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Municipality
    Barangay: Sta. Ines BULAKAN CELL M6 Province: BULACAN
: FIRST
Address or IMPORTANT INFO ON DATE FORMAT NO DATA ENTRY REQUIRED
Location Name of Mother Belongs to ENTRY: PLS READ RESULTS WILL BE AUTO-FILLED
Full Name of Child IP Group?
Sex Weight Height
of Child's or Caregiver
Child Residence
Purok, Block Height Weight
Seq. Age in Weight for
#, Area or Date of Birth Date Measured for Age for Lt/Ht
Months Age Status
Location in (Surname, First Name) (Surname, First Name) YES/NO M/F (kg) (cm) Status Status
the
Barangay

1  HULO  NAVARRO APRIL  NAVARRO ALLAIN CARL NO   M  JUN-28-2020 1-31-22  17.4 86.4  19 OW  N  Ob

2  HULO  NANO MARY LEA ESPIRITU MELTINA ROSE NO  F  AUG-24-2020 1-31-22   7.5 69.5   17  UW  Sst N 
 BUENAVENTURA
3  HULO  BALTAZAR ZAYN LUCAS  NO M  JUL-20-2018  1-31-22   28.8 101.0   42  OW N  Ob 
JAMAINE
4  HULO  ALCOBER JONALYN ALCOBER MA.SABRINA   NO  F  FEB-25-2019 1-31-22   24.7 93.3   35 OW  N   Ob

5  HULO  TORRES MARLON  TORRES BORRIS EZEKIEL NO   M APR-21-2021  1-31-22  10.1  69.8   9  N  N OW 

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