SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade levels)

School Name Distri vision Region

Track/Strand School
School ID Grade Section (SHS) Year
Learner's Name Heigh Nutritional StatusHeight
Weig Heig
(Last Name, Birthdate t
No LRN First Name, Name Extension, (MM/DD/YYYY)
Age ht ht
BMI
BMI for Age Remarks
(kg) (m²) (kg/m²) Categor (HFA)
Middle Name) (m) y
MALE

FEMALE
 SUMMARY TABLE

Nutritional Status Height for Age (HFA)

SEX Severely
Severel
Wasted Normal Overweight Obese TOTAL y Stunted Normal Tall TOTAL
Wasted
Stunted
MALE
FEMALE
TOTAL

Date of Assessment: Conducted/Assessed By: Certified Correct By: Reviewd By:

SFRT 2017