You are on page 1of 2

Form 1_2014

Classroom Record

Harmonized Schedule of Mass Drug Administration


for Selected Neglected Tropical Diseases

Legend: IMPORTANT REMINDER:


IS= in School SCH=Schistosomiasis ALB= Albendazole *Deworming= Albendazole
PP=Private Physician PZQ=Praziquantel *Treatment of Schistosomiasis=Praziquantel
AH= At Home LF=Lymphatic Filariasis *Treatment of Filariasis=DEC+ Albendazole
O=Others DEC=Diethylcarbamazine citrate DO NOTgive double dose for ALB for integrated treatment of helminthiasis and filariasis

Grade : 12
Section :LEEUWENHOEK
4P’s Deworming(ALB) SCH Deworming (ALB) LF
Name Beneficiary Remarks
Remarks PZQ Remarks DEC+ALB
Yes No 1ST Date 2nd Dose Date
Dose IS PP A O IS P A O
H P H
MALE:
1. Andaya, Edison M. 01/25/2021
X X X
9:45 AM
2. Cabico, Jordan M. 01/25/2021
X X X
9:45 AM
3. Grande, Mark Angelo 01/25/2021
X X X
9:45 AM
4. Magnaan, Christian Ivan 01/25/2021
X X X
9:45 AM
5. Mendoza, Jehan Zaie F. 01/25/2021
X X X
9:45 AM
6. Montemayor, Aldrin B. 01/25/2021
X X X
9:45 AM
7. Sumadsad, Andrew C. 01/25/2021
X X X
9:45 AM
Form 1_2014
Classroom Record
FEMALE:
1. Abulencia, Mia F. 01/25/2021
X X X
9:45 AM
2. Calimlim, Jade Kyla M. 01/25/2021
X X X
9:45 AM
3. Estefanio, Love Joy V. X 01/25/2021
X X
9:45 AM
4. Jacob, Crystal Jane B. X 01/25/2021
X X
9:45 AM
5. Nevado, Kyla A. 01/25/2021
X X X
9:45 AM
6. Oraza, Christine D. 01/25/2021
X X X
9:45 AM
8. Tamondong, Marriane M. 01/25/2021
X X X
9:45 AM
9. Supleto, Mary Ann M. 01/25/2021
X X X
9:45 AM
9. Zamora, JOycel Anne Marie N. 01/25/2021
X X X
9:45 AM
10. Zamora, Jaycel Anne Marie
01/25/2021
N. X X
9:45 AM
Prepared by: Checked by: Noted:
JEFFREY G. ANDRADA, DA LOURDES R. PABITO TEDIE A. DE VERA
Adviser Head Teacher III Principal IV

You might also like