SF 8

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

School Name GRACEVILLE ES District 8 Division SAN JOSE DEL MONTE Region III

School ID 162503 Grade 6 Section MALIKHAIN Track/Strand (SHS) NA School Year 2017-2018

Learner's Name Nutritional Status

Birthdate Weight Height Height for Age
No. LRN (Last Name, First Name, Name Age Height² (m²) BMI Remarks
(MM/DD/YYYY) (kg) (m) BMI Category (HFA)
Extension, Middle Name) (kg/m²)
MALE
1 192503110025 Manaloto, Jose A. 8/6/2005 12.05 35.00 1.56 2.43 14.38 Wasted Normal
 Learner's Name Nutritional Status
Birthdate Weight Height Height for Age
No. LRN (Last Name, First Name, Name Age Height² (m²) BMI Remarks
(MM/DD/YYYY) (kg) (m) BMI Category (HFA)
Extension, Middle Name) (kg/m²)
 Learner's Name Nutritional Status
Birthdate Weight Height Height for Age
No. LRN (Last Name, First Name, Name Age Height² (m²) BMI Remarks
(MM/DD/YYYY) (kg) (m) BMI Category (HFA)
Extension, Middle Name) (kg/m²)
FEMALE
 Learner's Name Nutritional Status
Birthdate Weight Height Height for Age
No. LRN (Last Name, First Name, Name Age Height² (m²) BMI Remarks
(MM/DD/YYYY) (kg) (m) BMI Category (HFA)
Extension, Middle Name) (kg/m²)

SUMMARY TABLE

Nutritional Status Height for Age (HFA)

Summary Table Summary Table
SEX
Severely
Severely Wasted Wasted Normal Overweight Obese TOTAL Stunted Normal Tall Total
Stunted
MALE 0 1 0 0 0 1 0 0 1 0 1
FEMALE 0 0 0 0 0 0 0 0 0 0 0
TOTAL 0 1 0 0 0 1 0 0 1 0 1

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

1/31/2018 MICHAEL ANGELO B. PAGARA

SFRT 2017
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