Professional Documents
Culture Documents
CY___________
Barangay:____________________________
City/Municipality:_____________________
Province:____________________________
DATE ACCOMPLISHED:
ACCOMPLISHED BY:06-30-19
SUMMARY ( Accomplished after 6 months):Erliza A. Bruegas
No. Identified Underweight and Severely Underweight. UW- 3 No. Improved in Weight Status:N-5 No. Dead: No. Moved Out:
Year Mo. Day Age Weight Weight Age Weigh Weight Age Weigh Weight Age Weight Weight Age Weight Weigh Age Weight Weight
Mo. (kgs.) Status Mo. t Status Mo. t Status Mo. (kgs.) Status Mo. (kgs.) t Mo. (kgs.) Status
(kgs.) (kgs.) Status
DATE ACCOMPLISHED:
ACCOMPLISHED BY:
SUMMARY ( Accomplished after 6 months):
No. Identified Underweight and Severely Underweight. No. Improved in Weight Status: No. Dead: No. Moved Out:
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo Day Mo. (kgs.) Status Mo. (kgs.) Status Mo. (kgs.) Status Mo. (kgs.) Status Mo. (kgs.) Status Mo. (kgs.) Status
.
NAME OF CHILD
HOUSE- NO. OF NAME OF OCCUPATION Check If: Check Toilet Type: Check Water Source Check Food Production Activity:
HOLD HH HOUSEHOLD HH
NO. Members HEAD Mother Mother Practice Water Open Others None Pipe Well Spring None Vege- Poultry/ Fish Using
Pregnan Nursing Family Seale Pit table Livestock Pond Iodized
t Planning d Garden Salt
B.REFERRALS
SCHEDULE OF ACTIVITIES
INTERVETIONS/ACTIVITIES TARGET GROUP TARGET COOPERATOR J F M A M J J A S O N D
NUMBER
C. OTHER ACTIVITIES
1. Organization/Reactivation of
Barangay Nutrition Committee
4. Information Campaigns
-Immunization
-Environmental Sanitation
-Family Planning
5. Home Visits
6.Others (Specify)