SUPPLEMENTAL FEEDING PROGRAM

ATTENDANCE TO FEEDING SESSIONS NSFP/Brgy Form 1

For the Month of________________

Barangay: ____________________ Province: ______________

Municipality: __________________ Region: _______________

Name of Child FEEDING SESSIONS (Pls. Check if present) No of

Days REMARKS
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Present

Prepared by: Attested by: Noted by:

____________________________ ________________________ ________________________
Parents Committee In-Charge Child Development Worker MSWDO
Prepared by: Attested by:
____________________________ ________________________
Parents Committee In-Charge Child Development Worker
 DAILY FEEDING SESSIONS REPORT
Month of _______________________

DATE OF NO. OF PROBLEM

FEEDING CHILDREN MENU SERVED ENCOUNTERED ACTION TAKEN

_________________________________ ANDREA M. QUIRONA

____________________________
DAY CARE WORKER MSWDO
 SUPPLEMENTARY FEEDING PROGRAM
WEIGHT MONITORING FORM

Name of DCC ________________________________

Name of DCW _______________________________
Location _______________________________
NUTRITIONAL STATUS
MONTH AFTER MONTHS AFTER
NAME OF CHILDREN SEX DATE OF AGE HEIGHT WEIGHT DEWORMING NUTRITIONAL DATE OF AGE HEIGHT WEIGHT DEWORMING NUTRITIONAL DATE OF AGE HEIGHT WEIGHT DEWORMING NUTRITIONAL REMARKS
WEIGHING (in mos.) (in cm.) (in kilos) (1ST DOSE) STATUS WEIGHING (in mos.) (in cm.) (in kilos) (1ST DOSE) STATUS WEIGHING (in mos.) (in cm) (in kilos) (1ST DOSE) STATUS

This form shall be used every month by the DCW inrecording weight and height of the child to determine Inpowerment in the child's nutritional status.
DCW should indicate date or month and year when the child was dewormed and provide V-A.
Nutritional Status
SU-Severely Underweight
UW-Under Weight Prepared by: _______________________
N-Normal NAME/POSITION
OW-OverWeight
 MSWDO
FOOD FOR SCHOOL PROGRAM
RICE TRANSACTION RECORD

REGION: ________________________________________________
PROVINCE/MUNICIPALITY/CITY: _____________________________
DAY CARE CENTER: ________________________________________

DATE No. of No. of Kilograms (kg) Allocation Amount

Beneficiaries Consume (Rice) Recieve Total
No. of Days

3 pesos per child

1 kg for 10 children

Prepared by: Noted by:

____________________________ ANDREA M. QUIRONA

DAY CARE WORKER MSWDO