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Deworming Parental

This document is a parental/guardian consent form allowing a child to take a deworming tablet. It includes spaces for the parent's or guardian's name, the child's name, year and section, and a signature. The consent is specifically for a deworming event scheduled for September 10, 2024, in Brgy. Victory, Babatngon, Leyte.

Uploaded by

Rowena Caharop Aguilon
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114 views6 pages

Deworming Parental

This document is a parental/guardian consent form allowing a child to take a deworming tablet. It includes spaces for the parent's or guardian's name, the child's name, year and section, and a signature. The consent is specifically for a deworming event scheduled for September 10, 2024, in Brgy. Victory, Babatngon, Leyte.

Uploaded by

Rowena Caharop Aguilon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

DEWORMING PARENTAL/GUARDIAN CONSENT

TO WHOM IT MAY CONCERN:


I,
_________________________________
_________
do hereby permit my son/daughter
(Name of Parent/Guardian)
___________________________________ ______
to take deworming tablet.
(Name of son/daughter)
(Year & Section)
__________________________________
Signature over printed nam
DEWORMING PARENTAL/GUARDIAN CONSENT
TO WHOM IT MAY CONCERN:
I,
_________________________________
_________
do hereby permit my son/daughter
(Name of Parent/Guardian)
___________________________________ ______
to take deworming tablet.
(Name of son/daughter)
(Year & Section)

__________________________________
Signature over printed nam
DEWORMING PARENT’S/GUARDIAN CONSENT

TO WHOM IT MAY CONCERN:

I,
_________________________________
_________
do hereby permit my son/daughter
(Name of Parent/Guardian)
___________________________________ ______
to take deworming tablet.
(Name of son/daughter)
(Year & Section)

__________________________________
Signature over printed name
I, ________________________________________, do hereby permit my son/daughter ____________________________________to take deworming
(Name of Parent/Guardian) (Name of child)
tablet from the BHW of Brgy. Victory, Babatngon , Leyte on September 10, 2024.

_____ Permit
_____ Does not Permit

____________________________________________
Name & Signature of Parent/Guardian
DEWORMING PARENT’S/GUARDIAN CONSENT

TO WHOM IT MAY CONCERN:

I,
_________________________________
_________
do hereby permit my son/daughter
(Name of Parent/Guardian)
___________________________________ ______
to take deworming tablet.
(Name of son/daughter)
(Year & Section)
__________________________________
Signature over printed name
I, ________________________________________, do hereby permit my son/daughter ____________________________________to take deworming
(Name of Parent/Guardian) (Name of child)
tablet from the BHW of Brgy. Victory, Babatngon , Leyte on September 10, 2024.

_____ Permit
_____ Does not Permit

____________________________________________
Name & Signature of Parent/Guardian

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