national deworming
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Department of Education
NATIONAL SCHOOL DEWORMING DAY
Deworming Checklist
Division: SURIGAO DEL SUR School: PINANAPATAN ELEMENTARY SCHOOL Total Enrolment: _________________
District: LINGIG - II Address: Km 23, Bogak Lingig Surigao del Sur Grade & Section:
No.Name of PupilGenderHandwashingFeedingDewormedToothbrushingRemarksAction
Last NameFirst NameMIDoneDoneDoneTaken
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
Accomplished by: Class AdviserDate Accomplished: _____________________
Department of Education
NATIONAL SCHOOL DEWORMING DAY
School Level Reporting Form
Division : SURIGAO DEL SURDistrict : LINGIG IIName of School : PINANAPATAN ELEMENTARY SCHOOLSchool Address : Km 23, Bogak Lingig Surigao del SurTotal Enrolment :
GRADE LEVELNO. OF ENROLLEDCHILRENNO. OF CHILDREN DEWORMEDREMARKS
Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
TOTAL
Accomplished by:CHANIELOU J. MARTINEZ School In-ChargeNoted by:
ELIZABETH GARDONEZ, Ph.D. Public Schools District Supervisor
Date Accomplished: ________________
Department of EducationRAPID COVERAGE ASSESSMENT FORMNATIONAL SCHOOL DEWORMING
Region: CARAGA REGION 13District: LINGIG IIDivision: SURIGAO DEL SURSchool: PINANAPATAN ELEMENTARY SCHOOLLOCATION (Barangay, Municipality, Province): Km23 Bogak, Lingig, Surigao del Sur
No.Name of PupilGenderDewormedIF NO, Indicate Reason
Last NameFirst NameMIYESNO
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
Accomplished by: Class AdviserDate Accomplished: _____________________