Region XI School Name ML QUEZON ES

Division DAVAO CITY School ID 129706

District STA. ANA Adviser WEDZMER B. MUNJILUL

Male Students Profile Baseline Data

Learner's Name Date of Birth
No. LRN (Last Name, First Name, Name (MM/DD/YYYY) Weight Height
(kg) (m)
Extension, Middle Name)
1 123456789012 test 1 1/1/1996 57 3.2
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ML QUEZON ES Grade 5 School Year
129706 Section AGILA Baseline Date Assessment
ZMER B. MUNJILUL Track/Strand Endline Date Assessment

Endline Data Female Students Profile

Learner's Name Date of Birth
Weight Height (MM/DD/YYYY)
No. LRN (Last Name, First Name, Name
(kg) (m)
Extension, Middle Name)
50 1.63 1 123456789012 test1G 1/1/1998
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 2017-2018
e Assessment 6/22/2017
Assessment 3/1/2018 Body Mass Index Chart:

Baseline Data Endline Data

Weight Height Weight Height

(kg) (m) (kg) (m)

57 3.2
ody Mass Index Chart: Height for Ag
Height for Age Chart
SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade Levels)

School Name ML QUEZON ES District STA. ANA Division DAVAO CIT

School ID 129706 Grade 5 Section AGILA Track/Strand

Learner's Name Nutritional Sta

Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Name Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Extension, Middle Name) (kg/m²)
MALE
1 123456789012 test 1 1/1/1996 21.05 57 3.2 10.24 5.57
 FEMALE
1 123456789012 test1G 1/1/1998 19.05 57 3.2 10.24 5.57
Integrated School Forms

SUMMARY TABLE
Nutritional Status Heig
Sex
Severely Wasted Wasted Normal Overweight Obese Total Severely Stunted Stunted

MALE 0 0 0 0 0 0 0 0
FEMALE 0 0 0 0 0 0 0 0
TOTAL 0 0 0 0 0 0 0 0

Date of Assessment Conducted/Assessed By Certified Correct By:

Thursday, June 22, 2017 WEDZMER B. MUNJILUL

SF8)

AVAO CITY Region XI

6/22/2017

School Year 2017-2018

itional Status
Height for Age
Remarks
BMI Category (HFA)

Underweight Tall
Underweight Tall
 WedzmerDesigns

Height for Age (HFA)

Normal Tall Total

0 1 1
0 1 1
0 2 2

Reviewed by:
SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade Levels)

School Name ML QUEZON ES District STA. ANA Division DAVAO CITY

School ID 129706 Grade 5 Section AGILA Track/Strand

Learner's Name Nutritional Stat

Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Name Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Extension, Middle Name) (kg/m²)
MALE
1 123456789012 test 1 1/1/1996 22.02 50 1.63 2.66 18.8
 FEMALE
1 123456789012 test1G 1/1/1998 20.02
Integrated School Forms

SUMMARY TABLE
Nutritional Status Heigh
Sex
Severely Wasted Wasted Normal Overweight Obese Total Severely Stunted Stunted

MALE 0 0 1 0 0 1 0 0
FEMALE 0 0 0 0 0 0 0 0
TOTAL 0 0 1 0 0 1 0 0

Date of Assessment Conducted/Assessed By Certified Correct By:

Thursday, March 01, 2018 WEDZMER B. MUNJILUL

 REMINDER:
SF8)
This
worksheet is designed
to fit in a Long Bond
AVAO CITY Region XI Paper (8.5" x 13")
3/1/2018

School Year 2017-2018

itional Status
Height for Age
Remarks
BMI Category (HFA)

Normal Normal
 WedzmerDesigns

Height for Age (HFA)

Normal Tall Total

1 0 1
0 0 0
1 0 1

Reviewed by: