SF 8

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

School Name District Division Region

School ID Grade Section Track/Strand (SHS) School Year

Learner's Name Nutritional Status

Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) Age (HFA)
Extension, Middle Name) (kg/m²) Category
MALE

FEMALE
 Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) Age (HFA)
Extension, Middle Name) (kg/m²) Category

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
FEMALE
TOTAL

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

SFRT 2017