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  • Deworming

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    Maki Espinosa
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    This document is a record form for a national schools deworming program at Inopacan National High School. It includes tables to record student names, 4Ps beneficiary status, dates of the first and second deworming rounds, and parent signatures for each of the school's barangays. The form is divided into pages for each barangay and will be used to track participation in the deworming program during the 2021-2022 school year.

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    This document is a record form for a national schools deworming program at Inopacan National High School. It includes tables to record student names, 4Ps beneficiary status, dates of the first and second deworming rounds, and parent signatures for each of the school's barangays. The form is divided into pages for each barangay and will be used to track participation in the deworming program during the 2021-2022 school year.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    10 views6 pages

    Deworming

    Uploaded by

    Maki Espinosa
    This document is a record form for a national schools deworming program at Inopacan National High School. It includes tables to record student names, 4Ps beneficiary status, dates of the first and second deworming rounds, and parent signatures for each of the school's barangays. The form is divided into pages for each barangay and will be used to track participation in the deworming program during the 2021-2022 school year.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 6

    Republic of the Philippines

    Department of Education
    REGION VIII
    SCHOOLS DIVISION OFFICE OF LEYTE
    INOPACAN NATIONAL HIGH SCHOOL
    ___________________________________________________________________________________________________________________________________________________________________________________________________________________________

    NATIONAL SCHOOLS DEWORMING

    School: Inopacan National High School School Year: 2021-2022


    Grade & Section: ________________

    Barangay Tinago
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Poblacion
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Tao-Taon
    Complete Name 4Ps 1st Round 2nd Round Parent’s Name Signature

    ____________________________________________________________________________________________________________________________________________
    Page 1 of 6
    Poblacion, Inopacan, Leyte
    303377@deped.gov.ph
    Tel. No. (053) 565-8004
    Republic of the Philippines
    Department of Education
    REGION VIII
    SCHOOLS DIVISION OFFICE OF LEYTE
    INOPACAN NATIONAL HIGH SCHOOL
    ___________________________________________________________________________________________________________________________________________________________________________________________________________________________

    Date Dewormed Date Dewormed


    Male

    Female

    Barangay Maljo
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Jubasan
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Esperanza
    Complete Name 4Ps 1st Round 2nd Round Parent’s Name Signature

    ____________________________________________________________________________________________________________________________________________
    Page 2 of 6
    Poblacion, Inopacan, Leyte
    303377@deped.gov.ph
    Tel. No. (053) 565-8004
    Republic of the Philippines
    Department of Education
    REGION VIII
    SCHOOLS DIVISION OFFICE OF LEYTE
    INOPACAN NATIONAL HIGH SCHOOL
    ___________________________________________________________________________________________________________________________________________________________________________________________________________________________

    Date Dewormed Date Dewormed


    Male

    Female

    Barangay Tahud
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Linao
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Cabulisan
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    ____________________________________________________________________________________________________________________________________________
    Page 3 of 6
    Poblacion, Inopacan, Leyte
    303377@deped.gov.ph
    Tel. No. (053) 565-8004
    Republic of the Philippines
    Department of Education
    REGION VIII
    SCHOOLS DIVISION OFFICE OF LEYTE
    INOPACAN NATIONAL HIGH SCHOOL
    ___________________________________________________________________________________________________________________________________________________________________________________________________________________________

    Female

    Barangay Caminto
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Delos Santos


    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Apid
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    ____________________________________________________________________________________________________________________________________________
    Page 4 of 6
    Poblacion, Inopacan, Leyte
    303377@deped.gov.ph
    Tel. No. (053) 565-8004
    Republic of the Philippines
    Department of Education
    REGION VIII
    SCHOOLS DIVISION OFFICE OF LEYTE
    INOPACAN NATIONAL HIGH SCHOOL
    ___________________________________________________________________________________________________________________________________________________________________________________________________________________________

    Female

    Barangay Mahaba
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Barangay Digyo
    1st Round 2nd Round
    Complete Name 4Ps Parent’s Name Signature
    Date Dewormed Date Dewormed
    Male

    Female

    Prepared by:
    SARA JOY L. BERNALES

    ____________________________________________________________________________________________________________________________________________
    Page 5 of 6
    Poblacion, Inopacan, Leyte
    303377@deped.gov.ph
    Tel. No. (053) 565-8004
    Republic of the Philippines
    Department of Education
    REGION VIII
    SCHOOLS DIVISION OFFICE OF LEYTE
    INOPACAN NATIONAL HIGH SCHOOL
    ___________________________________________________________________________________________________________________________________________________________________________________________________________________________

    School Clinic Teacher

    Noted by:
    ALEJANDRO P. RENOMERON
    School Principal II

    ____________________________________________________________________________________________________________________________________________
    Page 6 of 6
    Poblacion, Inopacan, Leyte
    303377@deped.gov.ph
    Tel. No. (053) 565-8004

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