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Age

Tot
al

TALLY SHEET

Tally
Extra Curric
ular
Club

13
14
15

Sport

16

None

17

Both

Tally
1-3

1
Subject
2
s
3
8

4-6
Tally

9
4
10
5
11
or of Sleep
Hours
more
1-3
4-6
7-9
Over 9

Tally

Hours of Study

Burden

7-9
Over 9

Tally

Sy
mp
to
m
SD
D

SA

Tired

Forget

Angry

Sleep

Headac
he

Sad

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