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Form 2: Consolidated Elementary / Secondary Deworming Report

This document contains reporting forms for tracking deworming of students in schools in Cebu Province, Philippines. It includes forms for reporting at the school, district, and regional level. The school-level form provides a template to record the number of enrolled and dewormed students by gender and grade. It also includes a sample listing of 25 students from Grade 4 of San Sebastian Elementary School who received deworming treatment on a given date.

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Antonia Catubig-Bebe
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93 views5 pages

Form 2: Consolidated Elementary / Secondary Deworming Report

This document contains reporting forms for tracking deworming of students in schools in Cebu Province, Philippines. It includes forms for reporting at the school, district, and regional level. The school-level form provides a template to record the number of enrolled and dewormed students by gender and grade. It also includes a sample listing of 25 students from Grade 4 of San Sebastian Elementary School who received deworming treatment on a given date.

Uploaded by

Antonia Catubig-Bebe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education
Region VII, Central Visayas
Division of Cebu Province
IPHO Building, Sudlon, Lahug, Cebu City

FORM 2
National School Deworming Month ( ) JULY - 1st Dose ( ) JANUARY-2nd DOSE
School Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District:
Name of School:
Grade Level:

CONSOLIDATED ELEMENTARY / SECONDARY DEWORMING REPORT

No. of Enrolled Learners No. of Learners Dewormed


Percentage
Grade Level
(%)
M F T M F T
GRAND TOTAL
Accomplished by:

First - Aid Teacher


Noted:

Date Accomplished
School Head
Republic of the Philippines
Department of Education
Region VII, Central Visayas
Division of Cebu Province
IPHO Building, Sudlon, Lahug, Cebu City

FORM 2A
National School Deworming Month
District Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District:

Grade Level:

No. of Enrolled No. of Learners


Learners Dewormed Percentage
No. Name of School
(%)
M F T M F T
GRAND TOTAL

Accomplished by:

First - Aid Teacher


Noted:

Date Accomplished:

District Supervisor
Department of Education
Region VII, Central Visayas
Division of Cebu

LIST OF LEARNERS DEWORMED


S.Y. 2020 - 2021
( ) 1st Dose Date: __________________ ( ) 2nd Dose Date: __________________
Name of School: San Sebastian Elementary School District: Samboan
Grade Level: FOUR Section: ORANGE Date Dewormed:

Name of Learners Name of Learners


No. AGE REMARKS No. AGE REMARKS
(BOYS) (BOYS)
1 ARANAS STEPHEN D. 9 1 BENSON KIETH NICOLE A. 9
2 CATIPAY PHELJAN C 9 2 BERIARMENTE JAMAICA 9
3 JUMUAD DEAN ANTHONY B. 9 3 CANENCIA NATHALIA MAE C. 9
4 MAGALLANESDAN RESTY 9 4 CAVALIDA HERSHYLLE 9
5 OMALE IVER JHON MATTHE C. 9 5 JERUSALEM JAIRAH A. 9
6 PAJULAS JHESTEVEN R. 9 6 RUDA ANGEL MAE L. 9
7 PIEDAD ADRIAN 9 7 RUDAS ROXIE MAE L. 9
8 PIEDAD ANGELO L. 9 8 RUSIANA CLARA MARYSE 9
9 VILLAMOR JONEL L. 9 9 RUSIANA SHARLOU KRIZA B. 9
10 10 TERRAZA AESSHA HARMONB. 9
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25

SUMMARY M F T
No. of Learners Enrolled 9 10 19
No. of Learners Dewormed

Prepared by:

LILIA C. BURBURAN
Class Adviser

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