The two teams battled to a scoreless tie in regulation and extension periods, paving the way for the shootout.
Host Patin-ay took a 2-0 lead on goals by Nat Villanueva and Dennis Egamao, but Butuan High converted four in a row after a miss by Antonio Izra to escape with the win.
In a related development, Holy Cross of Bukidnon-Del Monte crushed First Fruits Academy, 1-0, to rule the Bukidnon provincial eliminations.
Holy Cross will meet Cagayan de Oro titlist Initao National High on Nov. 21 in the Northern Mindanao sub-regional final for a berth in the all-Mindanao competition.
Meanwhile, West Negros College, Negros Occidental High, Don Bosco Technical Institute, University of St. La Salle, Colegio de Sto. Tomas Recoletos and Don Julio Ledesma High scored two victories each to grab early group leadership in the Negros Occidental Coke Go-for-Goal eliminations.
WNC ripped La Consolacion School-Gardenville, 13-0, and Pontevedra National High, 8-1, in Group D, NOHS swamped Bacolod City National High, 11-0, and Sagay NAtional High, 5-0, while USLS spilled SNHS, 5-1, and BCNHS, 3-0, in Group E; defending champion Don Bosco toppled Don Vicente Gustilo National High, 7-1, and Saint Michael Academy-Pontevedra, 16-0, in Group A; CSTR blanked Mansiligan National High, 8-0, and Catalino Soliguen National High, 14-0, in Group B; and DJLHS beat Antipolo National High, 12-0 and Victoria National High, 2-1, in Group C.
Twenty teams are vying in the tourney sponsored by Coca-Cola wth Adidas as official ball.
Congressman Charlie Cojuangco, who is also president of the Negros Occidental Football Association, graced the opening ceremony last Monday together with fellow solons Gary Acuna and Monico Puentevella, Philippine Football Federation president Rene Adad and Coca-Cola representatives Cindy Lim and Baby Aurelio.
In his welcome remarks, Cojuangko encouraged the athletes to perform with excellence and urged them to "aim for the most noble goal of wining without sacrificing respect for self, respect for your teammates and the opponents as well and respect for the rules of the game."