01.21.22 - Revised Inventory Form - Vaccinated Population - DILG MC Addendum

BARANGAY MONTHLY INVENTORY OF VACCINATED POPULATION
REGION: 3
PROVINCE: ZAMBALES
CITY/MUNICIPALITY: IBA
BARANGAY: LIPAY-DINGIN-PANIBUATAN
SUMMARY
A. TOTAL NO. OF BARANGAY INHABITANTS

AGED 12 -17 YEARS OLD, ELIGIBLE FOR VACCINATION: 80
B. TOTAL NO. OF BARANGAY INHABITANTS

AGED 18 YEARS AND ABOVE, ELIGIBLE FOR VACCINATION: 200
C. TOTAL NO. OF BARANGAY INHABITANTS

D. TOTAL NO. OF UNVACCINATED INDIVIDUALS AGED

12 YEARS AND ABOVE: 0
E. PERCENTAGE OF UNVACCINATED INDIVIDUALS AGED

12 YEARS AND ABOVE: 0.00%
F. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS

AGED 12 YEARS AND ABOVE: 0
G. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS

AGED 12 YEARS AND ABOVE: 0.00%
H. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS
AGED 12-17 YEARS: 15
I. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS
AGED 12-17 YEARS: 18.75%
J. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS
AGED 18 YEARS AND ABOVE 0
K. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS
L. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS
M. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS
N. TOTAL NO. OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH
BOOSTER SHOT: 0
O. PERCENTAGE OF INDIVIDUALS AGED 18 YEARS AND ABOVE
WITH BOOSTER SHOT: #DIV/0!
AS OF AUGUST, 2022
Prepared by
ROLANDO J. TATONG/
Name and Signature of Barangay Secretary/Health Worker
Full Name of Partially or Fully Vaccinated Barangay Inhabitants

No. Birthday Age
Aged 12 Y/O and Above
1 CODY ATASIA MESIANO JULY 4, 2010 12

2 JEREMY SANTOS INALGAN JUNE 7, 2006 16
3 REIVER KYLLE MANALO FRANCIA FEBRUARY 12,2009 13
4 REINER CLYDE MANALO FRANCIA JULY 09, 2005 17
5 PAULINE ESCALANTE MOSE AUGUST 19, 1984 37
6 JHON GABRIEL ROMANBAN DATIJAN DECEMBER 4, 2005 16
7 KEVIN ROMANBAN DATIJAN JANUARY 3, 2003 19
8 RHIANN ROMANBAN BUENAVENTURA MAY 24, 2010 12
9 VALERIE BUNDANG OCTOBER 20, 2013 8
10 PRINZ KIEPER RUADO APRIL 24, 2012 10
11 RHED K-ZEL RUADO SEPTEMBER 30, 2010 11
12 JULIA MERCADO JULY 31, 2011 11
13 JIKALA MERCADO OCTOBER 17, 2014 7
14 ERIK MERCADO JANUARY 01, 2011 11
15 ALDREN MERCADO APRIL 23, 2013 8
16 IAN JAY PABLITO DECEMBER 23, 2015 6
17 ANGELINE PABLITO NOVEMBER 06, 2012 9
18 MARCUS ABREE RUIZ P. CARIG AUGUST 25, 2015 6
19 BRET MERCADO Jr. SEPTEMBER 21, 2016 5
20 KYRIE GABREL PANTERIA MARCH 31 ,2015 7
21 CARVIN SINGAIN DECEMBER 18, 2008 13
22 KENNEDY UNGRIA JULY 19, 2008 14
23 AJ CAYABYAB MAY 01,2010 12
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
TOTAL
* Note: Input data for items A and B which may be sourced from the Registry of Barangay Inhabitants (RBI) which is updated every six months,
or from the 2020 Census of Population and Housing (2020 CPH) of the Philippine Statistics Authority (PSA).
Formula: C = A + B
Formula: D = C - (F + L)
Formula: E = D/C x 100
Formula: G = F/C x 100
Formula: I= H/A x 100

Formula: K= J/B x 100
Formula: L = H + J
Formula: M = L/C x 100
Formula: O = N/J x 100
Approved by
VICTOR S. BUENAVENTURA
Name and Signature of Punong Barangay
PRIMARY SERIES OF COVID-19 VACCINE

(Note: 1. If brand is "Janssen, put NA in the column for "2nd
Dose"; Put "None" if unvaccinated) Fully
Vaccinated
Partially Fully Vaccinated
18 years old
Date of Vaccination vaccinated? 12-17 years old?
and above?
(Type 1 if Yes ; (Type 1 if Yes ;
(Type 1 if Yes
0 if No) 0 if No)
Brand ;
1st Dose 2nd Dose 0 if No)
4/8/2022 Pfizer 1
1
1
1
1
4/8/2022 08\25\22 Pfizer 1
4/8/2022 08\25\22 Pfizer 1
05/26/2022 4/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
5/8/2022 Pfizer 1
9/8/2022 Pfizer 1
9/8/2022 Pfizer 1
07/19/2022 9/8/2022 Pfizer 1
7 15 1
dated every six months,
BOOSTER DOSE
Individuals 18 years
old and above with
Date of Vaccination
Booster Shot? Brand
(Booster Shot)
(Type 1 if Yes;
0 if No; NA if 12-17
Y/O)
4/8/2022 Pfizer
4/8/2022 Pfizer
4/8/2022 Pfizer
08/24/2022 Pfizer
0
REGION: 3
PROVINCE: ZAMBALES
SUMMARY

AGED 12 -17 YEARS OLD, ELIGIBLE FOR VACCINATION: 80



12 YEARS AND ABOVE: 0

12 YEARS AND ABOVE: 0.00%

G. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS

AGED 12-17 YEARS: 24
AGED 12-17 YEARS: 30.00%
AGED 18 YEARS AND ABOVE 0
K. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS
L. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS
M. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS
N. TOTAL NO. OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH
BOOSTER SHOT: 0
O. PERCENTAGE OF INDIVIDUALS AGED 18 YEARS AND ABOVE
WITH BOOSTER SHOT: #DIV/0!
AS OF JULY, 2022
Prepared by
ROLANDO J. TATONG/

No. Birthday Age
1 CLARENCE SERRANO JUNE 01, 2005 16

2 EFI JOHN CEDRIC AGRABIO OCTOBER 26, 2011 10
3 SARAH FAYE AGRABIO SEPTEMBER 7,2014 7
4 RICHELA LATAGAN JANUARY 28,2012 10
5 RICHARD LATAGAN JR. OCTOBER 10,2013 8
6 NATALIA RAPADA JANUARY 16,2016 6
7 JONALYN PONCE FEB 23,1991 31
8 EDUARD CASTILLO MAY 10,1993 29
9 DIANE BUGARIN AUGUST 8,2008 14
10 CONDRAD JAMES MESIANO OCTOBER 18,2012 11
11 ARRIANE LIEZELLE MESIANO AUGUST 6,2014 8
12 XHANNE ANTONIE ANGELES OCTOBER 10,2010 11
13 SHEANTAL DE GUIA MARCH 3,2013 9
14 CARL JUSTINE DE GUIA JULY 21,2015 7
15 SOLENN BUNDANG MAY 31,2012 10
16 JOHN PAUL BUNDANG MAY 2,2014 8
17 ALLIYAH CHLOE BUGARIN JULY 30,2010 12
18 RHIANN BUEANAVENTURA MAY 24,2010 12
19 CARVIN SINGIAN DECEMBER 18,2008 13
20 MICAELA MAE ELAN OCTOBER 6,2013 8
21 JENICA MESIANO APRIL 6,2013 9
22 JANELLE ATIENZA JULY 5,2013 9
23 JENELYN ATIENZA JUNE 1,2016 6
24 PRINCESS YAP OCTOBER 19,2012 9
25 NOEL YAP SEPTEMBER 6,2011 10
26 MARY ELYN MALONDRAS MAY 19,2016 6
27 SITTI AINA MACATANGCAL MAY 18,2013 9
28 SITTI AISSA MACATANGCAL MAY 6,2015 7
29 ALLIEN ATIENZA SEPTEMBER 14,2014 7
30 JINKY MESIANO FEB 17,2011 11
31 RICHARD LATAGAN SPTEMBER 12,1986 35
32 JOANN LATAGAN SEPTEMBER 1,1985 34
33 RAM-JADE ALAND JUNE 28.2012 10
34 SHANE ALANO OCTOBER 17,2010 11
35 JAMES ALANO MARCH 3,2017 5
36 KHEA ALEXIS PINCA JUNE 6,2013 9
37
38
39
40
41
42
43
44
45
46
47
48
49
50
TOTAL
* Note: Input data for items A and B which may be sourced from the Registry of Barangay Inhabitants (RBI) which is updated every six months,
or from the 2020 Census of Population and Housing (2020 CPH) of the Philippine Statistics Authority (PSA).
Formula: C = A + B

Formula: L = H + J
Approved by

(Note: 1. If brand is "Janssen, put NA in the column for "2nd
Dose"; Put "None" if unvaccinated) Fully
Vaccinated
Partially Fully Vaccinated
18 years old
Date of Vaccination vaccinated? 12-17 years old?
and above?
(Type 1 if Yes ; (Type 1 if Yes ;
(Type 1 if Yes
0 if No) 0 if No)
Brand ;
1st Dose 2nd Dose 0 if No)
11/25/21 7/24/22 Pfizer 1

8/7/2022 7/29/22 Pfizer 1
07\08\22 07\29\22 Pfizer 1
07\08\22 07\29\22 Pfizer 1
06\17\22 07\08\22 Pfizer 1
07\19\22 Pfizer 1
08\04\21 N\A Janssen
06\23\22 07\14\22 Pfizer
06\13\22 07\20\22 Pfizer 1
07\29\22 Pfizer
07\29\22 Pfizer 1
07\19\22 Pfizer 1
07\29\22 Pfizer 1
07\29\22 Pfizer 1
05\20\22 07\17\22 Pfizer 1
05\20\22 07\17\22 Pfizer 1
05\20\22 07\17\22 Pfizer 1
05\26\22 08\08\22 Pfizer 1
07\19\22 08\09\22 Pfizer 1
06\24\22 07\19\22 Pfizer 1
06\24\22 07\19\22 Pfizer 1
07\19\22 08\15\22 Pfizer 1
07\19\22 08\15\22 Pfizer 1
07\19\22 08\15\22 Pfizer 1
07\19\22 08\15\22 Pfizer 1
07\19\22 08\15\22 Pfizer 1
06\24\22 07\19\22 Pfizer 1
07\19\22 08\15\22 Pfizer 1
07\19\22 08\15\22 Pfizer 1
07\19\22 Pfizer 1
12\1\21 12\22\21 Pfizer 1
08\04\21 N\A Janssen 1
07\29\22 Pfizer 1
07\29\22 Pfizer 1
07\29\22 Pfizer 1
07\8\22 07\29\22 Pfizer 1
7 24 2
dated every six months,
BOOSTER DOSE
Individuals 18 years
old and above with
Date of Vaccination
Booster Shot? Brand
(Booster Shot)
(Type 1 if Yes;
Y/O)
1 07\04\22 Pfizer
1 07\25\22 Pfizer
1 07\19\22 Pfizer
3
REGION: 3
PROVINCE: ZAMBALES
SUMMARY

AGED 12 -17 YEARS OLD, ELIGIBLE FOR VACCINATION:
AGED 18 YEARS AND ABOVE, ELIGIBLE FOR VACCINATION:

AGED 12 YEARS AND ABOVE, ELIGIBLE FOR VACCINATION:
12 YEARS AND ABOVE:
12 YEARS AND ABOVE:
AGED 12 YEARS AND
G. PERCENTAGE ABOVE:
OF PARTIALLY VACCINATED INDIVIDUALS
AGED 12 YEARS AND ABOVE:
AGED 12-17 YEARS:
AGED 12-17 YEARS:
AGED 18 YEARS AND
K. PERCENTAGE ABOVE
OF FULLY VACCINATED INDIVIDUALS
AGED
L. 18 YEARS
TOTAL NO. OF AND ABOVE:
FULLY VACCINATED INDIVIDUALS
AGED
M. 12 YEARS AND
PERCENTAGE ABOVE:
OF FULLY VACCINATED INDIVIDUALS
N. TOTAL NO. OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH BOOSTER SHOT:
O. PERCENTAGE OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH BOOSTER SHOT:
AS OF AUGUST, 2022
Prepared by
ROLANDO J. TATONG/

No.
No.
1 JESUSA QUILLON BUENAVENTURA
2 EMILIO MICLAT RILLON

3 MELANIE GANAL LASTIMOSA
4 DINDI GABRIEL GALLARDO
5 MANOLITO CARREON UNGRIA SR.
6
VICTOR SORIANO BUENAVENTURA
7 KENNEDY REYES UNGRIA
8 ALDRIN CAVA ESPOSO
9 LYCIL DIAL ABAGON
10 ELIZABETH FORTIN ESCUSA
11 ELOISA UNGRIA
12 JOHNCEL PATANAO MALONDRAS
13 RICARDO CAROLINO UNGRIA
14 MIKE CAYABYAB BUENAVENTURA
15 MARL LESTER JUDAL ECALNIR
16 ROSALINA LAGUER NAVARRO
17 MARCELINO ELAYDA ARBIZO
18 CYNTHIA QUIÑONES GONZALES
19 JUNALEE NIEVES SEÑAROSA
20 VIEN KYLE CASTILLO COCHING
21 CHRISTIAN AUVI CASTILLO COCHING
22 WILMA DIAL DRAGON
23 WINCES LAURA DIAL DRAGON
24 MARILYN DEJESA FORTIN
25 DANIEL MESIANO FORTIN
26 CLEMENCIA LAGRIMAS PINCA
27 EJ ANDRE GUTIERREZ MORA
28 JUDY ROMANBAN MORA
29 ROXANNE MALAKAS ELAN
30 MARL SUGUE CAVA
31 CYNTHIA ROMANBAN BUENAVENTURA
32 MELVINA MANALO MEDINA
33 ROSARIO ABANAS MEDINA
34 DINDI GABRIEL GALLARDO
35 SHEILA ABLIAN ROMANBAN
36 RODRIGO JR. CAGUINIMAN ROMANBAN
37 ROLANDO JOSE TATONG
38
39
40
41
42
43
44
45
46
47
48
49
50
TOTAL
TION
* Note: Input data for items A and B which may be

458 or from the 2020 Census of Population and Housin
2,401
Formula: C = A + B
2859
0
0.00% Formula: E = D/C x 100
6
0.21% Formula: G = F/C x 100
31
6.77% Formula: I= H/A x 100
0
0.00% Formula: K= J/B x 100
0 Formula: L = H + J
0.00% Formula: M = L/C x 100
2,401
#DIV/0! Formula: O = N/J x 100
PRIMARY SERIES OF COVID-

(Note: 1. If brand is "Janssen, put NA in the c
"None" if unvaccinate
Date of Vaccination
Birthday Age
Birthday Age
1st Dose
DECEMBER 25,1964 58 /
OCTOBER 20, 1961 61 /
JUNE 06, 1986 36 9/9/2022
SEPTEMBER 28, 1998 17 9/9/2022
OCTOBER 07, 1947 75 /
JULY 08, 1958 64 /

JULY 19, 2008 14 /
FEBRUARY 20, 1986 36 /
JULY 21, 1986 36 /
SEPTEMBER 13, 1960 62 /
MAY 31, 1999 23 /
FEBRUARY 20, 1991 31 /
JULY 07, 1989 33 09/19/2022
OCTOBER 08, 1984 38 09/19/2022
APRIL 22, 1992 30 09/19/2022
FEBRUARY 14, 1993 29 09/19/2022
SEPTEMBER 09, 1959 63 /
AUGUST 20, 1976 46 /
JUNE 28, 1990 32 /
SEPTEMBER 12, 2002 20 /
JUNE 30, 1999 23 /
SEPTEMBER 12, 1955 67 /
JUNE 22, 1978 44 /
JUNE 19, 1952 70 /
AUGUST 02, 1952 70 /
APRIL 28, 1968 52 /
JUNE 10, 2008 14 /
NOVEMBER 16, 1980 42 /
JULY 07, 1984 38 /
AUGUST 10, 1985 37 09/29/2022
APRIL 03, 1985 37 /
MAY 17, 1963 61 /
JUNE 20, 1955 67 /
SEPTEMBER 28, 1998 24 /
DECEMBER 31, 1970 52 /
JUNE 03, 1967 55 /
JUNE 03, 1976 46 /
for items A and B which may be sourced from the Registry of Barangay Inhabitants (RBI) which is updated every six months,
Census of Population and Housing (2020 CPH) of the Philippine Statistics Authority (PSA).
Approved by
RIMARY SERIES OF COVID-19 VACCINE

nd is "Janssen, put NA in the column for "2nd Dose"; Put
"None" if unvaccinated)
Date of Vaccination
Fully Vaccinated
Partially vaccinated?
12-17 years old?
(Type 1 if Yes ;
Brand (Type 1 if Yes ;
0 if No)
0 if No)
Fully Vaccinated
Partially vaccinated?
12-17 years old?
(Type 1 if Yes ;
Brand (Type 1 if Yes ;
2nd Dose 0 if No)
0 if No)
/
Pfizer 1
Pfizer 1
/
09/13/2022 Pfizer 1
/
/
/
/
/
Pfizer 1
Pfizer 1
Pfizer 1
Pfizer 1
/
/
/
/
/
/
/
/
/
/
/ 1
/
/
Pfizer
/
/
/
09/30/2022 Pfizer
/
/
/
6 2
pdated every six months,
BOOSTER DOSE
Fully Vaccinated 18
years old and Individuals 18 years
above? (Type 1 if old and above with Date of
Yes ; Booster Shot? Vaccination Brand
0 if No) (Type 1 if Yes; (Booster Shot)
Y/O)
Fully Vaccinated 18
years old and Individuals 18 years
above? (Type 1 if old and above with Date of
Yes ; Booster Shot? Vaccination Brand
0 if No) (Type 1 if Yes; (Booster Shot)
Y/O)
1 1 5/9/2022 Pfizer
1 1 5/9/2022 Pfizer
1 1 9/9/2022 Pfizer
1 1 9/9/2022 Pfizer
1 1 09/13/2022 Pfizer
1 1 09/13/2022 Pfizer
1 1 09/13/2022 Pfizer
1 1 09/14/2022 Pfizer
1 1 09/19/2022 Pfizer
1 1 09/19/2022 Pfizer
1 1 09/19/2022 Pfizer
1 1 09/19/2022 Pfizer
1 1 09/19/2022 Pfizer
1 1 09/19/2022 Pfizer
1 1 09/27/2022 Pfizer
1 1 09/27/2022 Pfizer
1 1 09/27/2022 Pfizer
1 1 09/27/2022 Pfizer
1 1 09/27/2022 Pfizer
1 09/29/2022 Pfizer
1 1 09/29/2022 Pfizer
1 1 09/29/2022 Pfizer
1 1 09/29/2022 Pfizer
1 1 09/29/2022 Pfizer
1 1 09/30/2022 Pfizer
1 1 09/30/2022 Pfizer
1
1 1 09/30/2022 Pfizer
1 1 09/30/2022 Pfizer
1 1 09/29/2022 Pfizer
29 29
REGION: 3
PROVINCE: ZAMBALES
A. TOTAL NO. OF BARANGAY INHABITANTS SUMMARY

AGED 12 -17
B. TOTAL NO.YEARS OLD, ELIGIBLE
OF BARANGAY FOR VACCINATION:
INHABITANTS 458
AGED 18 YEARS AND ABOVE, ELIGIBLE FOR VACCINATION: 2,401

AGED 12 YEARS
D. TOTAL NO. OFAND ABOVE, ELIGIBLE
UNVACCINATED FOR VACCINATION:
INDIVIDUALS AGED 2859
12 PERCENTAGE
E. YEARS AND ABOVE:
OF UNVACCINATED INDIVIDUALS AGED 0
12 TOTAL
F. YEARSNO.
ANDOFABOVE:
PARTIALLY VACCINATED INDIVIDUALS 0.00%
AGED
G. 12 YEARS AND
PERCENTAGE ABOVE:
OF PARTIALLY VACCINATED INDIVIDUALS 6
H. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 0.21%
AGED 12-17 YEARS:
I. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS 31
AGED 12-17 YEARS:
J. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 6.77%
AGED 18 YEARS AND
K. PERCENTAGE ABOVE
OF FULLY VACCINATED INDIVIDUALS 0
L. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 0.00%
AGED 12 YEARS AND
M. PERCENTAGE ABOVE:
OF FULLY VACCINATED INDIVIDUALS 0
N. TOTAL NO. OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH 0.00%
BOOSTER SHOT: OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH
O. PERCENTAGE 2,401
BOOSTER SHOT: #DIV/0!
AS OF OCTOBER, 2022
Prepared by
ROLANDO J. TATONG/

No. Birthday
1 ROSEMARIE B. BAUGAN 4/26/1969

2 MA. VICTORIA U. GONZALES 6/26/71
3 AURORA R. ANCHETA 2/15/1980
4 MARY JANE D. MERCADO 09/18/96
5 ELIZA A. MARTICIO 05/30/1970
6 JOHN LOYD MESIANO 09/19/1999
7 IRENE A. CAYABYAB 04/20/1963
8 BENNY M. NORTE 05/19/1990
9 LIM D. SINGIAN 09/27/1983
10 MICHAEL M. YAP 09/26/1986
11 BRET A. MERCADO 3/3/1994
12 JANE D. RABAJA 6/8/1978
13 MARVIN M. MERCADO 03/19/1992
14 CHLOE ANNE P. CAVA 08/31/2011
15 KRISTEL KAYE D. OPULENTO 01/14/2011
16 KYRHO D. OPULENTO 01/21/2015
17 LANY BIANES 01/19/2012
18 EDWIN D. ADVINCULA 12/15/2010
19 ELSIE D. ADVINCULA 11/12/2012
20 GWEN S. MONTEHERMOSO 01/22/2011
21 PRINCE IVAN A. DOMINGO 08/28/2011
22 REIN MACK B. PANSACULA 4/4/2011
23 JOHN REL F. BULISAN 09/14/2012
24 MIKEE C. TAMAYO 1/12/2013
25 AILIANA D. ACAYAN 09/27/2014
26 PRINCESS Q. ABASTILLAS 07/27/2011
27 YHANZEL ROSE K. ROBO 9/9/2013
28 WENDELL ROY M. MENDOUS 06/17/2016
29 AIRA MAE D. MERETE 7/11/2014
30 KRISTINE R. KABILING 12/2/2011
31 LERMA B. UNGRIA 02/13/1978
32 MARVIN C. CAVA 10/12/1981
33 MARK S. CAVA 10/8/1985
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
TOTAL
N
* Note: Input data for items A and B which may be sourced from the Registry of Barangay Inhabitants (RBI
or from the 2020 Census of Population and Housing (2020 CPH) of the Philippine Statistics Authority (PSA
Formula: C = A + B

Formula: L = H + J
Approved by

(Note: 1. If brand is "Janssen, put NA in the column for "2nd Dose"; Put
"None" if unvaccinated)
Date of Vaccination
Age
Brand
1st Dose 2nd Dose
53 / /
51 / /
42 / /
26 / /
52 / /
23 / /
59 / /
32 / /
39 / /
36 / /
28 / /
44 / /
30 / /
11 7/10/2022 Pfizer
11 7/10/2022 Pfizer
7 7/10/2022 Pfizer
10 7/10/2022 Pfizer
12 7/10/2022 Pfizer
10 7/10/2022 Pfizer
11 7/10/2022 Pfizer
11 7/10/2022 Pfizer
11 7/10/2022 Pfizer
10 7/10/2022 Pfizer
9 7/10/2022 Pfizer
8 7/10/2022 Pfizer
11 7/10/2022 Pfizer
9 7/10/2022 Pfizer
6 7/10/2022 Pfizer
8 / 7/10/2022 Pfizer
11 7/10/2022 Pfizer
44 / /
41 / /
37 / /
Registry of Barangay Inhabitants (RBI) which is updated every six months,
he Philippine Statistics Authority (PSA).
Fully Vaccinated 18 BOOSTER DOSE

Fully Vaccinated 12- Booster Shot?
Partially vaccinated? years old and
17 years old? (Type 1 (Type 1 if Yes;
(Type 1 if Yes ; above? (Type 1 if
if Yes ; 0 if No; NA if 12-17
0 if No) Yes ;
0 if No) Y/O)
0 if No)
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1 1
1 1
1 1
16 1 16 16
BOOSTER DOSE
Date of Vaccination
Brand
(Booster Shot)
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
1/10/2022 Pfizer
11/10/2022 Pfizer
11/10/2022 Pfizer
11/10/2022 Pfizer
CITY/MUNICIPAL MONTHLY INVENTORY OF VACCINATED POPULATION
REGION:_________________
PROVINCE: ________________
CITY/MUNICIPALITY: __________________
SUMMARY
A. TOTAL NO. OF BARANGAY INHABITANTS 260,000

AGED 12 -17 YEARS:
B. TOTAL NO. OF BARANGAY INHABITANTS 345,000

C. TOTAL NO. OF BARANGAY INHABITANTS 605,000

D. TOTAL NO. OF UNVACCINATED INDIVIDUALS AGED 150,000

12 YEARS AND ABOVE:
E. PERCENTAGE OF UNVACCINATED INDIVIDUALS AGED 24.79%

12 YEARS AND ABOVE:
F. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS 155,000

G. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS 25.62%

H. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 125,000
AGED 12-17 YEARS:
I. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS 48.08%
AGED 12-17 YEARS:
J. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 175,000
AGED 18 YEARS AND ABOVE
K. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS 50.72%
L. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 300,000
M. PERCENTAGE OF FULLY VACCINATED INDIVIDUALS 49.59%
N. TOTAL NO. OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH 40,000
BOOSTER SHOT:
O. PERCENTAGE OF INDIVIDUALS AGED 18 YEARS AND ABOVE 22.86%
WITH BOOSTER SHOT:
AS OF (insert date): ___________________
Prepared and Submitted by
___________________________
Name and Signature of DILG C/MLGOO
Total No. of Total No. of

Total No. of
Barangay Barangay
Barangay
No. Name of Barangay Inhabitants Aged Inhabitants Aged
Inhabitants Aged
18 Y/O and 12 Y/O and
12 - 17 Y/O
Above Above
1 EX: BARANGAY A 160,000 260,000 420,000
2 EX: BARANGAY B 100,000 85,000 185,000
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
TOTAL 260,000 345,000 605,000
Unvaccinated Individuals Partially Vaccinated Individuals Fully Vaccinated Individuals Aged Fully Vaccinated Individuals Aged
Aged 12 Y/O and Above Aged 12 Y/O and Above 12 -17 Y/O 18 Y/O and Above
Number Percentage Number Percentage Number Percentage Number

100,000 23.81% 120,000 28.57% 75,000 46.88% 125,000
50,000 27.03% 35,000 18.92% 50,000 50.00% 50,000
150,000 24.79% 155,000 25.62% 125,000 48.08% 175,000
cinated Individuals Aged Fully Vaccinated Individuals Aged Individuals Aged 18 Y/O and
8 Y/O and Above 12 Y/O and Above Above with Booster Shot
Percentage Number Percentage Number Percentage

48.08% 200,000 47.62% 30,000 24.00%
58.82% 100,000 54.05% 10,000 20.00%
50.72% 300,000 49.59% 40,000 22.86%
PROVINCIAL MONTHLY INVENTORY OF VACCINATED POPULATION
REGION:_________________
PROVINCE: ________________
SUMMARY
A. TOTAL NO. OF CITY/MUNICIPALITY INHABITANTS 2,960,000

AGED 12 -17 YEARS:
B. TOTAL NO. OF CITY/MUNICIPALITY INHABITANTS 2,560,000

C. TOTAL NO. OF CITY/MUNICIPALITY INHABITANTS 5,520,000

D. TOTAL NO. OF UNVACCINATED INDIVIDUALS AGED 1,000,000

12 YEARS AND ABOVE:

12 YEARS AND ABOVE:
F. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS 1,900,000


H. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 620,000
AGED 12-17 YEARS:
AGED 12-17 YEARS:
J. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 2,000,000
L. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 2,620,000
N. TOTAL NO. OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH 700,000
BOOSTER SHOT:
WITH BOOSTER SHOT:
AS OF (insert date): ___________________
Prepared by: Submitted by:
___________________________ ___________________________
Name and Signature of DILG Provincial Focal Person Name and Signature of DILG Provincial Director
Total No. of
City/Municipality
City/Municipality City/Municipality
No. Name of City/Municipality Inhabitants Aged
Inhabitants Aged Inhabitants Aged
12 Y/O and
12 - 17 Y/O 18 Y/O and Above
Above
1 EX: CITY A 1,160,000 1,260,000 2,420,000
2 EX: MUNICIPALITY A 1,100,000 500,000 1,600,000
3 EX: MUNICIPALITY B 700,000 800,000 1,500,000
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
TOTAL 2,960,000 2,560,000 5,520,000

LG Provincial Director
Fully Vaccinated Fully Vaccinated

Unvaccinated Individuals Partially Vaccinated Individuals Fully Vaccinated Individuals
Individuals Aged 18 Y/O Individuals Aged 12 Y/O
Aged 12 Y/O and Above Aged 12 Y/O and Above Aged 12 -17 Y/O
and Above and Above
Number Percentage Number Percentage Number Percentage Number Percentage Number

500,000 20.66% 700,000 28.93% 220,000 18.97% 1,000,000 79.37% 1,220,000
300,000 18.75% 800,000 50.00% 100,000 9.09% 400,000 80.00% 500,000
200,000 13.33% 400,000 26.67% 300,000 42.86% 600,000 75.00% 900,000
1,000,000 18.12% 1,900,000 34.42% 620,000 20.95% 2,000,000 78.13% 2,620,000
Fully Vaccinated Individuals Aged 18 Y/O
ndividuals Aged 12 Y/O and Above with Booster
and Above Shot
Percentage Number Percentage

50.41% 400,000 40.00%
31.25% 100,000 25.00%
60.00% 200,000 33.33%
47.46% 700,000 35.00%
REGIONAL MONTHLY INVENTORY OF VACCINATED POPULATION
REGION:_________________
SUMMARY
A. TOTAL NO. OF PROVINCE/HUC/ICC INHABITANTS 6,060,000

AGED 12 -17 YEARS:
B. TOTAL NO. OF PROVINCE/HUC/ICC INHABITANTS 6,560,000

C. TOTAL NO. OF PROVINCE/HUC/ICC INHABITANTS 12,620,000

D. TOTAL NO. OF UNVACCINATED INDIVIDUALS AGED 2,000,000

12 YEARS AND ABOVE:

12 YEARS AND ABOVE:
F. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS 3,800,000


H. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 1,770,000
AGED 12-17 YEARS:
AGED 12-17 YEARS:
J. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 5,050,000
L. TOTAL NO. OF FULLY VACCINATED INDIVIDUALS 6,820,000
N. TOTAL NO. OF INDIVIDUALS AGED 18 YEARS AND ABOVE WITH 1,200,000
BOOSTER SHOT:
WITH BOOSTER SHOT:
AS OF (insert date): ___________________
Prepared by: Submitted by:
___________________________ ___________________________
Name and Signature of DILG Regional Focal Person Name and Signature of DILG Regional Director

Province/HUC/ICC Province/HUC/ICC
No. Name of Province/HUC/ICC
Inhabitants Aged 12 - Inhabitants Aged 18
17 Y/O Y/O and Above
1 EX: HUC A 1,560,000 1,260,000

2 EX: HUC B 1,200,000 500,000
3 EX: ICC A 800,000 1,000,000
4 EX: Province A 1,500,000 2,000,000
5 EX: Province B 1,000,000 1,800,000
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
TOTAL 6,060,000 6,560,000
__________________
Signature of DILG Regional Director
Total No. of Fully Vaccinated

Unvaccinated Individuals Partially Vaccinated Individuals Fully Vaccinated Individuals
Province/HUC/ICC Individuals Aged 18 Y/O
Aged 12 Y/O and Above Aged 12 Y/O and Above Aged 12 -17 Y/O
Inhabitants Aged 12 and Above
Y/O and Above
Number Percentage Number Percentage Number Percentage Number
2,820,000 600,000 21.28% 900,000 31.91% 320,000 20.51% 1,000,000
1,700,000 400,000 23.53% 800,000 47.06% 100,000 8.33% 400,000
1,800,000 200,000 11.11% 400,000 22.22% 500,000 62.50% 700,000
3,500,000 400,000 11.43% 700,000 20.00% 450,000 30.00% 1,950,000
2,800,000 400,000 14.29% 1,000,000 35.71% 400,000 40.00% 1,000,000
12,620,000 2,000,000 15.85% 3,800,000 30.11% 1,770,000 29.21% 5,050,000
Fully Vaccinated Fully Vaccinated Individuals Aged 18 Y/O
ndividuals Aged 18 Y/O Individuals Aged 12 Y/O and Above with Booster
and Above and Above Shot
Percentage Number Percentage Number Percentage

79.37% 1,320,000 46.81% 300,000 30.00%
80.00% 500,000 29.41% 150,000 37.50%
70.00% 1,200,000 66.67% 250,000 35.71%
97.50% 2,400,000 68.57% 300,000 15.38%
55.56% 1,400,000 50.00% 200,000 20.00%
76.98% 6,820,000 54.04% 1,200,000 23.76%

01.21.22 - Revised Inventory Form - Vaccinated Population - DILG MC Addendum

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01.21.22 - Revised Inventory Form - Vaccinated Population - DILG MC Addendum

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BARANGAY MONTHLY INVENTORY OF VACCINATED POPULATION

A. TOTAL NO. OF BARANGAY INHABITANTS

B. TOTAL NO. OF BARANGAY INHABITANTS

C. TOTAL NO. OF BARANGAY INHABITANTS

D. TOTAL NO. OF UNVACCINATED INDIVIDUALS AGED

E. PERCENTAGE OF UNVACCINATED INDIVIDUALS AGED

F. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS

G. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS

Full Name of Partially or Fully Vaccinated Barangay Inhabitants

1 CODY ATASIA MESIANO JULY 4, 2010 12

Formula: E = D/C x 100

Formula: G = F/C x 100

Formula: I= H/A x 100

Formula: M = L/C x 100

Formula: O = N/J x 100

PRIMARY SERIES OF COVID-19 VACCINE

A. TOTAL NO. OF BARANGAY INHABITANTS

B. TOTAL NO. OF BARANGAY INHABITANTS

C. TOTAL NO. OF BARANGAY INHABITANTS

D. TOTAL NO. OF UNVACCINATED INDIVIDUALS AGED

E. PERCENTAGE OF UNVACCINATED INDIVIDUALS AGED

F. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS

G. PERCENTAGE OF PARTIALLY VACCINATED INDIVIDUALS

Full Name of Partially or Fully Vaccinated Barangay Inhabitants

1 CLARENCE SERRANO JUNE 01, 2005 16

Formula: E = D/C x 100

Formula: G = F/C x 100

Formula: I= H/A x 100

Formula: M = L/C x 100

Formula: O = N/J x 100

PRIMARY SERIES OF COVID-19 VACCINE

11/25/21 7/24/22 Pfizer 1

A. TOTAL NO. OF BARANGAY INHABITANTS

C. TOTAL NO. OF BARANGAY INHABITANTS

Full Name of Partially or Fully Vaccinated Barangay Inhabitants

1 JESUSA QUILLON BUENAVENTURA

2 EMILIO MICLAT RILLON

5 MANOLITO CARREON UNGRIA SR.

* Note: Input data for items A and B which may be

PRIMARY SERIES OF COVID-

OCTOBER 20, 1961 61 /

JUNE 06, 1986 36 9/9/2022

SEPTEMBER 28, 1998 17 9/9/2022

OCTOBER 07, 1947 75 /

JULY 08, 1958 64 /

RIMARY SERIES OF COVID-19 VACCINE

A. TOTAL NO. OF BARANGAY INHABITANTS SUMMARY

C. TOTAL NO. OF BARANGAY INHABITANTS

Full Name of Partially or Fully Vaccinated Barangay Inhabitants

1 ROSEMARIE B. BAUGAN 4/26/1969

Formula: G = F/C x 100

Formula: I= H/A x 100

Formula: K= J/B x 100

Formula: O = N/J x 100

PRIMARY SERIES OF COVID-19 VACCINE

Fully Vaccinated 18 BOOSTER DOSE

A. TOTAL NO. OF BARANGAY INHABITANTS 260,000

B. TOTAL NO. OF BARANGAY INHABITANTS 345,000

C. TOTAL NO. OF BARANGAY INHABITANTS 605,000

D. TOTAL NO. OF UNVACCINATED INDIVIDUALS AGED 150,000

E. PERCENTAGE OF UNVACCINATED INDIVIDUALS AGED 24.79%

F. TOTAL NO. OF PARTIALLY VACCINATED INDIVIDUALS 155,000