Republic of the Philippines

DEPARTMENT OF EDUCATION
Region XI
DIVISION OF DAVAO DEL NORTE
New Corella District
San Roque Elementary School
S.Y. 2021-2022
CLASSROOM DAILY HEALTH MONITORING TOOL FOR COVID-19
Grade Level: __________II__________________ Section: __LAPU- LAPU (SET A)______
Instruction: Write under each column date the code(s) of the symptom(s) observed in the learner during the routine inspection, during the conduct of the class, or as reported by the learner or
their classmates. Refer to the list of symptoms below and their respective codes:

EN- Essentially Normal Fv-Fever F/T-Fatigue/Tiredness ST-Sore throat LoA-Loss of appetite D-Diarrhea R-Rashes

C-Cough HA-Headache C/RN-Colds/runny nose N-Nausea LoS-Loss of smell Others

Symptoms ported
Observed/Re
NAME
Monday Tuesday Wednesday Thursday Friday
Abastas, Rose Bert R.
Bautista, Christian C.
Dinosta, Dominec Dave A.
Molino, Xymon Faith
Pablo, Kent Clarenz S.
Racaza, Zian lee A.
Candia, Lady Avril U.
Domalag. Mae Lee Grace P.
Sabino, Megan Rose M.
Senangote, Maria Elaine S.

Note: As soon as any of the listed symptoms is observed among any of the learners, the teacher is expected to send the learner to the School Clinic immediately for the proper management by the School Clinic
Teacher or health personnel.
Submitted by: CLAUDITTE O. SALADO Noted by: ______________________________
Classroom Adviser Clinic Teacher
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
DIVISION OF DAVAO DEL NORTE
New Corella District
San Roque Elementary School
S.Y. 2021-2022
CLASSROOM DAILY HEALTH MONITORING TOOL FOR COVID-19
Grade Level: __________II__________________ Section: __LAPU- LAPU (SET A)______
Instruction: Write under each column date the code(s) of the symptom(s) observed in the learner during the routine inspection, during the conduct of the class, or as reported by the learner or
their classmates. Refer to the list of symptoms below and their respective codes:

EN- Essentially Normal Fv-Fever F/T-Fatigue/Tiredness ST-Sore throat LoA-Loss of appetite D-Diarrhea R-Rashes

C-Cough HA-Headache C/RN-Colds/runny nose N-Nausea LoS-Loss of smell Others

Symptoms ported
Observed/Re
NAME
Monday Tuesday Wednesday Thursday Friday
Alfaro, Erniel O.
Laniba, Prince John P.
Mantica, Marlon Ariel II G.
Olita, Zaldee P.
Asaw, Geralyn O.
Edpalina,Edelyn Mae D.
Mejares, Aina Jade S.
Olita, Maegan Ella M.
Saure, Rhea
Tecio, Krislyn Jean G.

Note: As soon as any of the listed symptoms is observed among any of the learners, the teacher is expected to send the learner to the School Clinic immediately for the proper management by the School Clinic
Teacher or health personnel.
Submitted by: CLAUDITTE O. SALADO Noted by: ______________________________
Classroom Adviser Clinic Teacher
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
DIVISION OF DAVAO DEL NORTE
New Corella District
San Roque Elementary School
S.Y. 2021-2022
CLASSROOM DAILY HEALTH MONITORING TOOL FOR COVID-19
Grade Level: __________II__________________ Section: _____________________
Instruction: Write under each column date the code(s) of the symptom(s) observed in the learner during the routine inspection, during the conduct of the class, or as reported by the learner or
their classmates. Refer to the list of symptoms below and their respective codes:

EN- Essentially Normal Fv-Fever F/T-Fatigue/Tiredness ST-Sore throat LoA-Loss of appetite D-Diarrhea R-Rashes

C-Cough HA-Headache C/RN-Colds/runny nose N-Nausea LoS-Loss of smell Others

Symptoms ported
Observed/Re
NAME
Monday Tuesday Wednesday Thursday Friday

Note: As soon as any of the listed symptoms is observed among any of the learners, the teacher is expected to send the learner to the School Clinic immediately for the proper management by the School Clinic
Teacher or health personnel.
Submitted by: ADELA L. VALLESER Noted by: ______________________________
Classroom Adviser Clinic Teacher