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Republic of the Philippines Republic of the Philippines

Department of Education Department of Education


REGION III – CENTRAL LUZON REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF SAN JOSE CITY SCHOOLS DIVISION OF SAN JOSE CITY
SAN JOSE CITY NATIONAL HIGH SCHOOL – SENIOR HIGH SCHOOL SAN JOSE CITY NATIONAL HIGH SCHOOL – SENIOR HIGH SCHOOL
Brgy. Calaocan, San Jose City, Nueva Ecija, 3121 Brgy. Calaocan, San Jose City, Nueva Ecija, 3121

Name:__________________________________________ Name:__________________________________________
Grade/Section:___________________________________ Grade/Section:___________________________________
Address:________________________________________ Address:________________________________________

1st Dose 2nd Dose Barangay 1st Dose 2nd Dose Barangay
(July) (January) Health Worker (July) (January) Health Worker
Indicate the Indicate the (Name and Indicate the Indicate the (Name and
date date Signature) date date Signature)
Deworming Deworming

WIFA WIFA

Republic of the Philippines Republic of the Philippines


Department of Education Department of Education
REGION III – CENTRAL LUZON REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF SAN JOSE CITY SCHOOLS DIVISION OF SAN JOSE CITY
SAN JOSE CITY NATIONAL HIGH SCHOOL – SENIOR HIGH SCHOOL SAN JOSE CITY NATIONAL HIGH SCHOOL – SENIOR HIGH SCHOOL
Brgy. Calaocan, San Jose City, Nueva Ecija, 3121 Brgy. Calaocan, San Jose City, Nueva Ecija, 3121

Name:__________________________________________ Name:__________________________________________
Grade/Section:___________________________________ Grade/Section:___________________________________
Address:________________________________________ Address:________________________________________

1st Dose 2nd Dose Barangay 1st Dose 2nd Dose Barangay
(July) (January) Health Worker (July) (January) Health Worker
Indicate the Indicate the (Name and Indicate the Indicate the (Name and
date date Signature) date date Signature)
Deworming Deworming

WIFA WIFA

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