SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

1 Bajada, Carl Andrew

2 Braceros, Sainz
3 De Nicolas Jhino
4 Dionson, Carlo
5 Hucalla, Reygan
6 Espiso, Jhon Stephen
7 Ortega,Rhyzell Brix C.
8 Toles,Khian
9 Rago,Reynalyn
10 Labrador,Ma. Katrina
11 Bonalos,Gerald
12 Celestial, Tommy
13 Daniel ,Jeger
14 Jaena, Michael
15 De Nicolas,Jonar M.
16 Espergosa ,Dante Jr. N.
17 Jocson ,Jerald
18 Flores,Jerica Jane
19 Almodiel.Nonamy
20 Dela Torre,Jenelyn
21 Quillano ,Rosaly
22 Talimodao,Ma.Sharville
23
24
25

Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght
 School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING
Nutritional Status Deworming Date Date Date Date Date
Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5

LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall
KD Form A.
 School: Fr.Gratian Murray AFSC, Integrated School_____________________________________
Grade: ___SIX_______ Section _____________________
School ID Number: _500190________________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15

D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

1 Alba Jhon
2 Amador, Kidish Kyle
3 Elare ,Narhaniel
4 Lumocso ,Lorwin
5 Pedrosa,Ailrimjie
6 Regalado,Rochelle
7 Magan, Don Isabella
8 Rata,Christine Marie
9 Rago,Rodelyn
10 Lopez Jr.,Hardy
11 Legaspino,Christian
12 Silvestre Roy
13 Silvestre ,Jhon Aby R.
14 Ebarra, Rodgie
15 Banguanga, Aira Jane
16 Esmeralda,Roselyn T.
17 Espinase,Aira Mariz
18 Canciller Jefferson
19 Repaso,James
20 Peraren ,Janella
21 Ceraspe, Veneah Bless
22 Torenueva ,Mayome
23
24
25

Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
 Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5

LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: Fr.Gratian Murray AFSC, Integrated School_____________________________________
Grade: ___FIVE_______ Section _____________________
School ID Number: _500190________________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15

D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

1 Alitao,Jan Cedric B.
2 Amador, Karl D.
3 Amador ,Karlo D.
4 Cabigo,Zhidre A.
5 Morales ,Rey Vincent
6 Pallorina,Mark Lyniel Z.
7 Dayot,Abby D.
8 Dionson, Teesha P.
9 Flores, Queen Heart O.
10 Pati -on ,Julia Mariz M.
11 Ecayan ,Juden Jr.
12 Ortega, Ajay
13 Quiom, Arniel
14 Sarabia ,Justine
15 Traspice,Joel C.
16 Empio,Jamaica A.
17 Escuadro,Jenepher
18 Deocampo,Janna Rose R.
19 Hucalla, Rose Ann
20 Rata, Beth Sheila
21 Solinap, Laiza R.
22 Aligayda,Marvin
23 Descutido, Rayven
24 Regalado,Jayro
25 Regalado, Rhod Jean C.
26 Legaspino,Alexander
27 Pendon, Adrian
28 Canoy, Chilcie P.
29 Cordero, Rhain Heart
30 Seraspe,Threshia L.
 Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date11-10-22 Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5

TOTAL:
 LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: Fr.Gratian Murray AFSC, Integrated School_____________________________________
Grade: ___FOUR_______ Section _____________________
School ID Number: _500190________________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

1 Bucaling, Aivan
2 Lasquite,Carl Anthony L.
3 Leonardo,Ariel Jr. R.
4 Ramping,Shad Daniel F.
5 Marait, Raylan Joseph
6 Torrenueva,Juaquin G
7 Ebara,Rica Cateo
8 Espinase,Zarenna Mae A.
9 Matricio,Stephi Joy D.
10 Velez, Kristel Jane A.
11 Ferrer,Jornie
12 Flores, Jorex
13 Alba ,Charmine Rose Y.
14 Amador,Friah C.
15 Hilado,,Jobelle M.
16 Morales, RV James
17 Saragoza,Alexandra
18 Ferrer,Jornie
19 Jabulan, Danry R.
20 Labrador, Hilley G.
21 Ferrer,Jornie
22 Remada,Francis Xavier A.
23 Alivare,,Nicke Grace G.
24 Barcelo,Althea Jane D.
25 Delgado,Kathrine Joyce R.
26 Espinosa, Angel A.
27 Lamag,,Dailyn Kaye P.
28 Lorezo,Kristine Lian
29 Rata, Bea
30 Mangilaya,Patricia V.
31 Montenid,Sofia Pearl
 32 Talagtag,Zoey B.

Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5
 TOTAL:

LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: Fr.Gratian Murray AFSC, Integrated School_____________________________________
Grade: ___Three_______ Section _____________________
School ID Number: _500190________________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

71 Hucalla,Rovelyn
72 Legaspino,Princess Nicole
73 Lovitania,Juris Abegail H.
74 Ramos,Ma. Rhian
75 Silvestre,Dyan Lorraine
76 Silvestre,Rihanna D.
77 Silvestre,Dyan Lorraine
78 Tatoy,Aryana B.

Prepared by:
 ____________________________ A. Nutritional Status
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5

TOTAL:

LEGEND
 A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: _Fr. Gratian Murray AFSC, Integrated School____________________________________
Grade: ___TWO_______ Section _____________________
School ID Number: __500190_______________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

31 Abellana,Breycee Ace B.
32 Cabigo,Princess Shannia M.
33 Lopez,Keisha A.
34 Pacardo,Princess Khiara L.
35 Saporga,Loche
36 Tingson,Crystal Kim
37 Tuma-ob, Kesha Jean A.
38 Tulmo,Kairen
39 Villarna, Franchchizka C.
40 Brezuela, Rodel Jr.
41 Flores, Jexter A.
42 Jolovelo, Luis Gabriel G.
43 Mariano,Luis
44 Montoya,Artron
45 Sapinit,John Philip A.
46 Alpuro,Anale
47 Canciller,Khea Marie
48 Ferrer,Ayesha P.
49 Leonar,Rhea Katryn E.
50 Morales,Ellen Mae
51 Rata,Lorein E.
52 So-ogon Pauline Mae
53 Aligayda, Benjie Jr.T.
54 Agravante, Raymund Jr.E.
55 Agono,Sean Gabriel
56 Bonalos,Dioces
57 Lorezo,Nash P.
58 Malvas,Raven Chloe R.
59 Nebre,Jude,C.
60 Repaso,Loreto
61 Godienes,Lian L.
 62 Regalado,RJ, C.
63 Catalan,Martena , M.
64 Canoy,Christel Joy A.
65 Delfin, Jezeil A.
66 Ecayan,Jamaica Rose
67 Ecayan, Thea
68 Aspan, Pincess Ariel
69 Bacalla, Geraldine
70 Canoy,Christel Joy A.

Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5
 TOTAL:

LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: _Fr. Gratian Murray AFSC, Integrated School____________________________________
Grade: ___TWO_______ Section _____________________
School ID Number: _______500190__________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

1 Arquio,Alex John
2 Asis,Khervic Pablo
3 Conserman,Gotham C.
4 Dayot,AJ D.
5 De Nicolas ,Loyd Marquez
6 Elare, Aneu D.
7 Endino,Nathan B
8 Garucho,John Cedric
9 Jalover,Lucas Antoin Miguel
10 Magallanes Jhared S.
11 Sebuyan,Johncel
12 Sibugan Kir Jay D.
13 Agravante, Rowela S.
14 Amador,Tyra Janine P.
15 Baroca,Xylah Brianna L.
16 Febreo,Mary Joy
17 Flandez, Julie Ann
18 Flores,Glaiza Grace
19 Gensoli,Zerahiah Jahleel
20 Maniego,Reinheart V.
21 Sebunas,Kate Marie
22 Arca,Alfred P.
23 Andea,Joel Ysrael P.
24 Daniel, Denziel
25 Fausto, John Alvin C.
26 Labrador,Claud Steven
27 Mediavilla,Kaidee D.
28 Rata,Jamier L.
29 Robles,Arvin
30 Tingson,Cedric
 Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5

TOTAL:
 LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: Fr.Gratian Murray AFSC,Integrated School_____________________________________
Grade: _____TWO____ Section _____________________
School ID Number: __500190_______________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

1 Arca,Jay -R Puro
2 Caromayan,Joemari Jr. C.
3 Ondoy,Rejean
4 Azucena,Kiel Gabriel
5 Romano, Rogelio
6 Salimbot, Reynel J.
7 Alba,Rheanna D.
8 Valenzuela, Ashnie Leona E.
9 Cabrillos,Ryliegh Shaun P.
10 Lasquite,John Henryl L.
11 Pallorina,Mark Zyniel Z.
12 Ballesteros Phionna Xiate
13 Arca,Nathaniel Q
14 Alba,,Jennifer R.
15 Dorimon ,Hayley Jade
16 Basco,Sky Walter C.
17 Caragayan ,Juno
18 Cordero,Klienth Mathew
19 Hequlan, Jhonbert
20 Marait, Alljhor
21 Mascardo,Wencel
22 Naquimbing,Antonio Juan
23 Robete,Jerecho L
24 Sarabia,JB C.
25 Silvino,Jhon Miko
26 Yanson,Johan R.
27 Baroca, Xyrene Blaine
28 Cagayan,Eliana P.
29 Dionson,Tresha P.
30 Labrador,Ma. Isabel
 Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5

TOTAL:
 LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: Fr. Gratian Murray AFSC, Integrated School_____________________________________
Grade: ____One______ Section _____________________
School ID Number: __500190_______________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status
(y or n)
Ht Wt
(cm) (kg)

31 Luces, Nicole
32 Malvas,Rechelle Chloe
33 Marfil, Gracemar
34 Naval,Alliahh Jane
35 Alitao,Janila B.
36 Espinase,Ma.Bella A.
37 Estuqia,Eunice N.
38 Posta,Khella Marie.
39 Plaser,Jemaicah R.
40 Saragoza,Patricia
41 Posta,,Kheilla Marie
42 Sivestre, Cindy
43 Amador,Rusty Allen
44 Chua,Liam Edrick
45 De Tomas ,Vaughn Ezekiel
46 Evangelista,Eljohn
47 Febreo, Jio Mathew
48 Hilado, Junmar
49 Labrador,Jose Clarrence
50 Sebuyan, Vicent
51 Villegas,Paul
52 Agravante, Merry Chris
53 Amador,Crist Lyn
54 Barcelo,Phinelopy
55 Gambito Chealsea Mallory
56 Rojas,Enrique John
57 Mabuque,Joergina Antoni
58 Matricio, Sophie
59 Pesanom, Prince Jen
60 Verallo,Leanne Marie S.
 Prepared by:

____________________________ A. Nutritional Status

Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o
SW - Severely wasted SU - Severely underweight
Approved by: W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overwieght Ow - Overwieght

School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
 SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY 2022

PRE FEEDING AC

Nutritional Status Deworming Date Date Date Date Date

Date NS (√ ) or (X) Date
Taken BMI-A HFA Taken 1 2 3 4 5

TOTAL:
 LEGEND
A. Nutritional Status
B. Deworming
For below 6 y.o For 3-19 y.o
ly underweight SS - Severely Stunted ( x ) - not dewormed
ight S - Stunted ( √ ) - dewormed
N - Normal
ght T - Tall

KD Form A.
 School: _Fr.Gratian Murray AFSC, Integrated School____________________________________
Grade: ____ONE______ Section _____________________
School ID Number: __500190_______________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date

6 7 8 9 10 11 12 13 14 15
 D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
 SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF NOVEMBER, FY

Region VI____________________________
Division _____Bacolod City______________________
District ____III_______________________

NAME OF PUPIL 4Ps Beneficiary PRE FEEDING

Beneficiary of Previous
(y or n) SBFP Age Birth Date Sex Nutritional Status Deworming Date Date
(y or n)
Ht Wt Date NS (√ ) or (X) Date
(cm) (kg) Taken BMI-A HFA Taken 1 2

1 Bngcaya,Angelo
2 Pati-on,Viel andrew
3 Seraspe,Sherwin
4 Magan,Zinna Maere
5 Mariano,Scarlet
6 Morales,Andre
7 Robles ,Albert
8 Magallanes,Jairah
9 Sevilla ,Saira Mae
10 So-ogon , Ehlyn
11 Espinosa,Argie
12 Morales,Prince Jheme
13 De Pedro,john Claide
14 Basco,Julia Ashsley
15 Saragoza, Ana Mae
16 Agravante, Renz
17 Billanes ,Raven
18 Etchon,James
 19 Gura,Cyrus Ivan
20 Jaena, Kenuie
21 Ambay,Shane Ashley
22 Calo, Joan Rose
23 Rata, Lucille
24
25
TOTAL:
Prepared by:
LE
____________________________ A. Nutritional Status
Feeding Teacher / School Nurse For 6-19 y.o For below 6 y.o For 3-19 y.o
SW - Severely wasted SU - Severely underweight SS - Severely Stunted ( x ) - not dewormed
Approved by: W - Wasted U - Underweight S - Stunted ( √ ) - dewormed
N - Normal N - Normal N - Normal
Ow - Overwieght Ow - Overwieght T - Tall
School Head O - Obese

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
EDING PROGRAM
ILY FEEDING

NOVEMBER, FY 2022

School: Fr. Gratian Murray AFSC, Integrated School_____________________________________

KINDER
School ID Number: 500190_________________________
ACTUAL FEEDING DAYS

Date Date Date Date Date Date Date Date Date Date Date Date Date

3 4 5 6 7 8 9 10 11 12 13 14 15
 LEGEND

B. Deworming D. Actual Feeding

dewormed (H ) - Present, served with Hot meals

ormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice