Form 2

National School Deworming Day

School Level Reporting Forms

Province: Capiz District: 1 Division: Roxas City

Name of School: Culasi National High School School Address: Brgy. Culasi, Roxas City, Capiz
No. of Children Enrolled in the school: 592

Grade level No. of Enrolled No. of Children Remarks

Children Dewormed
Grade 7 119 119
Grade 8 159 159
Grade 9 117 116 1 student not feeling well
Grade 10 98 98
Grade 11 42 41 1 student no consent
Grade 12 57 57
Total 592 590

Accomplished by:

MRS. JUVY M. BERDUGO

School Coordinator
Date Accomplished: January 29, 2020
Noted by:

DR. LEOFELLE C. MORCOSO

Principal III