Republic of the Philippines

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

GRADE 10 LAVOISIER HEALTH DECLARATION SHEET DATE: JULY 7, 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. APIGO, Wilsen Z.
2. Apigo, Roderick
3. DOMINCEL, Dave D
4. Calla, Julie Anne
5. FONTANILLA, Jerick John D.
6. Fontanilla, Merlie
7. MATEO, Frederic C.
8.
9. NANTES, Francis Ian P.
10. Nantes, Terry
11. NUESTRO, John Vitex M.
12. Nuestro, Jing
13. OLIVEROS, Mark Alexis N.
14. Oliveros, Marites
15. ONIA, Kyle Francis G.
16. Onia, Edelyn
17. ORANI, Zyrus Kenjay C.
18. Martinez, Alex
19. ORPIANO, Harley Keith A.
20. Orpiano, Judith
21. PADILLA, Reyser M.
22. Padilla, Raven

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
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. SILAO, Jon Rovic P.
24. Silao, Victoria
25. VALDERAMA, Van Joshua A.
26. Valderama, Lailani
27. ALCANTARA, Akiza Feleiz M.
28. Alcantara, Leizl
29. ARANDA, Catherine G.
30. Aranda, Aiza
31. ARANDA, Roan Mae B.
32. Aranda, Raquel
33. ASUNZA, Richelle Joy H.
34. Herrera, Caren
35. BELTRAN, Francess Cabrini R.
36. Rivera, Carmela
37. BLANCO, Alyssa Bea A.
38. Blanco, Ammy
39. CAJIMAT, Ella Faye A.
40. Cajimat, Alma Bella
41. CALIBUSO, Leila Claire B.
42. Calibuso, Maribel
43. CAYETANO, Micah Daniela O.
44. Cayetano, Norie
45. DACANAY, Kayla May O.
46. Dacana, Analyn

NAME Temp. Fever Cough & Difficulty of Sore Throat Diarrhea Fatigue or Headache Loss of Taste Body Pain REMARKS

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
Colds Breathing Tiredness or smell
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
47. ELLAZAR, Bernadette P.
48. Ellaza, Gloria
49. EQUILA, Lorraine Jade U.
50. Equila, Liezel
51. HERNANDEZ, Rhoelyne T.
52. Hernandez, Rhoel
53. HERRERA, Shanille Rose D.
54. Peralta, Marian Joy
55. LORENZO, Kathleen Kate V.
56. Lorenzo, Leonard
57. MANDILAG, Melissa A.
58. Mandilag, Edwin
59. MASANQUE, Jovylea G.
60. Masanque, Jovelyn
61. MEPA, Precious Gayle S.
62. Santos, Rachel
63. OLIVEROS, Precious Damea M.
64. Oliveros, Darwin
65. ORALLO, Wilren Reandrea R.
66. Reyes, Rhea
67. PASCUA, Wilshelle Xyly
68. Pascua, Cheriemy
69. PENARANDA, Chelsie Joy C.
70. Castillo, Brenda Jane

NAME Temp. Fever Cough & Difficulty of Sore Throat Diarrhea Fatigue or Headache Loss of Taste Body Pain REMARKS
Colds Breathing Tiredness or smell

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
 Republic of the Philippines
Department of Education
Region II – Cagayan Valley
Schools Division of Nueva Vizcaya
Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No
71. REYES, Michelle Anne L.
72. Llanan, Marcelina
73. SOMERA, Jaina Rose M.
74. Mangabat, Cresencia
75. TIMBAL, Kristina Mae A.
76. Timbal, Rhoan A
77. WATAN, Jaira Yvonne A.
78. Aranda, Rosalina
79.
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
94.

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: 4