Master List and Nutritional Data for School Feeding Program

SBFP Form 1
Department of Education
Region __V_
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Division/Province: MASBATE Name of Principal : CHONA R. OCSING

City/ Municipality/Barangay : MOBO, MASBATE Name of Feeding Focal Person : SONIA O. VITERBO
Name of School / School District : BAGACAY ELEMENTARY SCHOOL / MOBO SOUTH
Beneficiary of
Date of Weighing / Age in Years / Weigh Height Nutrition 4Ps ID SBFP in
Date of Birth BMI for 6 y.o.
No. Name Sex (MM/DD/YYYY)
Measuring
Months t (Kg) (cm) and above al Status Ethnicity Disability Number Name of Parents Previous
(MM/DD/YYYY) (NS) Years(yes or
no)
1 Asuncion , Rain B. M 3/19/2012 6/15/2017 6 12 98 SW Asherine Asuncion No

2 Balatucan, Mark Ian N. M 4/6/2012 6/15/2017 6.1 13 101 W Edgar Balatucan No
3 Bigueras, MI-Jhay G. M 10/30/2011 6/15/2017 8.1 14 119 W Mark Begueras No
4 Carmen Carl Joshua M 4/29/2011 6/15/2017 6.1 14 105 12.60 W Manuel Carmen No
5 Cesista, Jyrus S. M 7/14//10 6/15/2017 6.11 13 103 12.20 W Lina Cesista No
6 Fernandez, Rommel R. M 4/9/2012 6/15/2017 6.2 14 106 W Ferdinand Fernandez No
7 Nunez, JayMark L. M 9/28/2011 6/15/2017 6.8 15 106 W Junie Nunez No
8 Sampaga, Maico M 9/14/2012 6/15/2017 5.7 12 96 W Maricel Samapaga No
9 Abe, Jennifer V. F 3/6/2012 6/15/2017 6.3 12 SW Juna Abe No
10 Cervantes, Princess Jean G. F 3/23/2008 6/15/2017 9.0 18 SW Marilou Cervantes No
11 Galvon, Alma C F 11/19/2011 6/15/2017 6.6 13 W Arnel Galvon No
12 Gigante,Jovelyn F 2/29/2012 6/15/2017 6.3 13 SW Bemjamin Gigante No
13 Gonzalezs, Joanne Febie F 2/6/2012 6/15/2017 6.4 13 W Wilmor Gonzales No
14 Natural, Messy L. F 8/26/2012 6/15/2017 5.4 13 W Rowena Natural No
15 Rondena, Jela M. F 4/4/2012 6/15/2017 6.2 13 W Florinda Rodena No
16 Valencia, Michaella F 9/19/2011 6/15/2017 6.8 13 SW Rizza Valencia No
17
18
19
20
Prepared by:
SONIA O. VITERBO
Feeding Focal Person
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
SBFP Form 1
Region __V_
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Division/Province: MASBATE Name of P CHONA R. OCSING

City/ Municipality/Barangay : MOBO, MASBATE Name of Feeding Focal Person : MYLENE T. BALATUCAN
Name B
o AGACAY ELEMENTARY SCHOOL
Nutrition Beneficiary of
Date of Weighing / Age in Weight Height BMI for 6 y.o. Participation in 4Ps SBFP in
Date of Birth
No. Name Sex Gender Measuring Years / al Status Name of Parents
(MM/DD/YYYY) Months (Kg) (cm) and above
(MM/DD/YYYY) (Yes or No) Previous Years
(NS) (yes or no)
1 Tidon, Vilma Ilagan M ### 6/27/2011 71 months 12 1.03 SW NO

2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Prepared by: Noted :
MYLENE T. BALATUCAN MA. JOCELYN B. BARBOSA

Feeding Focal Person School Head
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
SBFP Form 2
Region _V__
SCHOOL-BASED FEEDING PROGRAM (SBFP)

Division/Province: MASBATE
City/ Municipality/Barangay : BAGACAY, MOBO, MASBATE
Name of School / School District : BAGACAY ELEMENTARY SCHOOL - MOBO SOUTH DISTRICT
Nutritional Status at Start of Feeding Ethnicity 4 Ps Beneficiaries
Number of Undernourished School
Children by Grade Level No. of No. of Pupils who
No. of Severely No. of Total No. of Ethnic No. of 4 Ps are beneficiaries
Normal Wasted Wasted Beneficiaries Ben. Ben. in previous years Remarks
1. Kinder
34 11 25 36 70
2. Grade I
43 8 12 20 63
3. Grade II
67 0 6 6 73
4. Grade III
64 5 7 12 76
5. Grade IV
59 6 13 19 72
6. Grade V
80 5 3 8 88
7. Grade VI
68 3 9 12 80
Total 415 38 75 113
Prepared by: Noted by:
SONIA O. VITERBO CHONA R. OCSING

SBFP DepEd Focal Unit Chief
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy
furnished DepEd-HNC
SBFP Form 5
SCHOOL-BASED FEEDING PROGRAM
CONSOLIDATED NUTRITIONAL STATUS AND ATTENDANCE REPORT

Region: _______
Division/District: ________________________
School: ________________________________
BEIS ID No.: ___________________________
NUTRITIONAL STATUS
No. of Pupils BEFORE AFTER PERCENTAGE
GRADES AND SECTIONS
Dewormed ATTENDANCE
SW/SU W/U N Ow Ob Total SW/SU W/U N Ow O Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL AVERAGE:
Legend:
For 6-19 y.o For below 6 y.o
SW - Severely Wasted SU - Severely Underweight
W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overweight Ow - Overweight
O - Obese
Prepared by: Noted by:
_____________________________ ___________________________
Classroom Adviser / School Nurse School Head
Note: This form shall be prepared by the school using the data from SBFP Form 4.
SBFP Form 1
Region __V_
Master List Beneficiaries for School-Based Feeding Pro
City/ Municipality/Barangay : MOBO, MASBATE
Date of Weighing / Age in Years / Weigh Height

Date of Birth
No. Name Sex (MM/DD/YYYY) Measuring
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Abatayo, Bernardino II M 11/17/2011 6/15/2017 6.6 14

2 Aragon, Renato Jr. C. M 11/25/2011 6/15/2017 6.6 13
3 Azares, Kyle Xian A. M 12/17/2011 6/15/2017 6.5 14
4 Bagalihog, Amver F. M 7/11/2012 6/15/2017 5.9 13
5 Bongue, Prince Sharmylle M 5/1/2012 6/15/2017 6.1 14
6 Codera, John Nicole L. M 7/23/2012 6/15/2017 5.8 11
7 Flores, Vicente Jr. S. M 2/12/2012 6/15/2017 6.4 12
8 Lalaguna, Albien Z. M 5/15/2012 6/15/2017 6.1 14
9 Abujuela, Armina Jade F 12/29/2011 6/15/2017 6.5 12
10 Bon, Lyka F 2/23/2012 6/15/2017 6.3 13
11 Bongue, Rhealyn G. F 2/20/2012 6/15/2017 6.3 14
12 Cervantes, Ellaguin F 6/18/2011 6/15/2017 7.1 14
13 Cervantes, Rose Mariel P. F 5/10/2011 6/15/2017 6.1 13
14 Cos, Camel F 3/4/2012 6/15/2017 6.3 14
15 Dayday, Irene P. F 6/17/2011 6/15/2017 7.1 13
16 Delos, Reyes, Ellyza Jane F 1/22/2012 6/15/2017 6.4 13
17 Libanieno, Aprilyn G. F 4/23/2012 6/15/2017 6.1 13
18 Viterbo, Hannah Joy M. F 1/14/2012 6/15/2017 6.5 14
19 Cervantes, Maria C. F 12/27/2011 6/15/2017 6.5 13
20 Bantayan, Juvelyn V. F 3/5/2012 6/15/2017 6.3 12
Prepared by:
SONIA O. VITERBO
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for su
partment of Education
Region __V_
s for School-Based Feeding Program (SBFP)
Name of Principal : CHONA R. OCSING

Name of Feeding Focal Person : SONIA O. VITERBO
Beneficiary of
Nutrition 4Ps ID SBFP in
BMI for 6 y.o.
al Status Ethnicity Disability Name of Parents Previous
and above
(NS) Number Years(yes or
no)
W Josephine Abatayo
SW Renato Aragon
W Joan Azares
W Gloria Bagalihog
W Merlinda Bongue
SW Elvira Codera
SW Vicente Flores
W Alvin Lalaguna
SW Gina Abujuela
W Junalyn Bon
W Mary Ann Bongue
W Bernard Cervantes
W Ruby Cos
W Antonio Dayday
W Rosejean Delos Reyes
W Daniel Libaniano
W Alma Mahawan
W Remmy Cervantes
W Linda Bantayan
SW
compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Gemi, Christian Karl M 9/6/2008 6/15/2017 8.9 16 112

2 Aresgado,Judy Ann F 7/21/2009 6/15/2017 7.10 16 115
3 Brioso, Rhea Angela F 5/4/2010 6/15/2017 7.1 14 106
4 Pacanico, Eraiza F 1/2/2010 6/15/2017 7.5 16 112
5 Mingoy, Rachel Joy F 10/1/2010 6/15/2017 6.8 16 115
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
12.70 W Gina Gemi No

12.00 W Angie Aresgado No
12.40 W Michelle Brioso No
12.70 W Gretchen Pacanico No
12.00 W Marisa Mingoy No
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Adi Jerelyn M. F 12/14/2011 6/15/2017 66 mos. 13 104

2 Cervantes, Menchie A. F 7/6/2011 6/15/2017 71 mos. 13 104
3 Cervantes, Richelle Van F 8/24//11 6/15/2017 69 mos. 11 111
4 De Jesus, Jahnreil I. M 2/6/2009 6/15/2017 84 mos. 16 112
5 Lalaguna, Hershey C. F 2/22/2011 6/15/2017 63 mos. 13 103
6 Bandol, Manilyn F 2/14/2010 6/15/2017 74 mos. 16 114
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
SW Jerry Adi No
SW John Paul Cervantes No
SW Richard Cervantes No
W Raul De Jesus No
W Randy Cervantes No
W Myrna Bandol No
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Bagalihog, Zedrick V. M 4/4/2011 6//15/17 6.2 10.5 111

2 Bona, Anthony B. M 10/27/2010 6//15/17 6.7 13 109
3 Rodrigo, James Clinton C. M 1/2/2011 6//15/17 6.5 14 114
4 Fernandez, Sherilyn G. F 8/30/2011 6//15/17 6.9 13 107
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
8.50 SW Rose Bagalihog No

12.80 SW Marilyn Bona No
10.70 SW Manilyn Rodrigo No
SW Melinda Fernandez No
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Sanay, Dana A. F 10/25/2010 6/15/2017 6.8 16 114

2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
12.30 W Jessie Altiche No

SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Bagalihog, Jan Mark G. M 9/14/2009 6/15/2017 7.9 16 112

2 Malinao, Remier V. M 8/26/2008 6/15/2017 8.9 14 106
3 Tibooc, Gina Mae G. M 3/9/2009 6/15/2017 8.2 16 112
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
12.70 W Ronnie Bagalihog No

12.40 SW Remie Malinao No
12.70 W Ronnie Tibooc No
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Jayme, Renz S. M 9/24/2009 6/15/2017 7.8 15 113

2 Gigante, Nelson M 11/15/2007 6/15/2017 9.7 19 125
3 Adi, Nicole F 7/26/2008 6/15/2017 8.10 16 120
4 Sampaga, Marian F 12/2/2008 6/15/2017 8.6 15 113
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
12.70 SW Irene C. Jayme NO

12.40 SW Nilda G. Gigante NO
12.70 SW Nemia C. Adi NO
11.70 SW Melanie T. Sampaga NO
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Bongue, Nica B. F 7/29/2009 6/15/2017 7.1 15 110

2 Claveria, Abiguel L. F 11/2/2008 6/15/2017 8.7 19 123
3 Gigante, Janine R. F 1/15/2009 6/15/2017 8.5 18 120
4 Guilaran, Charice Marie F 9/27/2008 6/15/2017 8.8 18 119
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
12.30 W NO
12.50 W NO
12.50 W NO
12.70 W NO
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Bibillo, Marl Ian M. M 6/11/2008 6/15/2017 9.6 18 117

2 Codera, John Vincent L. M 5/11/2008 6/15/2017 9.1 18 116
3 Sanay, Danica A. F 11/16/2007 6/15/2017 9.6 18 120
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
13.10 SW Alma C. Bibillo NO

13.30 SW Rommel Codera NO
12.50 SW Jissie A. Sanay NO
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Abaja, Mark Tidon M 4/19/2008 6/15/2017 9.1 17 119

2 Cervantes, Ryan Bation M 1/13/2006 6/15/2017 11.5 17 118
3 Cervantes, Ronalyn Masamoc F 1/2/2008 6/15/2017 9.5 18 125
4 Columna, Keith Amber Bagalihog F 2/20/2008 6/15/2017 9.3 16 118
5 Guerrero, Allyra Jean Bagalihog F 10/24/2007 6/15/2017 9.7 18 122
6 Subito, Key Mae Evangelista F 11/22/2007 6/15/2017 9.6 21 142
7 Bagalihog, Mark Adrianne Gigante M 12/14/2007 6/15/2017 9.6 19 122
8 Bandol, Andrei Aninon M 8/20/2008 6/15/2017 8.9 17 114
9 Bongue, Reymond Bon M 2/2/2008 6/15/2017 9.4 20 123
10 Flores, Mark Eadde Aresgado M 11/27/2007 6/15/2017 9.6 20 124
11 Ongonion, Elimira Claire Abayon F 1/10/2008 6/15/2017 9.5 16 112
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
12.00 SW Dante M. Abaja NO

12.00 SW Renerio D. Cervantes NO
11.50 SW Ricky B. Cervantes NO
11.40 SW Vernie S. Columna NO
12.00 SW Vicente I. Guerrero NO
10.40 SW Rowel G. Subito NO
12.70 W Ronnie B. Bagalihog NO
13.00 W Marlon B. Bandol NO
13.20 W Clodualdo Bongue NO
13.00 W Ijedio Flores NO
12.70 W Elmer Palanigo Ongonion NO
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Etang, Christian Kyle Abejuela M 7/7/2007 6/15/2017 9.11 17 116

2 Cervantes, Miles Michael Bandol M 7/22/2006 6/15/2017 10.10 20 120
3 Sanay, Marvin Macadat M 8/17/2006 6/15/2017 10.10 24 131
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
12.60 SW Hazel A. Etang NO

13.80 W Easther B. Cervantes NO
13.90 W Lilibeth M. Sanay NO
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Lalaguna, Shanell M 9/24/2007 6/15/2017 9.8 17 121

2 Balatucan, Jenny F 1/29/2007 6/15/2017 10.4 25 136
3 Etel, Angela F 5/11/2004 6/15/2017 13.1 24 135
4 Macadat, Jenilyn F 7/18/2005 6/15/2017 11.10 23 135
5 Sanay, Catherine F 8/12/2006 6/15/2017 10.5 30 129
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
11.60 SW Loralyn Lalaguna NO

13.50 W Glenda Balatucan NO
13.10 SW Glenda Etel NO
12.60 SW Teresita Macadat NO
17.20 SW Romeo Sanay NO
SBFP Form 1
Region __V_

Date of Birth
Months t (Kg) (cm)
(MM/DD/YYYY)
1 Cervantes, Ai-jay M. M 3/9/2003 6/15/2017 14.3 33 150

2 Codera, Rommel Jr. L. M 12/13/2005 6/15/2017 11.6 22 128
3 David, Jayvie B. M 6/14/2005 6/15/2017 12.0 22 127
4 Lalaguna, Eron B. M 10/16/2003 6/15/2017 13.7 29 139
5 Aragon, Renzel C. M 1/3/2006 6/15/2017 11.5 28 146
6 Cervantes, Carlo S. M 4/8/2004 6/15/2017 13.2 21 126
7 Yamson, Filmar C. M 5/13/2005 6/15/2017 12.1 23 132
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
SONIA O. VITERBO
Region __V_

Beneficiary of
BMI for 6 y.o.
and above
no)
14.60 W Juan Cervantes NO

13.40 W Rommel Codera Sr. NO
13.60 W Emerson P. David NO
15.00 W Efren C. Lalaguna NO
13.10 W Renato Aragon NO
13.20 W Carlito Cervantes NO
13.20 W Freddie S. Yamson NO

Master List and Nutritional Data for School Feeding Program

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SBFP Form 1

Master List Beneficiaries for School-Based Feeding Program (SBFP)

Division/Province: MASBATE Name of Principal : CHONA R. OCSING

1 Asuncion , Rain B. M 3/19/2012 6/15/2017 6 12 98 SW Asherine Asuncion No

Master List Beneficiaries for School-Based Feeding Program (SBFP)

Division/Province: MASBATE Name of P CHONA R. OCSING

1 Tidon, Vilma Ilagan M ### 6/27/2011 71 months 12 1.03 SW NO

MYLENE T. BALATUCAN MA. JOCELYN B. BARBOSA

SCHOOL-BASED FEEDING PROGRAM (SBFP)

Prepared by: Noted by:

SONIA O. VITERBO CHONA R. OCSING

CONSOLIDATED NUTRITIONAL STATUS AND ATTENDANCE REPORT

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Abatayo, Bernardino II M 11/17/2011 6/15/2017 6.6 14

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Gemi, Christian Karl M 9/6/2008 6/15/2017 8.9 16 112

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

12.70 W Gina Gemi No

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Adi Jerelyn M. F 12/14/2011 6/15/2017 66 mos. 13 104

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Bagalihog, Zedrick V. M 4/4/2011 6//15/17 6.2 10.5 111

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

8.50 SW Rose Bagalihog No

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Sanay, Dana A. F 10/25/2010 6/15/2017 6.8 16 114

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

12.30 W Jessie Altiche No

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Bagalihog, Jan Mark G. M 9/14/2009 6/15/2017 7.9 16 112

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

12.70 W Ronnie Bagalihog No

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Jayme, Renz S. M 9/24/2009 6/15/2017 7.8 15 113

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

12.70 SW Irene C. Jayme NO

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Bongue, Nica B. F 7/29/2009 6/15/2017 7.1 15 110

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

Master List Beneficiaries for School-Based Feeding Pro

Date of Weighing / Age in Years / Weigh Height

1 Bibillo, Marl Ian M. M 6/11/2008 6/15/2017 9.6 18 117

s for School-Based Feeding Program (SBFP)

Name of Principal : CHONA R. OCSING

13.10 SW Alma C. Bibillo NO