Republic of the Philippines

Department of Education
Region VII, Central Visayas
Division of Cebu Province
IPHO Building, Sudlon, Lahug, Cebu City

FORM 2
National School Deworming Month ( ) JULY - 1st Dose ( ) JANUARY-2nd DOSE
School Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District: BORBON
Name of School:
Grade Level: K-G-12

CONSOLIDATED ELEMENTARY / SECONDARY DEWORMING REPORT

No. of Enrolled Learners No. of Learners Dewormed

Percentage
Grade Level
(%)
M F T M F T

KINDER
GRADE 1
GRADE 2
GRADE 3
GRADE 4
GRADE 5
GRADE 6
GRADE 7
GRAADE 8
GRADE 9
GRADE 10
GRADE 11
GRADE 12
 GRAND TOTAL
Accomplished by:

First - Aid Teacher

Noted:

Date Accomplished
School Head
 Republic of the Philippines
Department of Education
Region VII, Central Visayas
Division of Cebu Province
IPHO Building, Sudlon, Lahug, Cebu City

FORM 2A
National School Deworming Month
District Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District: BORBON

Grade Level: GRADE 7-10

Grade Level: Grade 7-10

No. of Enrolled No. of Learners

Learners Dewormed Percentage
No. Name of School
M F T M F T (%)
1 Borbon NHS
2 Bongdo NHS
3 Campusong NHS
4 Dona Milagros NHS
5 Mar & Dorie Darunday NHS

GRAND TOTAL

breakdown
GRADE 7 GRADE 8 GRADE 9
No. Name of School
M F T M F T M F
1 Borbon NHS
2 Bongdo NHS
3 Campusong NHS
4 Dona Milagros NHS
5 Mar & Dorie Darunday NHS

GRAND TOTAL

Accomplished by:
 First - Aid Teacher
Noted:

Date Accomplished:

SCHOOL HEAD
DE 9 GRADE 10
T M F
 GRADE 10 Percentage
T M F T (%)
 Republic of the Phili
Department of Edu
Region VII, Central V
Division of Cebu Pr
IPHO Building, Sudlon, Lah

FORM 2A
National School Deworming Month
District Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District: BORBON

Grade Level: Kinder to Grade 6

KINDER GRADE 1 GRADE 2

No. Name of School
M F T M F T M F T

1 AMANCIO SEPULVIDA ES
2 BAGACAY ES
3 BILI ES
4 BONGOYAN ES
5 BONGDO ES
6 BORBON CENTRAL ES
7 CADARUHAN ES
8 CAJEL ES
9 CAMPUSONG ES
10 DON GREGORIO ANTIGUA ES
11 DONA MARY OSMENA ES
12 DON MILAGROS OSMENA ES
13 LAAW ES
14 MAGDOLINOG ES
15 MANAGASE ES
16 SAN JOSE ES
17 SALING-IT ES
18 TABUNAN ES
 GRAND TOTAL

Acc

Noted:

Date Accomplished:

District Supervisor

Grade Level: Grade 7-12

No. of Enrolled No. of Learners

No. Name of School Learners Dewormed
M F T M F T
1 Borbon NHS
2 Bongdo NHS
3 Campusong NHS
4 Dona Milagros NHS
5 Mar & Dorie Darunday NHS

GRAND TOTAL

Acc

Noted:

Date Accomplished:

District Supervisor
 the Philippines
nt of Education
Central Visayas
Cebu Province
dlon, Lahug, Cebu City

GRADE 3 GRADE 4 GRADE 5 GRADE 6

Percentage
(%)
M F T M F T M F T M F T
Accomplished by:

Clinic Teacher

Percentage
(%)

Accomplished by:

First - Aid Teacher

 Republic of the Philippines
Department of Education
Region VII, Central Visayas
Division of Cebu Province
IPHO Building, Sudlon, Lahug, Cebu City

FORM 2A
National School Deworming Month
District Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District: BORBON

Grade Level: Kinder to Grade 6

No. of Enrolled No. of Learners

Learners Dewormed Percentage
No. Name of School
(%)
M F T M F T

1 Borbon NHS
2 Bongdo NHS
3 Campusong NHS
4 Dona Milagros NHS
5 Mar & Dorie Darunday NHS

GRAND TOTAL

Accomplished by:

First - Aid Teacher

Noted:

Date Accomplished:

District Supervisor

breakdown
GRADE 11 GRADE 12 Percentage (%)
No. Name of School
M F T M F T M F
1 Borbon NHS
2 Bongdo NHS
3 Campusong NHS
4 Dona Milagros NHS
5 Mar & Dorie Darunday NHS

GRAND TOTAL
(%)
T
 Department of Education
Region VII, Central Visayas
Division of Cebu

LIST OF LEARNERS DEWORMED

S.Y. 20___ - 20___
( ) 1st Dose Date: __________________ ( ) 2nd Dose Date: __________________
Name of School: District:
Grade Level: Section: Date Dewormed:

Name of Learners Name of Learners

No. AGE REMARKS No. AGE REMARKS
(BOYS) (BOYS)
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
32 32
33 33
34 34
35 35

SUMMARY M F T
No. of Learners Enrolled
No. of Learners Dewormed

Prepared by:

Class Adviser