Department of Education

NUTRITIONAL STATUS RECORD

Name of School LOKEB NORTE NATIONAL HIGH SCHOOL School ID 300212 Region 1 2022
Grade Level 12 Section ICT District 1 2021
Date of Weighing August 30, 2022 S.Y 2022-2023 Division PANGASINAN I

Weight (In Height (In Body

NAMES BIRTHDAY SEX
Mass NS HS
Kg) meters)
Index*
1. BARGO,BRYLE BARG'S, ABAGA 5/27/02 M
2. BAUTISTA,ALFONSO III, RESUELLO 6/15/05 M 42 1.6 16.4 Wasted STUNTED
3. BINAMIRA,LHEONELL, BULATAO 9/3/05 M 54 1.6 21.1 Normal NORMAL
4. CASTILLO,CRISBER, TAMAYO 12/10/03 M SEVERELY STUNTED
5. CASTILLO,JHENBER, TAMAYO 4/21/02 M
6. DACANAY,REYAN MIGUEL, QUILATES 08/15/04 M 61 1.71 20.9 Normal NORMAL
7. HESARZA,R.J. CHRISTIAN, VASQUEZ 7/30/04 M 57 1.63 21.5 Normal NORMAL
8. IDOS,JASPER KERVIN, PALAD 10/27/03 M 58 1.6 22.7 Normal STUNTED
9. MATA,JONATHAN, DELOS SANTOS 6/26/05 M SEVERELY STUNTED
10 . MEDINA,RICO, CANILANG 8/3/05 M 65 1.7 22.5 Normal NORMAL
11 . PASCUA,JANRHEY, AQUINO 1/6/04 M 53 1.59 21.0 Normal STUNTED
12 . QUILATES,MARK, MONA CRUZ 12/28/04 M 50 1.55 20.8 Normal STUNTED
13 . TOMAS,GERALD, DORADO 9/30/04 M SEVERELY STUNTED
14 . VASQUEZ,ALDRIX, HITEROZA 9/1/04 M 55 1.6 21.5 Normal STUNTED
15 . VASQUEZ,ROMMEL, CUIZON 2/16/04 M 50 1.64 18.6 Normal NORMAL
16 . VIRAY,AVELINO JR, FABIA 1/25/05 M 70 1.71 23.9 Normal NORMAL
17 . VIRAY,ENRICO, RAMIREZ 4/20/03 M 70 1.71 23.9 Normal
18 . IDOS, RAYMUND 12/31/03 M 49 1.57 19.9 Normal STUNTED

19 . ABOY,REGINE, SABINIANO 2/7/04 F 47 1.5 20.9 Normal NORMAL

20 . BARGO,ANGELINE, ABAGA 9/2/04 F SEVERELY STUNTED
21 . BAUTISTA,VENUS, DE VERA 6/18/04 F 45 1.49 20.3 Normal STUNTED
22 . BULATAO,SHANE, CAGUIOA 9/29/05 F 53 1.7 18.3 Normal NORMAL
23 . CANCINO,MARIA RISAH, BATAAN 4/24/05 F 58 1.58 23.2 Normal NORMAL
24 . CERVAS,APRIL ROSE, MALONG 4/11/05 F 50 1.57 20.3 Normal NORMAL
25 . DE VERA,KRISTEL, ABOY 12/30/04 F 50 1.47 23.1 Normal STUNTED
26 . DIAZ,ANDREA MAY, DACASIN 5/14/05 F 37 1.47 17.1 Normal STUNTED
27 . DIO,AILEEN JOY, DE VERA 7/9/05 F 55 1.65 20.2 Normal NORMAL
28 . FERRER,RICA, MATEO 2/7/03 F
29 . GALZOTE,ABEGAIL, VALDEZ 7/2/04 F 43 1.48 19.6 Normal STUNTED
30 . GALZOTE,JOANA, TAMONDONG 12/31/04 F 36 1.49 16.2 Wasted STUNTED
31 . MAMARIL,MAUREEN, PATUNGAN
SALINAS,CHRISTINE JANELLE,
8/11/05 F 42 1.46 19.7 Normal STUNTED
32 . 4/1/05 F 46 1.48 21.0 Normal STUNTED
BICERA
33 . SANCHEZ,SALVIE, - 1/26/04 F 40 1.5 17.8 Normal NORMAL
34 . SOLIS,JUDY, JOVES 3/13/04 F 48 1.51 21.1 Normal NORMAL
35 . UNTALAN,BARBIE, NAZARENO 9/20/05 F 50 1.52 21.6 Normal NORMAL
36 . VASQUEZ,LOVELY, FERNANDEZ 11/30/03 F SEVERELY STUNTED
 Department of Education
NUTRITIONAL STATUS RECORD
Name of School LOKEB NORTE NATIONAL HIGH SCHOOL School ID 300212 Region 1 2022
Grade Level 12 Section ICT District 1 2021
Date of Weighing August 30, 2022 S.Y 2022-2023 Division PANGASINAN I
###
BOYS 13 Percentage Class Percentage ###
Severely Wasted : 0 0% Severely Wasted 0% ###
Wasted : 1 8% Wasted 6% ###
Normal : 12 92% Normal 74% ###
Overweight : 0 0% Overweight 0% ###
Obese : 0 0% Obese 0% ###
GIRLS 18 Percentage ###
Severely Wasted : 0 0% ###
Wasted : 1 6% ###
Normal : 11 61% ###
Overweight : 0 0% ###
Obese : 0 0% ###
###
Prepared by: ###
###
PAULO A. BALDELOMAR, RN ###
SCHOOL HEALTH COORDINATOR ###
SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade Levels)

School Name LOKEB NORTE NATIONAL HIGH SCHOOL District 1 Division PANGASINAN I Region 1

School ID 300212 Grade 12 Section ICT Track/Strand (SHS) School Year 2022-2023

Learner's Name Nutritional Status

Birthdate Weight Height
No. LRN (Last Name, First Name, Name Age Height² (m²) BMI Height for Age (HFA) Remarks
(MM/DD/YYYY) (kg) (m) BMI Category
Extension, Middle Name) (kg/m²)
MALE
1 BARGO,BRYLE BARG'S, ABAGA 5/27/2002 20 0 0 0.00
2 BAUTISTA,ALFONSO III, RESUELLO 6/15/2005 17 42 1.6 2.56 16.41 Wasted Stunted
3 BINAMIRA,LHEONELL, BULATAO 9/3/2005 16 54 1.6 2.56 21.09 Normal Normal
4 CASTILLO,CRISBER, TAMAYO 12/10/2003 18 0 0 0.00 Severely Stunted
5 CASTILLO,JHENBER, TAMAYO 4/21/2002 20 0 0 0.00
DACANAY,REYAN MIGUEL,
6 8/15/2004 18 61 1.71 2.92 20.86 Normal Normal
QUILATES
HESARZA,R.J. CHRISTIAN,
7 7/30/2004 18 57 1.63 2.66 21.45 Normal Normal
VASQUEZ
8 IDOS,JASPER KERVIN, PALAD 10/27/2003 18 58 1.6 2.56 22.66 Normal Stunted
9 MATA,JONATHAN, DELOS SANTOS 6/26/2005 17 0 0 0.00 Severely Stunted
10 MEDINA,RICO, CANILANG 8/3/2005 17 65 1.7 2.89 22.49 Normal Normal
11 PASCUA,JANRHEY, AQUINO 1/6/2004 18 53 1.59 2.53 20.96 Normal Stunted
12 QUILATES,MARK, MONA CRUZ 12/28/2004 17 50 1.55 2.40 20.81 Normal Stunted
13 TOMAS,GERALD, DORADO 9/30/2004 17 0 0 0.00 Severely Stunted
14 VASQUEZ,ALDRIX, HITEROZA 9/1/2004 17 55 1.6 2.56 21.48 Normal Stunted
15 VASQUEZ,ROMMEL, CUIZON 2/16/2004 18 50 1.64 2.69 18.59 Normal Normal
16 VIRAY,AVELINO JR, FABIA 1/25/2005 17 70 1.71 2.92 23.94 Normal Normal
17 VIRAY,ENRICO, RAMIREZ 4/20/2003 19 70 1.71 2.92 23.94 Normal
18 IDOS, RAYMUND 12/31/2003 18 49 1.57 2.46 19.88 Normal Stunted
FEMALE
1 ABOY,REGINE, SABINIANO 2/7/2004 18 47 1.50 2.25 20.89 Normal Normal
4 BARGO,ANGELINE, ABAGA 9/2/2004 17 0 0.00 0.00 Severely Stunted
5 BAUTISTA,VENUS, DE VERA 6/18/2004 18 45 1.49 2.22 20.27 Normal Stunted
6 BULATAO,SHANE, CAGUIOA 9/29/2005 16 53 1.70 2.89 18.34 Normal Normal
7 CANCINO,MARIA RISAH, BATAAN 4/24/2005 17 58 1.58 2.50 23.23 Normal Normal
8 CERVAS,APRIL ROSE, MALONG 4/11/2005 17 50 1.57 2.46 20.28 Normal Normal
9 DE VERA,KRISTEL, ABOY 12/30/2004 17 50 1.47 2.16 23.14 Normal Stunted
10 DIAZ,ANDREA MAY, DACASIN 5/14/2005 17 37 1.47 2.16 17.12 Normal Stunted
11 DIO,AILEEN JOY, DE VERA 7/9/2005 17 55 1.65 2.72 20.20 Normal Normal
12 FERRER,RICA, MATEO 2/7/2003 19 0 0.00 0.00
13 GALZOTE,ABEGAIL, VALDEZ 7/2/2004 18 43 1.48 2.19 19.63 Normal Stunted
14 GALZOTE,JOANA, TAMONDONG 12/31/2004 17 36 1.49 2.22 16.22 Wasted Stunted
15 MAMARIL,MAUREEN, PATUNGAN 8/11/2005 17 42 1.46 2.13 19.70 Normal Stunted
SALINAS,CHRISTINE JANELLE,
16 4/1/2005 17 46 1.48 2.19 21.00 Normal Stunted
BICERA
17 SANCHEZ,SALVIE, - 12/30/1899 122 40 1.50 2.25 17.78 Normal Normal
18 SOLIS,JUDY, JOVES 12/30/1899 122 48 1.51 2.28 21.05 Normal Normal
19 UNTALAN,BARBIE, NAZARENO 12/30/1899 122 50 1.52 2.31 21.64 Normal Normal
20 VASQUEZ,LOVELY, FERNANDEZ 12/30/1899 122 0 0.00 0.00 Severely Stunted

SUMMARY TABLE
Nutritional Status Height for Age (HFA)
Summary Table Summary Table
SEX Severely
Severely Wasted Wasted Normal Overweight Obese TOTAL Stunted Normal Tall Total
Stunted
MALE 0 1 12 0 0 13 3 6 6 0 15
FEMALE 0 1 11 0 0 12 0 7 5 0 12
TOTAL 0 2 23 0 0 25 3 13 11 0 27

Date of Assessment: Conducted/Assessed By: Certified Correct By: Reviewed By:

08/30/2022 PAULO A. BALDELOMAR

SFRT 2017
 NUTRITIONAL STATUS (Baseline: [ ] Endline: [ ]) S.Y. : 2021 - 2022

SCHOOL :LOKEB NORTE NATIONAL HIGH SCHOOL DISTRICT: 1, GRADE LEVEL: 12

Age in Raw Ht. Div. Raw

NO. NAME OF PUPILS BIRTHDAY SEX Mos. Ht./cm. 100cm. Ht. in m2 Wt./kgs. BMI Nut. Status Ht.Status

1 . BARGO,BRYLE BARG'S, ABAGA 5/27/02 M 243 0 0 0 0

2 . BAUTISTA,ALFONSO III, RESUELLO 6/15/05 M 206 160 1.6 2.56 42 16.4 Wasted STUNTED

3 . BINAMIRA,LHEONELL, BULATAO 9/3/05 M 203 160 1.6 2.56 54 21.1 Normal NORMAL

4 . CASTILLO,CRISBER, TAMAYO 12/10/03 M 224 0 0 0 0 SEVERELY STUNTED

5 . CASTILLO,JHENBER, TAMAYO 4/21/02 M 244 0 0 0 0

DACANAY,REYAN MIGUEL,
6 . QUILATES 8/15/04 M 216 171 1.71 2.9241 61 20.9 Normal NORMAL
HESARZA,R.J. CHRISTIAN,
7 . VASQUEZ 7/30/04 M 217 163 1.63 2.6569 57 21.5 Normal NORMAL

8 . IDOS,JASPER KERVIN, PALAD 10/27/03 M 226 160 1.6 2.56 58 22.7 Normal STUNTED

9. MATA,JONATHAN, DELOS SANTOS 6/26/05 M 206 0 0 0 0 SEVERELY STUNTED

10 . MEDINA,RICO, CANILANG 8/3/05 M 204 170 1.7 2.89 65 22.5 Normal NORMAL

11 . PASCUA,JANRHEY, AQUINO 1/6/04 M 223 159 1.59 2.5281 53 21.0 Normal STUNTED

12 . QUILATES,MARK, MONA CRUZ 12/28/04 M 212 155 1.55 2.4025 50 20.8 Normal STUNTED

13 . TOMAS,GERALD, DORADO 9/30/04 M 215 0 0 0 0 SEVERELY STUNTED

14 . VASQUEZ,ALDRIX, HITEROZA 9/1/04 M 215 160 1.6 2.56 55 21.5 Normal STUNTED
15 . VASQUEZ,ROMMEL, CUIZON 2/16/04 M 222 164 1.64 2.6896 50 18.6 Normal NORMAL
16 . VIRAY,AVELINO JR, FABIA 1/25/05 M 211 171 1.71 2.9241 70 23.9 Normal NORMAL

17 . VIRAY,ENRICO, RAMIREZ 4/20/03 M 232 171 1.71 2.9241 70 23.9 Normal

18 . IDOS, RAYMUND 12/31/03 M 224 157 1.57 2.4649 49 19.9 Normal STUNTED
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19 . ABOY,REGINE, SABINIANO 2/7/04 F 222 150 1.5 2.25 47 20.9 Normal NORMAL

20 . BARGO,ANGELINE, ABAGA 9/2/04 F 215 0 0 0 0 SEVERELY STUNTED

21 . BAUTISTA,VENUS, DE VERA 6/18/04 F 218 149 1.49 2.2201 45 20.3 Normal STUNTED

22 BULATAO,SHANE, CAGUIOA 9/29/05 F 203 170 1.7 2.89 53 18.3 Normal NORMAL

23 CANCINO,MARIA RISAH, BATAAN 4/24/05 F 208 158 1.58 2.4964 58 23.2 Normal NORMAL

24 CERVAS,APRIL ROSE, MALONG 4/11/05 F 208 157 1.57 2.4649 50 20.3 Normal NORMAL

25 DE VERA,KRISTEL, ABOY 12/30/04 F 212 147 1.47 2.1609 50 23.1 Normal STUNTED

26 DIAZ,ANDREA MAY, DACASIN 5/14/05 F 207 147 1.47 2.1609 37 17.1 Normal STUNTED

27 DIO,AILEEN JOY, DE VERA 7/9/05 F 205 165 1.65 2.7225 55 20.2 Normal NORMAL

28 FERRER,RICA, MATEO 2/7/03 F 234 0 0 0 0

29 GALZOTE,ABEGAIL, VALDEZ 7/2/04 F 217 148 1.48 2.1904 43 19.6 Normal STUNTED

30 GALZOTE,JOANA, TAMONDONG 12/31/04 F 212 149 1.49 2.2201 36 16.2 Wasted STUNTED

31 MAMARIL,MAUREEN, PATUNGAN 8/11/05 F 204 146 1.46 2.1316 42 19.7 Normal STUNTED
SALINAS,CHRISTINE JANELLE,
32 BICERA 4/1/05 F 208 148 1.48 2.1904 46 21.0 Normal STUNTED

33 SANCHEZ,SALVIE, - 1/26/04 F 223 150 1.5 2.25 40 17.8 Normal NORMAL

34 SOLIS,JUDY, JOVES 3/13/04 F 221 151 1.51 2.2801 48 21.1 Normal NORMAL

35 UNTALAN,BARBIE, NAZARENO 9/20/05 F 203 152 1.52 2.3104 50 21.6 Normal NORMAL

36 VASQUEZ,LOVELY, FERNANDEZ 11/30/03 F 225 0 0 0 0 SEVERELY STUNTED

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NO. of Pupils: Prepared by:

Male: 13
Female 18 PAULO A. BALDELOMAR, RN
Total: 31 Adviser

BMI: Male Female

Severely Wasted 0 0
Wasted 1 1
Normal 12 11
Overweight 0 0
Obese 0 0
Total 13 12