SBFP Form 1 (2021)

Department of Education
Region IV MIMAROPA

Master List Beneficiaries for School-Based Feeding Program (SBFP) (SY 2023-2024)

Division/Province: ORIENTAL MINDORO Name of Principal : JAMES MARLON D. RONQUILLO

City/ Municipality/Barangay : PUERTO GALERA Name of Feeding Focal Person : ROXANE D. CALDERON
Name of School / School District : PAGTURIAN MANGYAN SCHOOL
School ID Number: 110617

Nutritional Parent's
BMI for Beneficiary of
Date of Weighing / Age in Weight Height Dewormed? consent for Participation
No. Name Sex Grade/ Date of Birth
Measuring Years /
6 y.o. Status (NS) milk? in 4Ps
SBFP in
Section (MM/DD/YYYY) (MM/DD/YYYY) Months (Kg) (cm) and
(yes or no) (yes or (yes or no)
Previous Years
above (yes or no)
no)
BMI-A HFA
Kinder/
1 GABRIEL GARCIA M
Masigla
15-Apr-18 9/1/2023 64 15 0.97 Normal Severel YES YES NO NO
Kinder/
2 JABES LINOMBAY M
Masigla
22-Sep-18 9/1/2023 59 14 1.08 Normal Normal YES YES NO NO
Kinder/
3 ERWIN MINERVA M
Masigla
30-Sep-18 9/1/2023 59 14 0.97 Normal Stunted YES YES NO NO
Kinder/
4 JONEL MINERVA M
Masigla
28-Mar-18 9/1/2023 65 19 1.06 Normal Normal YES YES NO NO
Kinder/
5 JOVIN MINERVA M
Masigla
31-Mar-18 9/1/2023 65 14 0.95 Wasted Severel YES YES NO NO
Kinder/
6 MARK ANDREI MINERVA M
Masigla
4-Jan-18 9/1/2023 67 16 1 Normal Stunted YES YES NO NO
Kinder/
7 RENIEL MINERVA M
Masigla
4-Jul-17 9/1/2023 6.1 12 0.95 13.20 Normal Severel YES YES NO NO
Kinder/
8 MARWIN SINDURAAN M
Masigla
5-Feb-18 9/1/2023 66 15 1.09 Normal Normal YES YES NO NO
Kinder/
9 ENJANE AYAG F
Masigla
24-Mar-18 9/1/2023 65 13 1.03 Wasted Normal YES YES NO NO
Kinder/
10 KRIS MINERVA F
Masigla
25-Jul-16 9/1/2023 6.1 15 1.05 13.60 Normal Stunted YES YES NO NO
Kinder/
11 ROSELYN MINERVA F
Masigla
9-Mar-18 9/1/2023 65 16 0.96 Normal Severel YES YES NO NO
Kinder/
12 ARLENE JOY SINDURAAN F
Masigla
21-Jan-18 9/1/2023 67 18 1.11 Normal Normal YES YES NO NO
Kinder/
13 ROSEL TACULOY F
Masigla
27-Dec-16 9/1/2023 6.8 19 1.12 15.10 Normal Normal YES YES NO NO
Kinder/
14 BELLA TAUGAN F
Masigla
23-May-18 9/1/2023 63 13 0.95 Wasted Severel YES YES NO NO
Kinder/
15 ABEGAIL TAUGAN F
Masigla
31-Aug-18 9/1/2023 60 15 0.98 Normal Stunted YES YES NO NO
Kinder/
16 APRILYN TAUGAN F
Masigla
12-Apr-17 9/1/2023 6.4 15 1.12 11.90 Wasted Normal YES YES NO NO
Kinder/
17 KYLINE DULASAN F
Masigla
30-Sep-18 9/1/2023 59 15 1.03 Normal Normal YES YES NO NO
Kinder/
18 EDWARD MINERVA M
Masigla
30-Sep-18 9/1/2023 59 15 0.97 Normal Stunted YES YES NO NO
Kinder/
19 EUNICE SINDURAAN F
Masigla
17-Apr-18 9/1/2023 64 17 0.98 Normal Stunted YES YES NO NO
Grade
20 IVAN ARANZADO M
1/Masigla
10-Jun-17 9/1/2023 6.2 11 0.95 12.10
Severely Wasted
Severely Stunted YES YES YES YES
 Grade
21 JORDAN LICDAWAN M
1/Masigla
14-May-16 9/1/2023 7.3 18 1.09 15.10 Normal Stunted YES YES YES YES
Grade
22 AIZA ARANZADO F
1/Masigla
10-Apr-17 9/1/2023 6.4 15 1.04 13.80 Normal Stunted YES YES YES YES
Grade
23 EMELYN DIZON F
1/Masigla
19-Feb-15 9/1/2023 8.6 17 1.11 13.70 Normal
Severely Stunted YES YES YES YES
Grade
24 NOEMI DIZON F
1/Masigla
27-Jul-16 9/1/2023 7.1 19 1.07 16.50 Normal Stunted YES YES YES YES
Grade
25 MILET EVANGELISTA F
1/Masigla
14-Dec-16 9/1/2023 6.8 12 0.96 13.00 Normal
Severely Stunted YES YES YES YES
Grade
26 NANA KIM LICDAWAN F
1/Masigla
25-Oct-17 9/1/2023 70 20 1.19 Normal Normal YES YES YES YES
Grade
27 AIDA SINDURAAN F
1/Masigla
11-Sep-17 9/1/2023 71 17 1.12 Normal Normal YES YES YES YES
Grade
28 MARY SINDURAAN F
1/Masigla
5-Nov-16 9/1/2023 6.9 20 1.16 14.80 Normal Normal YES YES YES YES
Grade
29 ARJAY DULASAN M
1/Masigla
28-Oct-16 9/1/2023 6.1 17 1.22 11.40
Severely Wasted
Normal YES YES YES YES
Grade
30 CELYNE COCO F
1/Masigla
24-Oct-17 9/1/2023 70 23 1.11 Normal Normal YES YES YES YES
Grade
31 GIRLIE V. AXALAN F 2/Magala 1/2/2016 9/1/2023 7.7 15 1.16 11.10
Severely Wasted
Normal YES YES YES YES
ng
Grade
32 AQUILINA CABILOGAN F 2/Magala 2/7/2016 9/1/2023 7.6 16 1.25 10.20
Severely Wasted
Normal YES YES YES YES
ng
Grade
33 MARIFE D. DIZON F 2/Magala 12/23/2014 9/1/2023 8.8 23 1.25 14.70 Normal Normal YES YES YES YES
ng
Grade
34 DIVINA S. GARCIA F 2/Magala 4/19/2013 9/1/2023 10.4 30 1.36 16.20 Normal Normal YES YES YES YES
ng
Grade
35 LAIRA MAE M. GARCIA F 2/Magala 1/12/2016 9/1/2023 7.7 16 1.07 13.90 Normal
Severely Stunted YES YES YES YES
ng
Grade
36 JULIET T. MANALO F 2/Magala 1/9/2016 9/1/2023 7.7 20 1.18 14.30 Normal Normal YES YES YES YES
ng
Grade
37 KRISTINE JOY M. MINERVA F 2/Magala 25-Sep-14 9/1/2023 8.11 19 1.14 14.60 Normal Stunted YES YES YES YES
ng
Grade
38 JIMBOY AXALAN M 2/Magala 5-Mar-15 9/1/2023 8.5 21 1.2 14.50 Normal Normal YES YES YES YES
ng
Grade
39 MELMAR T. SINDURAAN M 2/Magala 7/16/2016 9/1/2023 7.1 14.2 1.05 12.80 Wasted
Severely Stunted YES YES YES YES
ng
Grade
40 MARVIN A. MINERVA M 3/Magala 30-Dec-13 9/1/2023 9.8 19 1.18 13.60 Normal Stunted YES YES YES YES
ng
Grade
41 HENRY I. PAMPILO M 3/Magala 9-Dec-14 9/1/2023 8.8 20 1.17 14.60 Normal Stunted YES YES YES YES
ng
Grade
42 XANDER A. TAUGAN M 3/Magala 10-Jul-15 9/1/2023 8.1 16 1.125 12.60 Wasted Stunted YES YES YES YES
ng
Grade
43 GEMMA T. LICDAWAN F 3/Magala 9-Apr-13 9/1/2023 10.4 20 1.145 15.20 Normal
Severely StuntedYES YES YES YES
ng
Grade
44 MARIBEL A. MINERVA F 3/Magala 29-Oct-14 9/1/2023 8.1 22 1.235 14.40 Normal Normal YES YES YES YES
ng
Grade
45 MONICA D. SINDURAAN F 3/Magala 8-Aug-14 9/1/2023 9 24 1.21 16.30 Normal Normal YES YES YES YES
ng
Grade
46 EMILYN A. TAUGAN F 3/Magala 8-Apr-15 9/1/2023 8.4 18 1.145 13.70 Normal Stunted YES YES YES YES
ng
Grade
Severely
47 MANALO, KRIZIA A. F 3/Magala 9-May-14 9/1/2023 9.3 21 1.39 10.80
Wasted Normal
YES YES YES YES
ng
Grade
48 GINO C. LICDAWAN M 4/Mapag 5/14/2011 9/1/2023 12.3 32 1.49 14.40 Wasted Normal YES YES YES YES
mahal
Grade
49 LILIBETH D. DIZON F 4/Mapag 12/13/2012 9/1/2023 10.8 25 1.26 15.70 Normal Stunted YES YES YES YES
mahal
Grade
50 ANDREA A. DULASAN F 4/Mapag 5/21/2014 9/1/2023 9.3 25 1.3 14.70 Normal Normal YES YES YES YES
mahal
Grade
51 JULIE D. SINDURAAN F 4/Mapag 6/9/2014 9/1/2023 9.2 33 1.35 18.10 Normal Normal YES YES YES YES
mahal
 Grade
52 RIZALY HINALMAN F 5/Mapag 27-Jul-14 9/1/2023 9.1 28 1.26 17.60 Normal Normal YES YES YES YES
mahal
Grade
53 ABEL E. AYAG M 5/Mapag 9-Apr-13 9/1/2023 10.4 21 1.17 15.30 Normal
Severely StuntedYES YES YES YES
mahal
Grade
54 IKING I. ARANSADO M 5/Mapag 25-Nov-12 9/1/2023 10.9 25 1.23 16.50 Normal Stunted YES YES YES YES
mahal
Grade
55 JOVIT M. MENIRVA M 5/Mapag 4-Aug-12 9/1/2023 11 25 1.2 17.30 Normal
Severely StuntedYES YES YES YES
mahal
Grade
56 CHRISTINE A. MINERVA F 5/Mapag 19-Nov-13 9/1/2023 9.9 21 1.2 14.50 Normal Stunted YES YES YES YES
mahal
Grade
57 MYRINE A. SINDURAAN F 5/Mapag 5-May-13 9/1/2023 10.3 24 1.22 16.10 Normal Stunted YES YES YES YES
mahal
Grade
58 BOY MANALO M 5/Mapag 22-Feb-12 9/1/2023 11.6 21 1.24 13.60 Wasted
Severely StuntedYES YES YES YES
mahal
Grade
58 GINO COCO M 5/Mapag 10-Jul-11 9/1/2023 12.1 28 1.27 17.30 Normal
Severely StuntedYES YES YES YES
Grade
mahal
6/Mapag
60 GLEN MARK A. HINALMAN M mahal 28-Feb-12 9/1/2023 11.6 25 1.33 14.10 Wasted Normal YES YES YES YES
Grade
6/Mapag
61 GLEN MART A. HINALMAN M mahal 28-Feb-12 9/1/2023 11.6 27 1.35 14.80 Normal Normal YES YES YES YES
Grade
6/Mapag
62 PAUL MARK A. HINALMAN M mahal 3-Mar-11 9/1/2023 12.5 29 1.37 15.40 Normal Stunted YES YES YES YES
Grade
6/Mapag
63 WILSON H. MINERVA M mahal 29-Mar-11 9/1/2023 12.5 31 1.42 15.30 Normal Normal YES YES YES YES
Grade
6/Mapag
64 BOY A. MANALO M mahal 22-Feb-12 9/1/2023 11.6 27 1.35 14.80 Normal Normal YES YES YES YES
Grade
6/Mapag
65 ESMAEL A. TAUGAN M mahal 22-Feb-11 9/1/2023 12.6 28 1.31 16.30 Normal Stunted YES YES YES YES
Grade
6/Mapag
66 JOCELYN M. ANANGI F mahal 9-Jun-11 9/1/2023 12.2 28 1.38 14.70 Normal Stunted YES YES YES YES
Grade
6/Mapag
67 MARITES M. ANANGI F mahal 22-Sep-09 9/1/2023 13.11 25 1.35 13.70 Wasted StuntedYES
SeverelySeverely YES YES YES
Grade
6/Mapag
68 LARA MAE M. GARCIA F mahal 8-Nov-11 9/1/2023 11.9 24 1.39 12.40 Normal
Severely Wasted YES YES YES YES
Grade
6/Mapag
69 LANIE D. DULASAN F mahal 7-May-11 9/1/2023 12.3 35 1.46 16.40 Normal Normal YES YES YES YES
Grade
6/Mapag
70 MARILOU A. HINALMAN F mahal 15-Jun-09 9/1/2023 14.2 30 1.43 14.60 Wasted Stunted YES YES YES YES
Grade
6/Mapag
71 LENLEN A. LIKDAWAN F mahal 7-Dec-11 9/1/2023 11.8 34 1.38 17.80 Normal Normal YES YES YES YES
Grade
6/Mapag
72 RUBILYN E. MINERVA F mahal 30-Nov-11 9/1/2023 11.9 30 1.32 17.20 Normal Stunted YES YES YES YES
Approved by:

JAMES MARLON D. RONQUILLO

School Head

ROXANE D. CALDERON
Feeding Focal Person

Note: This form shall be prepared by the school before the start of feeding to be compiled by the SDO.
Keep columns 6-12 blank if nutritional assesment is still suspended.
SBFP Form 2 (2021)
Department of Education
Region IV MIMAROPA

SCHOOL-BASED FEEDING PROGRAM (SBFP) SUMMARY OF BENEFICIARIES & START OF FEEDING (SY 2023-2024)
Division/Province: ORIENTAL MINDORO
City/ Municipality/Barangay : PUERTO GALERA
Name of School / School District : PAGTURIAN MANGYAN SCHOOL
School ID Number: 110617
Date of Start of Feeding:
Last Mile School: / Y ___N
Nutritional Status at Start/End of Feeding No. of Secondary Targets No. of 4 No. of 4 Ps No. of Pupils
Learners Beneficiaries who are
SW W N OW+O SS S N T No. of Pupils- No. of No. of No. of Dewormed beneficiaries
Number of Undernourished School at-risk-of- Stunted/ Indigent Indigenous in previous
Children by Grade Level dropping-out Severely Learners Peoples (IPs) years
(PARDOs) (Repeaters)
Stunted

0 4 0 0 5 6 8 0 0 0 0 15 19 0 0
1. Kinder

0 2 0 0 3 3 5 0 0 0 0 9 11 9 11
2. Grade I

1 1 0 0 2 2 5 0 0 0 0 7 9 6 9
3. Grade II

1 1 0 0 1 4 3 0 0 0 0 6 8 8 8
4. Grade III

0 1 0 0 0 1 4 0 0 0 0 4 5 5 5
5. Grade IV

0 1 0 0 4 3 0 0 0 0 0 6 7 7 7
6. Grade V

2 2 0 0 2 4 7 0 0 0 0 9 13 9 13
7. Grade VI

Total 4 12 0 0 17 23 32 0 0 0 0 56 72 44 53

Prepared by: Approved by:

ROXANE D. CALDERON JAMES MARLON D. RONQUILLO

SBFP DepEd Focal School Head

Note: This form shall be prepared by the school before the start of feeding and after feeding, to be compiled by the SDO, and for final compilation by the RO, for submission to DepEd BLSS-SHD
 Date Feeding
Started/Ended

DepEd BLSS-SHD
 SBFP Form 3 (2021)
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF SEPTEMBER AND OCOBER , SY 2022

Region IV MIMAROPA
Division ORIENTAL MINDORO School: PAGTURIAN MANGYAN SCHOOL
District PUERTO GALERA Grade: __________ Section _____________________
School ID Number: 110617
NAME OF PUPIL ACTUAL FEEDING

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 GABRIEL GARCIA
2 JABES LINOMBAY
3 ERWIN MINERVA
4 JONEL MINERVA
5 JOVIN MINERVA
6 MARK ANDREI MINERVA
7 RENIEL MINERVA
8 MARWIN SINDURAAN
9 ENJANE AYAG
10 KRIS MINERVA
11 ROSELYN MINERVA
12 ARLENE JOY SINDURAAN
13 ROSEL TACULOY
14 BELLA TAUGAN
15 ABEGAIL TAUGAN
16 APRILYN TAUGAN
17 KYLINE DULASAN
18 EDWARD MINERVA
19 EUNICE SINDURAAN
20 IVAN ARANZADO
21 JORDAN LICDAWAN
22 AIZA ARANZADO
23 EMELYN DIZON
24 NOEMI DIZON
25 MILET EVANGELISTA
26 NANA KIM LICDAWAN
27 AIDA SINDURAAN
28 MARY SINDURAAN
29 ARJAY DULASAN
30 CELYNE COCO
31 GIRLIE V. AXALAN

Page 6
32 AQUILINA CABILOGAN
33 MARIFE D. DIZON
34 DIVINA S. GARCIA
35 LAIRA MAE M. GARCIA
36 JULIET T. MANALO
37 KRISTINE JOY M. MINERVA
38 JIMBOY AXALAN
39 MELMAR T. SINDURAAN
40 MARVIN A. MINERVA
41 HENRY I. PAMPILO
42 XANDER A. TAUGAN
43 GEMMA T. LICDAWAN
44 MARIBEL A. MINERVA
45 MONICA D. SINDURAAN
46 EMILYN A. TAUGAN
47 MANALO, KRIZIA A.
48 GINO C. LICDAWAN
49 LILIBETH D. DIZON
50 ANDREA A. DULASAN
51 JULIE D. SINDURAAN
52 RIZALY HINALMAN
53 ABEL E. AYAG
54 IKING I. ARANSADO
55 JOVIT M. MENIRVA
56 CHRISTINE A. MINERVA
57 MYRINE A. SINDURAAN
58 BOY MANALO
59 GINO COCO
60 GLEN MARK A. HINALMAN
61 GLEN MART A. HINALMAN
62 PAUL MARK A. HINALMAN
63 WILSON H. MINERVA
64 BOY A. MANALO
65 ESMAEL A. TAUGAN
66 JOCELYN M. ANANGI
67 MARITES M. ANANGI
68 LARA MAE M. GARCIA
69 LANIE D. DULASAN
70 MARILOU A. HINALMAN
71 LENLEN A. LIKDAWAN
72 RUBILYN E. MINERVA
73
TOTAL:

Page 7
 Prepared by:

ROXANE D. CALDERON
Feeding Teacher / School Nurse
Approved by:
JAMES MARLON D. RONQUILLO
School Head
B. Deworming D. Actual Feeding
( x ) - not dewormed (H ) - Present, served with Hot meals
( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice

Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.

Page 8
 SBFP Form 3 (2021)

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF OCOBER AND NOVEMBER, SY 2022-2023

Region IV MIMAROPA
Division ORIENTAL MINDORO School: PAGTURIAN MANGYAN SCHOOL
District PUERTO GALERA Grade: __________ Section _____________________
School ID Number: 110617

ACTUAL FEEDING

NAME OF PUPIL

21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
1 Aranzado, Ivan M. H H H H H A A A A A M M M M M A M M M M M M M M M M
2 Licdawan, Jordan T. H H H H H H H A H H M M M A A A M M M M M M M M M M
3 Aranzado, Aiza H A A A H H H A H H M M M M M M M M M M M M M M M M
4 Dizon, Emelyn D. H H A H H H H A H H M M M M M M M M M M M M A A A A
5 Dizon, Noemi D. H H H H H H H H H H M M M M M M M M M M M M M M M M
6 Evangelista, Milet M. H H H H H H H H H H M M M M M M M M M M M M M M M A
7 Licdawan, Nana Kim C. H H H H H H H H H H M M M A M M M M M M M M M M M M
8 Sinduraan, Aida D. H H H H H A H H H H M M M A M M M M M M M M M A M M
9 Sinduraan, Balbena K. H H H H H H H H H H M M M M M M M M M M M M M M M M
10 Sinduraan, Jessebel I. H H H H H H H H H H M M M M M M M M M M M M M M M M
11 Sinduraan, Mary D. H H H H H H H H H A M M M M M M M M M M M M M M M M
12 Aranzado, Marwin D. H A A H H H H H H A A A M M M M M M M M M M M M M M
13 Garcia, Elgar A. H H H H H H H H H H M M M M M M M M M M M M M M M M
14 Sinduraan, Melmar H H H H H H H H H H M M M M M A M M M M M M M A M M
15 Aranzado, Aiza H H H H H H H H H H M M M M A A M M M M M A A A M M
16 Cabilogan, Aquilina H H H H H H H H H H M M M M A A M M M M M M M A M M
17 Dulasan, Ronalyn H H H H H H H H H H M M M M M M M M M M M M A A A A
18 Garcia, Laira Mae H H H H H H H H H H M M M M M M M M M M M M M M M M
19 Garcia, Rose Ann H H H H H H H H H H M M M M M M M M M A A M M M M M
20 Garcia, Tintin A. H H H H H H H H H H M M M M A A M M M M M M M M M M
21 Garcia, Divina H H H H H H H H H H M M A A A M M M M M M M M M M M
22 Manalo, Juliet H H H H H H H H H H M M A A A A M M M M M M M M M M
23 Minerva, Kristine Joy H H A A H H H H H H M M M M M M M M M M M M M M M M
24 Taugan, Emily A. H H H A H H H H H H M M M M M M M M M M M M M M M M
25 Axalan, Girlie A. H H H H H H H H H H M M M M M M M M M A A A M M M A
26 Anangi, Marvin M. H H H H H H H H H H M M M M M M M M M M M M M M M A
27 Sinduraan, Jemmar I. H H H H H H H H H H M M M M M M M M M M M M M M M M
28 Licdawan, Gemma T. H H H H H H H H H H M M M M M M M M M M M M M M M M
29 Taugan, Xander H H H H A A A H H H M M M M M M M M M M M M M M M M
30 Sinduraan, Monica D. H H H H H H H H H H M M M M M M M M M M M M M M M M

page 2
31 Taugan, Emilyn A. H H H H H H H H H H M M M M M M M M M M M M M M M M
32 Pacheco, Carltheouz H H H H H H H H H H M M M M M M M M M M M M M M M M
33 Pampilo, Henry I. H H H H H H H H H H M M M M M M M M M M M M M M M M
34 Likdawan, Gino C. H H H H H H H H H H M M M M M M M M M M M M M M M M
35 Dizon, Lilibeth H H H H H H H H H H M M M M M M M M M M M M M M M M
36 Manalo, Krizia A. H H H H A H H H H H M M M M M M M M M A M M M M M M
37 Arasado, Iking I. H H H H H H H H H H M M M M M M M M M M M M M M M M
38 Ayag, Abel E. H H H H H H H H H H M M M M M M M M M M M M M M M M
39 Menirva, Jovit M. H H H H H H H H H H M M M M M M M M M M M M M M M M
40 Manalo, Amy M. H H H H H H H H H H M M M M M A A M M M M M M M M M
41 Minerva Christine A. H H H H H H H H H H M M M M M M M M M M M M M M M M
42 Sinduraan, Myrine A. H H H H H H H H H H M M M M M M M M M M M M M M M M
43 Sinduraan, Marible I. H H A H H H H H H H M M M M M M M M M M M M M M M M
44 Coco, Edwin L. H H H H H H H H H H M M M M M M M M M M M M M M M M
45 Hinalman, Glen Mark A. H H H H H H H H H H M M M M M M M M M M M M M M M M
46 Hinalman, Glen Mart A. H H H H H A H H H H M M M M M M M M M M A A A M M M
47 Hinalman, Paul Mark A. H H H H H H H H H H M M M M M M M M A A M A A M M M
48 Manalo, Boy A. H H H H H H H H H H M M M M M M M M A A M M M M M M
49 Minerva, Wilson H. H A H H H H H H H H M M M M M M M M M M M M M M M M
50 Taugan, Esmael A. H H H H H H H H H H M M M M M M M M M M M M M M M M
51 Anangi, Jocelyn M. H H H H H H H H H H A A A A M M M M M M M M M M M M
52 Dulasan, Judy V. H H H H H H H H H H M M A A A A M M M M M M M M M M
53 Dulasan, Lanie D. H H H H H H H H H H M M M M A M M M M M M M M M M M
54 Garcia, Lara Mae M. A H H H H H H H H H M M M M A M M M M M M M M M M M
55 Hinalman, Marilou A. H H H H H H H H H H M M M M M M M M M A M M M M M M
56 Minerva, Rubilyn E. H H H H H A H H H H M M A M M M M M M A M M M M M M
57 Minerva, Rosalinda H. H A H H H H H H H H M M M M M M M M M M M M M M M M
58 Sinduraan, May T. H H H H H H H H H H M M M M A M M M M M M M M M M M
59 Sinduraan, Jessa T. H H H H H H H H H H M M M M A A A A A M M M M M M M
60 Ayag, Billy Boy Evangelista H H H H H H H H H H A M M M A M M M A M M M M M M M
61 Ayag, Daniel E. H H H H H A A A H H A A M M M M M M A M M M M M M M
62 Coco, Enar H H H H H H H H H H M M M M M M M M A A M M M M M M
63 Dizon, Bangkero H H H H H H H H H H M M M M M M M M M M M M M M M M
64 Dizon, Joey Dulasan H H H H H H H H H H M M M M M M M M M M A A M M M M
65 Dizon, Rodel H H H H H H H H H H M M M M M M M M M M A M M M M M
66 Dulasan, Arnold A. H H H H H H H H H H A M M M M M M M M M A M M M M M
67 Garcia, Boy A. H H H H H H H H H H A M M M M M M M M M A M M M M M
68 Minerva, Jordan H. H H H H H H H H H H A A A M M M M M M M M M M M M M
69 Sinduraan, Jimber I. H H H H H H H H H H M M A M M M M M M M M M M M M M
70 Ayag, Nelly E. H H H H H H H H H H M M M M M M M M M M M M M M M M
71 Manalo, Rochelle H H A A H H H H H H M M M M M M M M M M M M M M M M
71 Ayag, Marlon Sinduraan H H H H H H H H H H M M M M M M M M M M M M M M M M
73 Dulasan, Allan H H H H H H H H H H M M M M M M M M M M M M M M M M

page 2
74 Dulasan, Mark Anangi H H H H H H H H H H M M M M M M M M M M M M M M M M
75 Evangelista, Marlon H H H H H H H A A A A A M M M M M M M M M M M M M M
76 Garcia, Loreno M H H H H H H H H H H M A M M M M M M M M M M M M M M
77 Manalo,Jefrey, Aranzado H H H H H H H H H H M A M M M M M M M M M M M M M M
78 Minerva, Homer Evangelista H H H A H H H H H H M M M A A M M M M M M M M M M M
79 Sinduraan, Warren Tupas H H H H H H H H H H M M M M A M M M M M M M M M M M
80 Sinduraaan, Pipito K. H H H H H H H H H H M M M M M M M M M M M M M M M M
TOTAL:

D. Actual Feeding

(H ) - Present, served with Hot meals

(M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice

page 2
SBFP Form 5 (2020)

DEPARTMENT OF EDUCATION
Region ____

REGION/DIVISION/DISTRICT: ____________________________________________________________________
NAME OF SCHOOL: ____________________________________________________________________
SCHOOL ID NO.: ____________________________________________________________________

SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT

LIST OF AUTHORIZED CONSIGNEES (SY________)

NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN
SIGNATURE
1 JAMES MARLON D. RONQUILLO 9173041639 jamesmarlon.ronquillo@deped.gov.ph

2 ROXANE D. CALDERON 9155845916

9684548266 roxane.calderon@deped.gov.ph

3 REIBERT B. SALAZAR 9274271809 reibert.salazar@deped.gov.ph

SCHOOL INSPECTION TEAM (SY________)

NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN
SIGNATURE
1 JAMES MARLON D. RONQUILLO 9173041639 jamesmarlon.ronquillo@deped.gov.ph

2 ROXANE D. CALDERON 9155845916

9684548266 roxane.calderon@deped.gov.ph

3 REIBERT B. SALAZAR 9274271809 reibert.salazar@deped.gov.ph

Note: Only authorized consignees are allowed to receive the goods.

SBFP Form 5 (2021)

DEPARTMENT OF EDUCATION
Region ___

REGION/DIVISION/DISTRICT: ______________________________________________________________________________
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________

SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT

LIST OF BENEFICIARIES (SY________)

Classification of Students in terms of Milk Tolerance
(Please check one)
Without milk With milk Not allowed by
intolerance and will intolerance but parents to
Name Grade & Section
participate in milk willing to participate in milk
feeding participate in milk feeding
feeding
1 Aranzado, Ivan M. Kinder/Masigla /
2 Licdawan, Jordan T. Kinder/Masigla /
3 Aranzado, Aiza Kinder/Masigla /
4 Dizon, Emelyn D. Kinder/Masigla /
5 Dizon, Noemi D. Kinder/Masigla /
6 Evangelista, Milet M. Kinder/Masigla /
7 Licdawan, Nana Kim C. Kinder/Masigla /
8 Sinduraan, Aida D. Kinder/Masigla /
9 Sinduraan, Balbena K. Kinder/Masigla /
10 Sinduraan, Jessebel I. Kinder/Masigla /
11 Sinduraan, Mary D. Kinder/Masigla /
12 Aranzado, Marwin D. Grade 1/Masigla /
13 Garcia, Elgar A. Grade 1/Masigla /
14 Sinduraan, Melmar Grade 1/Masigla /
15 Aranzado, Aiza Grade 1/Masigla /
16 Cabilogan, Aquilina Grade 1/Masigla /
17 Dulasan, Ronalyn Grade 1/Masigla /
18 Garcia, Laira Mae Grade 1/Masigla /
19 Garcia, Rose Ann Grade 1/Masigla /
20 Garcia, Tintin A. Grade 1/Masigla /
21 Garcia, Divina Grade 1/Masigla /
22 Manalo, Juliet Grade 1/Masigla /
23 Minerva, Kristine Joy Grade 1/Masigla /
24 Taugan, Emily A. Grade 1/Masigla /
25 Axalan, Girlie A. Grade 1/Masigla /
26 Anangi, Marvin M. Grade 2/Magalang /
27 Sinduraan, Jemmar I. Grade 2/Magalang /
28 Licdawan, Gemma T. Grade 2/Magalang /
29 Taugan, Xander Grade 2/Magalang /
30 Sinduraan, Monica D. Grade 2/Magalang /
31 Taugan, Emilyn A. Grade 2/Magalang /
32 Pacheco, Carltheouz Grade 2/Magalang /
33 Pampilo, Henry I. Grade 3/Magalang /
34 Likdawan, Gino C. Grade 3/Magalang /
35 Dizon, Lilibeth Grade 3/Magalang /
36 Manalo, Krizia A. Grade 3/Magalang /
37 Arasado, Iking I. Grade 3/Magalang /
38 Ayag, Abel E. Grade 3/Magalang /
39 Menirva, Jovit M. Grade 4/Mapagmahal /
SBFP Form 5 (2021)

40 Manalo, Amy M. Grade 4/Mapagmahal /

41 Minerva Christine A. Grade 4/Mapagmahal /
42 Sinduraan, Myrine A. Grade 4/Mapagmahal /
43 Sinduraan, Marible I. Grade 4/Mapagmahal /
44 Coco, Edwin L. Grade 4/Mapagmahal /
45 Hinalman, Glen Mark A. Grade 4/Mapagmahal /
46 Hinalman, Glen Mart A. Grade 4/Mapagmahal /
47 Hinalman, Paul Mark A. Grade 5/Mapagmahal /
48 Manalo, Boy A. Grade 5/Mapagmahal /
49 Minerva, Wilson H. Grade 5/Mapagmahal /
50 Taugan, Esmael A. Grade 5/Mapagmahal /
51 Anangi, Jocelyn M. Grade 5/Mapagmahal /
52 Dulasan, Judy V. Grade 5/Mapagmahal /
53 Dulasan, Lanie D. Grade 5/Mapagmahal /
54 Garcia, Lara Mae M. Grade 5/Mapagmahal /
55 Hinalman, Marilou A. Grade 5/Mapagmahal /
56 Minerva, Rubilyn E. Grade 5/Mapagmahal /
57 Minerva, Rosalinda H. Grade 5/Mapagmahal /
58 Sinduraan, May T. Grade 5/Mapagmahal /
58 Sinduraan, Jessa T. Grade 5/Mapagmahal /
60 Ayag, Billy Boy Evangelista Grade 5/Mapagmahal /
61 Ayag, Daniel E. Grade 5/Mapagmahal /
62 Coco, Enar Grade 5/Mapagmahal /
63 Dizon, Bangkero Grade 5/Mapagmahal /
64 Dizon, Joey Dulasan Grade 5/Mapagmahal /
65 Dizon, Rodel Grade 6/Mapagmahal /
66 Dulasan, Arnold A. Grade 6/Mapagmahal /
67 Garcia, Boy A. Grade 6/Mapagmahal /
68 Minerva, Jordan H. Grade 6/Mapagmahal /
69 Sinduraan, Jimber I. Grade 6/Mapagmahal /
70 Ayag, Nelly E. Grade 6/Mapagmahal /
71 Manalo, Rochelle Grade 6/Mapagmahal /
72 Ayag, Marlon Sinduraan Grade 6/Mapagmahal /
73 Dulasan, Allan Grade 6/Mapagmahal /
74 Dulasan, Mark Anangi Grade 6/Mapagmahal /
75 Evangelista, Marlon Grade 6/Mapagmahal /
76 Garcia, Loreno M Grade 6/Mapagmahal /
77 Manalo,Jefrey, Aranzado Grade 6/Mapagmahal /
78 Minerva, Homer Evangelista Grade 6/Mapagmahal /
79 Sinduraan, Warren Tupas Grade 6/Mapagmahal /
80 Sinduraaan, Pipito K. Grade 6/Mapagmahal /
Prepared by: APPROVED BY:

ROXANE D. CALDERON JAMES MARLON D. RONQUILLO

School Feeding Coordinator School Head
SBFP Form 6 (2021)

DEPARTMENT OF EDUCATION
Region IV MIMAROPA

REGION/DIVISION/DISTRICT: MIMAROPA/ORIENAL MINDORO/PUERO GALERA

NAME OF SCHOOL: PAGTURIAN MANGYAN SCHOOL
SCHOOL ID NO.: 110617

SCHOOL-BASED FEEDING PROGRAM

NFP DELIVERIES (SY2022-2023)

Grade Level Number of Beneficiaries Date No. of Packs Received
Delivered
New Replacement Total (New +
Replacement)
Kinder 8/9/2022 RIMO CURLS (240)
NUTY FRUITY
Grade 1 BARS (320)
NUTRI COOKIES
Grade 2 8/25/2022 (400)
CHAMPORADO
Grade 3 (160)
MACARONI SOUP
Grade 4 (160)
ARROZCALDO
Grade 5 (160)
Grade 6 8/30/2022 PANCIT CANTON (400)
TOTAL: SHING ALING (400)

MILK DELIVERIES (SY2022-2023)

Grade Level Number of Beneficiaries Date No. of Packs Received
Delivered
New Replacement Total (New +
Replacement)
Powdered Milk
Kinder
12/15/2022 (2240)
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
TOTAL:

Prepared by: APPROVED BY:

ROXANE D. CALDERON JAMES MARLO

School Feeding Coordinator Scho
 SBFP Form 6 (2021)

ARTMENT OF EDUCATION
Region IV MIMAROPA

BASED FEEDING PROGRAM

ELIVERIES (SY2022-2023)
No. of Packs for Remarks
Replacement/
Rejected

ELIVERIES (SY2022-2023)
No. of Packs for Remarks
Replacement/
Rejected

APPROVED BY:

JAMES MARLON D. RONQUILLO

School Head