Republic of the Philippines

Department of Education
Region IV - A CALABARZON
Form 1 - Classroom Level

National School Deworming Month (NSDM) Round 1

March 2023

District: Morong
Name of School:TALAGA ELEMENTARY School ID: 109437
Enrolment: _______________________________ Grade /Section:

Dewormed Consented to Not Dewormed

Deworming
No. Name of Child Refused No consent Precautionary
4Ps Non - 4Ps (as indicated in
consent form) deworming form returned Measure
1 ABALOS,JHON NAZARETH, PEREZ
2 ALMAZAR,CHLARK JHADE, MALBOG
3 ALMERO,RUZEL JOHN, RAMILO
4 ALOJADO,MARK KIAN, MANIGSASA
5 ALON JR,ANDY, LEGASPI
6 AMAY,HAAMIAH KAIZER, CABALISA
7 AMONCIO,JHON DAVE, ANDILAO
8 AÑES,MARK ANDREW, DE LA PEÑA
9 ANGELO,JHARED ZYMON, FRAGENAL
10 AQUINO,JOHN MICHEAL, REPIA
11 BAHADE,GEO, BALUNDO
12 BALMES,LORENCE, DUKA
13 BARRAQUIO,ARON DRAKE, EMNAS
14 BASTATAS,JOHN EDRIAN, PATANGAN
15 BEJO,JHUN REIM, BATAC
16 BELARDO,MARK, GULA
17 BELISTA,JOHN KYLE, ABASOLA
18 BERDON,DANIEL JHON, BUENA-AGNA
19 BETITO,MARKY AKIHIRO YHAEL, MARIKIT
20 BOOC,ZAIRENZ JONG, LAHOY-LAHOY
21 GAMBALA,CARL KENZO, -
22 HECIDO,JOHN MARK, -
23 REYES,ELRAE IñIGO, CARBON
24 SOLANO,PRINCE CHESTER, MAGTERA
25 ALDEA,PRINCESS ANIKA, ESPEJON
26 ALPAHANDO,ATHEA, CARDILLO
27 AMOGUIS,JOVELYN, GOLO
28 ANDA-AS,JUDY ANN, LUTAWAN
29 ANDAYA,FRANCHESKA DIVINA, LONGKOP
30 ARADO,ANGHIE, COLIGADO
31 ARBAN,JHOANA MARIE, DEDAL
32 AREVALO,ALLERIA, PECASO
33 ARNILLA,ALJEAH GWEEN, BUOT
34 ARQUIO,RYZZA MAE, SEVERINO
35 ASINAS,FARRAH MARGAUX, -
36 BALABA,ALLIANNA FAITH, RABUSA
37 BANTASAN,CLAIRE VALEEN, FAJANIL
38 BARCENILLA,MICHAELLA, DOMANAIS
39 BASADRE,JENEL JANG, ONDOG
40 BASTES,NESTLYN GREIGHN, STO. DOMINGO
41 BATOTO,CASSANDRA, DEL MUNDO
42 GAMBALA,GEORGEENA KAYLIE, -
43 HECIDO,YHUMI, MARCELINO
44
45
46
47
48
50
51
52
53
54
55
56
57
58
59
60
TOTAL
Accomplished by: N O T E D:

Class Adviser JETTY CYREM P. AREVALO

Date Accomplished: ___________ School Deworming Coordinator
IV-Rizal

Adverse Event
M P. AREVALO
ming Coordinator
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
DIVISION OF RIZAL
Form 2 - School Level (Elementary)
National School Deworming Month (NSDM) Round __
JULY 2018
Month Year
District / Name of School:__ Tayuman Elementary School
No. of Children Dewormed No. of Children NOT Dewormed
Consented to Precautionary measure % Dewormed
Refused No Adverse event
Deworming (as (Seriously ill, with abdominal pain, (total
Grade Enrolment
indicated in
Deworming (as consent reported (yes
dewormed /
TOTAL 4Ps indicated in diarrhea, has previous sensitivity with or no)
4Ps Non-4Ps consent form) form enrollment)
& Non-4Ps consent form) deworming drug
returned
"Annex B" MDAP Guide #1 page 14

Grand Total
Accomplished by: N O T E D:
MARIE JEANNE C. AYSON CARMINA AMOR D. PORTUGUEZ MRS. FE A. ANO
Deworming Coordinator School Nurse School Head
Date Accomplished: __________________
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
DIVISION OF RIZAL
Form 2 - School Level (Elementary)
National School Deworming Month (NSDM) Round _1_
JULY 2018
Month Year
District / Name of School:__ Tayuman Elementary School
No. of Children Dewormed No. of Children NOT Dewormed
Consented to Precautionary measure
Refused Adverse event % Dewormed
Deworming (as No consent (Seriously ill, with abdominal pain,
Grade Enrolment indicated in Deworming reported (yes (total dewormed /
TOTAL 4Ps (as form diarrhea, has previous sensitivity with or no) enrollment)
4Ps Non-4Ps consent form) returned deworming drug
& Non-4Ps indicated in
consent "Annex B" MDAP Guide #1 page 14
Kindergarten 410 32 187 219 219 191 53.41
Grade 1 464 47 198 245 245 219 52.80
Grade 2 290 25 128 153 153 137 52.76
Grade 3 463 56 169 225 225 238 48.60
Grade 4 480 42 214 256 256 224 53.33
Grade 5 554 62 270 332 332 222 59.93
Grade 6 459 80 174 254 254 205 55.34
TOTAL
(1-6) 3120 344 1340 1684 1684 1436 53.97

SPED 72 3 22 25 25 47 34.72
Grand
Total
3192 347 1362 1709 1709 1483 53.54

Accomplished by: N O T E D:
MARIE JEANNE C. AYSON CARMINA AMOR D. PORTUGUEZ MRS. FE A. AÑO
Deworming Coordinator School Nurse School Head
Date Accomplished: July 26, 2018

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
DIVISION OF RIZAL
Form 2 - School Level (Secondary)
National School Deworming Month (NSDM) Round __
_____________ _______
Month Year
District / Name of School:_____________________________________________________________

No. of Children Dewormed No. of Children NOT Dewormed

Consented to
Refused Precautionary measure ( Seriously ill, Adverse event % Dewormed
Deworming (as
Grade Enrolment TOTAL 4Ps deworming No consent with abdominal pain, diarrhea, has reported (yes (total dewormed /
4Ps Non-4Ps indicated in form
& Non-4Ps (as previous sensitivity with deworming or no) enrollment)
consent form) returned
indicated in drug)
the consent
Grade 7 0 0 0 #DIV/0!
Grade 8 0 0 0 #DIV/0!
Grade 9 0 0 0 #DIV/0!
Grade 10 0 0 0 #DIV/0!
TOTAL
(7-10) 0 0 0 0 0 0 #DIV/0!
Grade 11 0 0 0 #DIV/0!
Grade 12 0 0 0 #DIV/0!
TOTAL
(11-12) 0 0 0 0 0 0 #DIV/0!
SPED 0 0 0 #DIV/0!
ALS 149 4 105 109 109 40 73.154362416107
Grand
Total
149 4 105 109 109 40 0.7315436241611
Accomplished by: N O T E D:

MRS. ERLINDA M. NAMOCO CARMINA AMOR D. PORTUGUEZ MRS. FE A. ANO

Deworming Coordinator School Nurse School Head
Date Accomplished: __ ###
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
DIVISION OF RIZAL
Form 2 - School Level (Elementary)
National School Deworming Month (NSDM) Round _1_
JANUARY 2019
Month Year
District / Name of School: Tayuman Elementary School
No. of Children Dewormed No. of Children NOT Dewormed
Consented to Precautionary measure
Refused Adverse event % Dewormed
Deworming (as No consent (Seriously ill, with abdominal pain,
Grade Enrolment indicated in Deworming reported (yes (total dewormed /
TOTAL 4Ps (as form diarrhea, has previous sensitivity or no) enrollment)
4Ps Non-4Ps consent form) returned with deworming drug
& Non-4Ps indicated in
consent "Annex B" MDAP Guide #1 page 14
Kindergarten 463 1 235 236 236 227 0 None No 50.97
Grade 1 458 5 248 253 253 205 0 None No 55.24
Grade 2 302 0 162 162 162 140 0 None No 53.64
Grade 3 462 29 231 260 260 202 0 None No 56.28
Grade 4 477 35 229 264 264 213 0 None No 55.35
Grade 5 548 54 294 348 348 200 0 None No 63.50
Grade 6 439 65 202 267 267 172 0 None No 60.82
TOTAL
(1-6) 3149 189 1601 1790 1790 1359 0 None No 56.84

SPED 78 5 24 29 29 49 0 None No 37.18

Grand
Total
3227 194 1625 1819 1819 1408 0 None No 56.37

Accomplished by: N O T E D:
MARIE JEANNE C. AYSON CARMINA AMOR D. PORTUGUEZ MRS. FE A. AÑO
Deworming Coordinator School Nurse School Head
Date Accomplished: January 28,2019

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
DIVISION OF RIZAL
Form 2 - School Level (Secondary)
National School Deworming Month (NSDM) Round __
_____________ _______
Month Year
District / Name of School:_____________________________________________________________

No. of Children Dewormed No. of Children NOT Dewormed

Consented to
Refused Precautionary measure ( Seriously ill, Adverse event % Dewormed
Deworming (as
Grade Enrolment TOTAL 4Ps deworming No consent with abdominal pain, diarrhea, has reported (yes (total dewormed /
4Ps Non-4Ps indicated in form
& Non-4Ps (as previous sensitivity with deworming or no) enrollment)
consent form) returned
indicated in drug)
the consent
Grade 7 77 5 24 29 29 48 37.6623376623377
Grade 8 0 0 0 #DIV/0!
Grade 9 0 0 0 #DIV/0!
Grade 10 0 0 0 #DIV/0!
TOTAL
(7-10) 77 5 24 29 29 48 37.662337662338
Grade 11 0 0 0 #DIV/0!
Grade 12 0 0 0 #DIV/0!
TOTAL
(11-12) 0 0 0 0 0 0 #DIV/0!
SPED 0 0 0 #DIV/0!
ALS 149 4 105 109 109 40 73.154362416107
Grand
Total
226 9 129 138 138 88 0.6106194690265
Accomplished by: N O T E D:

MRS. ERLINDA M. NAMOCO CARMINA AMOR D. PORTUGUEZ MRS. FE A. ANO

Deworming Coordinator School Nurse School Head
Date Accomplished: ___ ###