Republic of the Philippines

Department of Education
Cordillera Administrative Region
SCHOOLS DIVISION OF KALINGA
Bulanao Sports Complex, Bulanao Tabuk City Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

HEALTH PROTOCOLS
COMPLIANCE (Put √ or
X) HEALTH VACCINATION
DECLARATION STATUS
Date TIME NAME ADDRESS C.P Number Temp. YES/NO
(If Yes, What
Hand Mask/ Face COUG COLDS Brand)
Washing Shield H
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH VACCINATION
COMPLIANCE (Put √ or DECLARATION STATUS
X) YES/NO
(If Yes, What
Brand)
Hand Mask/ Face COUG COLDS
Washing Shield H
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date: _____________________

No. TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH VACCINATION
COMPLIANCE (Put √ or DECLARATION STATUS
X) YES/NO
(If Yes, What Brand)
Hand Mask/ Face COUGH COLDS
Washing Shield
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date: _____________________

No TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH

. COMPLIANCE (Put √ or X) DECLARATION

Hand Mask/ Face COUGH COLDS

Washing Shield
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date: _____________________

No TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH

. COMPLIANCE (Put √ or X) DECLARATION

Hand Mask/ Face COUGH COLDS

Washing Shield
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date: _____________________

No TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH

. COMPLIANCE (Put √ or X) DECLARATION

Hand Mask/ Face COUGH COLDS

Washing Shield
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date: _____________________

No TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH

. COMPLIANCE (Put √ or X) DECLARATION

Hand Mask/ Face COUGH COLDS

Washing Shield

Republic of the Philippines

 Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date: _____________________

No TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH

. COMPLIANCE (Put √ or X) DECLARATION

Hand Mask/ Face COUGH COLDS

Washing Shield

Republic of the Philippines

Department of Education
 Cordillera Administrative Region
Schools Division of Kalinga
Northern Pinukpuk District
SOCBOT NATIONAL HIGH SCHOOL
Socbot, Pinukpuk, Kalinga

BANTAY COVID-19 DAILY MONITORING RECORD

Date: _____________________

No. TIME NAME ADDRESS C.P Number Temp. HEALTH PROTOCOLS HEALTH VACCINATION
COMPLIANCE (Put √ or DECLARATION STATUS
X) YES/NO
(If Yes, What
Brand)
Hand Mask/ Face COUGH COLDS
Washin Shield
g