Republic of the Philippines

Region X
Province of Misamis Occidental
Municipality of Clarin
OFFICE OF THE CITY/MUNICIPAL SOCIAL WELFARE AND DEVELOPMENT

Supplementary Feeding Program

MASTERLIST OF DAYCARE CHILDREN
13th Cycle Implementation

Barangay: _____________________Center Type:CDC/SNP(kindly encircle)Center Name:_____________________________________ Name of CDW:______________________________

WITH SOLO DE- BIRTH DATE OF
EXT. BIRTH DATE 4Ps CWD IP VIT A NAME OF FAMILY HEAD (Last
# LAST NAME FIRST NAME MI SEX Household ID PARENTS WORMED FAMILY HEAD
Name (mm/dd/yyyy) (YES/NO) (YES/NO) (YES/NO) (YES/NO) Name, First Name)
(YES/NO) (YES/NO) (mm/dd/yyyy)
VILLA KRIZZEL ALEXA D. F NO NO NO NO YES YES
MAÑABO JOHN GABRIEL I. 01-04-2020 M

I hereby certify that the above information is true and correct:

Prepared by: ____________________________________Reviewedby: ___________________________________ Noted by: _________________________________ Attested by: _________________________________
Child Development Worker C/MSWD Staff – SFP Focal Person C/MSWDO DSWD X - SFP Nutritionist-Dietitian I