Republic of the Phillipines

Department of Education
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
REGION III
TALAVERA NATIONAL HIGH SCHOOL
ROXAS STREET, PAG-ASA DISTRICT, TALAVERA, NUEVA ECIJA 3114
Feasibility test of Cilantro (Persicaria Odarata) As anti Stomach pain medicine.

Name (Optional):________________________ Grade & Section:___________________

Sex: Male Female Age:____________

Directions: For each statement in the survey, Please indicate how much you agree or
disagree with the statement by putting a check in the box on the right side of each
statement. There are no right or wrong answers. Your answers will be kept strictly
confidential and you will not be identified.

Scale: 5- Strongly Agree (Indicates that the characteristic is always manifested)

4- Agree (Indicates that the characteristic is often manifested)

3- Neutral (Indicates that the characteristic is often manifested)

2-Disagree (Indicates that the characteristic is seldom manifested)

1-Strongly Disagree (Indicates that the characteristic is never manifested)

 5 4 3 2 1
Strongly Agree Neutral Disagree Strongly
Agree Disagree
A. Before treatment
1. The time between the entry of germ and
the appearance of a symptom is long.
2. The interval between the appearance of the
last symptom and the disappearance of the
bacteria is long.
3. The bacteria took effect after the exposure.
4. A higher medicine concentration showed
better results
5. Taking commercial medicines is more
effective than herbal medicine
B. After treatment

1. The time between the entry of germ and

the appearance of a symptom is long.
2. The interval between the appearance of the
last symptom and the disappearance of the
bacteria is long.
3. The bacteria took effect after the exposure.
4. A higher medicine concentration showed
better results
5. Taking commercial medicines is more
effective than herbal medicine