Professional Documents
Culture Documents
Department of Education
Region VI – Western Visayas
Division of Capiz
COMMISSIONER LUIS R. ASIS NATIONAL HIGH SCHOOL
VACCINATED LEARNERS
Grade 11 - GAS FBS B
NO. NAME AGE SEX DATE OF DATE OF VACCINATION NAME OF VACCINE DATE OF BOOSTER NAME OF
BIRTH INJECTED BOOSTER INJECTED
1ST DOSE 2ND DOSE
1. Abalen͂a, VJ Bonita
8. Balgos, JR Besana
NO. NAME AGE SEX DATE OF DATE OF VACCINATION NAME OF VACCINE DATE OF BOOSTER NAME OF
BIRTH INJECTED BOOSTER INJECTED
NO. NAME AGE SEX DATE OF DATE OF VACCINATION NAME OF VACCINE DATE OF BOOSTER NAME OF
BIRTH INJECTED BOOSTER INJECTED