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Republic of the Philippines

Department of Education
SCHOOLS DIVISION OF MANDAUE CITY
LABOGON NATIONAL HIGH SCHOOL
Labogon, Mandaue City

ANECDOTAL RECORD
Observer: Observation Date:
Student’s Name: Signature: Observation Time:

Year & Section:

Description of the Incident:


Qa

Description of the
Location/Setting:

Notes/Recommendations/Action

Witnesses:
____________________________ _________________________
Name & Signature Name & Signature
Noted by:
__________________________
Adviser/ Teacher
Agreement:
Student__________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

___________________________
Name of Student over Signature
Parent:__________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
___________________________
Name of Parent/Guardian over Signature

Address: Labogon, Mandaue City


Email Address.: 303200@deped.gov.ph
https://www.facebook.com/LabogonNHS| Website: http://labogonnhs.depedmandaue.net

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