STHCP FORM 3 District Level

To be accomplished by District Deworming Coordinator

JANUARY ___, 2023
DISTRICT__________________

GRADE NO. OF LEARNERS TOTAL NO. OF LEARNERS TOTAL NO. OF 4P’S BENEFICIARIES TOTAL/
LEVEL ENROLLED DEWORMED / DEWORMED %
%
MALE FEMALE MALE FEMALE MALE FEMALE
KINDER
I
II
III
IV
V
VI

JUNIOR
HIGH
VII
VIII
IX
X

SENIOR
HIGH
XI
XII

Prepared by: Approved by:

_______________________ _____________________
STHCP FORM 2 School Level
To be accomplished by School Deworming Coordinator
JANUARY ___, 2023
SCHOOL _________________
DISTRICT__________________

GRADE NO. OF LEARNERS TOTAL NO. OF LEARNERS TOTAL/ NO. OF 4P’S BENEFICIARIES TOTAL/
LEVEL ENROLLED DEWORMED % DEWORMED %
MALE FEMALE MALE FEMALE MALE FEMALE
KINDER
I
II
III
IV
V
VI

JUNIOR
HIGH
VII
VIII
IX
X

SENIOR
HIGH
XI
XII

Prepared by: Approved by:

_______________________ _____________________
STHCP FORM 1 Classroom Level
To be accomplished by the Class Adviser
JANUARY ___, 2023
SCHOOL _________________
DISTRICT_________________

GRADE LEVEL _____________

NO. OF 4P’S BENEFICIARIES
NAME OF LEARNERS AGE DEWORMED NOT DEWORMED DEWORMED NOT DEWORMED REMARKS

TOTAL