National School Deworming Month July 2017

ANNEX C : Form 1 Deworming Masterlist

Province Rizal
Division Rizal
District Tanay IB
Name of School Tanay West NHS
School Address G. Trinidad St., Brgy Wawa, Tanay, Rizal
Total Enrolment 42
Grade Level and Section 7 Dahlia

DEWORMED
Number Refused
Name of Child with consent
Enrolled Deworming

4 P's non 4 P's

1 Abad, Manuel M.
2 Alcantara, Aeron Lloyd P.
3 Alcoreza, Oliver E.
4 Bajado, Ashly R.
5 Binaluyo, Adrian C.
6 Brequillo, Arjay T.
7 Capistrano, John Marco L.
8 Catapusan, Jhosmel T.
9 Catolos,Francis Adriane V.
10 Dapug, Jj Iverson P.
11 Doltiao, Teodoro D.
12 Duan, Anthony O.
13 Flores, Geoff Michael L.
14 Lagramada, Den Eiron S.
15 Lim, Jhon Lee B.
16 Lorica, Shan Rei T.
17 Mataverde, Albert H.
18 Matienzo, Sygman-Rhee D.
19 Salas, Jazele Mark B.
20 Sta. Ana, Justin F.
21 Tulio, Fritz Andrei H.
22 Zari, Rocky B.
23 Abraham, Erwina B.
24 Bumanlag, Trisha Shane P.
25 Dacunos, Ma. Angela Anzel
26 Denlauso, Diane Ivy B.
27 Galot, Ellyza Joyce M.
28 Guevarra, Sophia P.
29 Jesuitas, Renalyn P.
30 Lentija, Jemaica N.
31 Mario, Amihan T.
32 Matawaran, Rose Ann O.
33 Mengorio, Michaela
34 Mercado, Francia Mae T.
35 Owapin, Ashley Nicole A.
36 Pitoral, Irene Yvette A.
37 Riocasa, Ansherina Jade S.
38 Tirado, Abrecel Joy A.
39 Torres, Apreal G.
 40 Villar, Lowela Angela M.
41 Viray, Annachael R.
42 Viray, Jocelyn J.
TOTAL 18

Accomplished By: Noted By:

Raul T. Reyes Maylyn B. Mawili

Adviser GLC
(Name and Signature) (Name and Signature)

Date: August 9, 2017 Date: August 9, 2017

 l Deworming Month July 2017
orm 1 Deworming Masterlist

Precautionary Measure
(seriously ill, with abdominal
Deferred pain, diarrhea, who has
previous hypersensitivity
with deworming drug)
(Name and Signature)

Date: August 9, 2017

 National School Deworming Month July 2016
ANNEX C : Form 2 Modified School Level Reporting Form

Province RIZAL
Division TANAY
District TANAY
Name of School TANAY WEST NATIONAL HIGH SCHOOL
School Address G. TRINIDAD ST. BRGY. WAWA TANAY, RIZAL
Total Enrolment

CHILDREN DEWORMED

No. of Enrolled Refused

Grade Level with consent Deferred
Chidren Deworming
4 P's non 4 P's

Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
TOTAL

Noted By:
Accomplished By:

School Principal District Supervisor

(Name and Signature) (Name and Signature)

Date Accomplished:
worming Month July 2016
d School Level Reporting Form

Precautionary Measure
(seriously ill, with Remarks
abdominal pain, diarrhea, ( Reasons for
who has previous Refusals and being
hypersensitivity with deferred )
deworming drug)
 National School Deworming Month July 2016
ANNEX C : Form 2 Modified School Level Reporting

Province RIZAL
Division RIZAL
District TANAY I
Name of School TANAY WEST NATIONAL HIGH SCHOOL
School Address G. TRINIDAD ST. BRGY. WAWA TANAY, RIZAL
Total Enrolment 597

CHILDREN
Remar
DEWORMED

No. of Enrolled
Grade Level with consent Ineligible
Chidren
4 P's non 4 P's ( Dewormed
before June 1)

Grade 7
Grade 8
Grade 9
Grade 10
Grade 11

TOTAL 0 0 0 0 0

Accomplished By:

LYNDEL R. DAVID
Principal I

Date Accomplished: July 26,2016

hool Deworming Month July 2016
2 Modified School Level Reporting Form

Remarks for not being dewormed

Precautionary
Measure (seriously ill,
with abdominal pain,
Refused Deferred due to
diarrhea, who has
Deworming Prevalence Survey
previous
hypersensitivity with
deworming drug)

0 0 0

Noted By:

IMELDA M. ASUNCION
District Supervisor

Date Accomplished: