Republic of the Philippines

Department of Education
Region II – Cagayan Valley
Schools Division of Nueva Vizcaya

GRADE 12 GAS HEALTH DECLARATION SHEET DATE: JULY 6, 2022

Cough & Difficulty of Fatigue or Loss of Taste
Fever Sore Throat Diarrhea Headache Body Pain
NAME Temp. Colds Breathing Tiredness or smell REMARKS
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
1. ALCANTARA, John Lloyd B.
2.
3. AMBROSE, Joey Jr. R.
4. Ambrose, Racquel
5. ARANDA, Rencel Wynn C.
6. Aranda, Cheryll
7. BANIQUET, Christian Mark V.
8. Romero, Ronnie
9. BARCENAS, Melvin Justine P.
10.
11. BOADO, Tom Lester B.
12. Briones, Bernalyn
13. BULLECER, Rex S.
14. Bullecer, Marivel
15. CALIBUSO, Ernesto Olsen B.
16. Calibuso, Rachel
17. GARALDE, Isagani Jr. D.
18. Garalde, Marc Jan
19. GUMANGAN, Mark James M.
20. Malto, Cory
21. JOGUILON, Ervyl U.
22.

Address: Quezon St., Don Domingo Maddela, Bayombong, Nueva Vizcaya

Telephone Nos.: (078) 362-0106, 09171589
Email Address: nuevavizcaya@deped.gov.ph
Website: www.deped-nv.com.ph Doc Code: FM-SGOD-HRD-004 Rev: 02
As of: 11.12.2019 Page: 1
 Republic of the Philippines
Department of Education
Region II – Cagayan Valley
Schools Division of Nueva Vizcaya

GRADE 12 GAS HEALTH DECLARATION SHEET DATE: JULY 6, 2022

Cough & Difficulty of Fatigue or Loss of Taste
Fever Sore Throat Diarrhea Headache Body Pain
NAME Temp. Colds Breathing Tiredness or smell REMARKS
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
23. LORENZO, Christian
24. Lorenzo, Froilan
25. MENDOZA, Jassen Dyne E.
26. Mendoza, Rodelio
27. ORTIZ, Romhel M.
28.
29. PASCUA, Jerick C.
30. Pascua, Jerry
31. PARUBROB, Junel B.
32.
33. PISANG, Khaylord N.
34.
35. SANTOS, Aaron P.
36. Santos, Rosario
37. TABERNA, Jovan V.
38. Taberna, Ovidio
39. AÑANA, Venus A.
40.
41. BAY-AN, Precy S.
42.
43. BOSITO, Shaina Leigh M.
44. Bosito, Verna

Address: Quezon St., Don Domingo Maddela, Bayombong, Nueva Vizcaya

Telephone Nos.: (078) 362-0106, 09171589
Email Address: nuevavizcaya@deped.gov.ph
Website: www.deped-nv.com.ph Doc Code: FM-SGOD-HRD-004 Rev: 02
As of: 11.12.2019 Page: 2
 Republic of the Philippines
Department of Education
Region II – Cagayan Valley
Schools Division of Nueva Vizcaya

GRADE 12 GAS HEALTH DECLARATION SHEET DATE: JULY 6, 2022

Cough & Difficulty of Fatigue or Loss of Taste
Fever Sore Throat Diarrhea Headache Body Pain
NAME Temp. Colds Breathing Tiredness or smell REMARKS
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
45. CATIGAY, Siti Nur A.
46. Catigay, Helena
47. JOGUILON, Erica U.
48. Joguilon, Eric Sr. C.
49. JOSE, Rizza May L.
50.
51. ORANI, Rica B.
52. Orani, Rene
53. RALUTIN, Mikylla O.
54. Ralutin,Mary Grace
55. VELASCO, Kate
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.

Address: Quezon St., Don Domingo Maddela, Bayombong, Nueva Vizcaya

Telephone Nos.: (078) 362-0106, 09171589
Email Address: nuevavizcaya@deped.gov.ph
Website: www.deped-nv.com.ph Doc Code: FM-SGOD-HRD-004 Rev: 02
As of: 11.12.2019 Page: 3