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Republic of the Philippines

Department of Education
Region 02
Division of Santiago City
BALINTOCATOC INTEGRATED SCHOOL
Santiago City

Form 1
National Deworming Day (JANUARY)
Classroom Level
Enrolment:
Grade Level and Section:

Enrolment Dewormed
Handwashing Feeding Toothbrushing Actions
Name of Child Non Non Remarks
4ps done done 4ps done Taken
4Ps 4Ps

Accomplished by: Noted by:

ALPRECY D. MARQUEZ
Class Adviser School Nutrition Coordinator
Date Accomplished: _________________