Republic of the Philippines

DEPARTMENT OF EDUCATION
National Capital Region
DIVISION OF TAGUIG CITY AND PATEROS
GEN. RICARDO G. PAPA SR. MEMORIAL HIGH SCHOOL
Gen. A. Luna St., Ususan, Taguig City

LEARNER’S HEALTH RECORD

Name: CENTENO, KRISTAL JOY A. Gender: FEMALE
Date of Birth: JANUARY 9, 2001 Age: 19
Parent/ Guardian: RICARDITO CENTENO Contact Number: ____
Address: ___

Health Condition/Illness (for the past two weeks): ___

No. of children in the family: __ Birth Order: __

Guided Questions:
YES NO REMARKS
1. Does your child know/aware of Pandemic-Covid 
19?
Alam ba ng iyong anak ang tungkol sa Pandemya na Covid 19?
2. Does your child go out of your house? 
Lumalabas ba ng bahay ang iyong anak?
How often?
Gaano kadalas?
3. Does your child wear face mask when going out? 
Nagsusuot ba ng face mask ang iyong anak kapag lumalabas?
Does your child wear face shield when going out? 
Nagsusuot ba ng face shield ang iyong anak kapag lumalabas?
4. Does your child wash his/her hands regularly? 
Palagi bang naghuhugas ng kamay ang iyong anak?
5. What is your child’s practice at present after going out of your house?
Ano ang ginagawa ng iyong anak pagkagaling sa labas ng bahay?

 Take a bath (Naliligo)  Wash hands (Naghuhugas ng kamay)

 Change clothes (Nagpapalit ng damit)  Cleans using towel (Nagpupunas gamit ang bimpo)
 None (Wala)  Uses alcohol/Sanitize ( Nagamit ng alcohol)