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Deworming Form Blank

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Jobert r. Totanes

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National School Deworming Day

Province: CAMARINES NORTE Division: CAMARINES NORTE

Name of School: PARACALE NATIONAL HIGH SCHOOL District: PARACALE CLUSTER
Grade level & Section: _______ Total Enrollment: _____________

Gender
Age

Washing

Feeding done

Action taken
Dewormed
4P’s

doneBrushingTooth
Hand

Remarks
Name of Child

Done
Accomplished by:
_______________________ Date Accomplished: _________________
Class Adviser

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