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DATE OF OPERATION 8. PERIOD OF MEDICAL ATTENDANCE/ TREATMENT/ACTUAL SICKNESS CONVALESCING OR RECUPERATION PERIOD PLACE OR PLACES WHERE THE PATIENT WAS CONFINED DURING MY MEDICAL ATTENDANCE AND/OR TREATMENT PLACE/S OF CONFINEMENT DATE FROM TO 9. OTHER REMARKS PURSUANT TO SECTION 28 OF THE SOCIAL SECURITY LAW AS AMENDED ANYONE WHO RESORTS TO MISREPRESENTATION OR CONCEALMENT OF A MATERIAL FACT OR WHO IS A PARTY THERETO FOR THE PURPOSE OF CAUSING ANY PAYMENT OF FRAUDULENT CLAIM OR BENEFIT UNDER ...

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