE: _____ 40 WEIGHT: ______ 67 HEIGHT: _____ 5’5” EYES: _____ HAIR: ____ BLACK BLACK COMPLEXION: _____ BROWN OCCUPATION: ________ UNEMPLOYED NATIONALITY: __________ FILIPINO ETHNIC GROUP: ________ TAGALOG DIALECT/LANGUAGE: _______________ TAGALOG HIGHEST EDUCATIONAL ATTAINMENT: __________________________ COLLEGE UNDERGRADUATE NAME OF SCHOOL: _________________________________________ JOSE RIZAL STATE COLLEGE LOCATION OF SCHOOL: ______________________________________ TONDO MANILA
IDENTIFYING MARKS: MOLE TATOO BIRTHMARK SCAR
LOCATION OF IDENTIFYING MARKS: _____________________ MOLE LEFT CHEEK PHYSICAL DEFORMITY/DEFECT: _______ NONE DRIVER’S LIC NR: ______ N/A ISSUED AT: ______ N/A ON: ______ N/A RES CERT NR : ______ N/A DATE AND PLACE OF ISSUE: ________________ N/A OTHER ID CARDS: ______ N/A ID NR: N/A ARREST INFORMATION: ______________________ THEFT _____ CC#1234 OFFENSE CHARGE: (NATURE OF OFFENSE) (CRIM/IS NO.) MODUS OPERANDA : _______ NONE PLACE OF ARREST : ___ BRGY______________________________________ BLUMENRIT DATE OF ARREST : __________________ MARCH 20, 2014 TIME: _______________ 2:40 PM ARRESTING OFFICER/S: RANK: _______________________________ PAT JOHN BOGART SIGNATURE: __________________ _______________________________ PSSg RONALD KUGMO SIGNATURE: __________________ UNIT: ____________________________________ PS9 MANILA
MEDICAL EXAMINATION CONDUCTED AT: ________________________________________
TONDO HOSPITAL, MANILA BY: DR. ______________ PEDRO AGUSTIN ON: __________ REMARKS: _______________________ MARCH 20, 2014 FINGERPRINT TAKEN BY : _______________________________ PSMS ABLERTO DIAZ PHOTO TAKEN BY : _______________________________ PSMS ABLERTO DIAZ INVESTIGATOR ON CASE : _______________________________ PSMS KENT TUTAN BOOKED BY (RANK/NAME/SIGNATURE: _________________________________ PSMS ABLERTO DIAZ SIGNATURE OF PERSON ARRESTED: ____________________________________________ (INDICATE IF SUSPECT REFUSE TO SIGN) OTHER INFORMATION: NAME OF FATHER: _________________________ JONATHAN REYES AGE : _______ 70 ADDRESS:________________________________ DIVISORIA, MANILA NAME OF MOTHER:_________________________ ROSALINA REYES AGE : ______ 66 ADDRESS: ________________________________ DIVISORIA, MANILA NAME & ADDRESS OF PERSON TO BE CONTACTED IN CASE OF EMERGENCY: NAME : ____________________________ ROSALINA REYES RELATIONSHIP: ________ MOTHER ADDRESS: __________________________ DIVISORIA, MANILA TEL #: _______ none LAWYER: _______ none TEL #: _______ none DOCTOR: _______ none TEL #: _______ none HEALTH PROBLEM: _________ none NOTE: USE THE PNPCL FORM 452-038 (STANDARD TEN PRINT CARD) TO TAKE THE TENPRINT OF THE SUSPECT FOR EVENTUAL SUBMISSION TO PNPCL-AFIS (ATTACH THE MEDICAL EXAM RESULT; MUG SHOTS; TENPRINTS OF SUSPECT)
(Essentials in Ophthalmology) Gyan Prakash, Takeshi Iwata - Advances in Vision Research, Volume II - Genetic Eye Research in Asia and The Pacific (2019, Springer Singapore) PDF