MASTERLIST

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MASTER LIST OF NEWBORNS, INFANTS,

UNDER-FIVE CHILDREN, SCHOOL AGE-


CHILDREN, ADOLESCENTS, ADULTS &
SENIOR CITIZENS

Name of Barangay/RHU: ____________________________________

Municipality: ____________________________________

Province/City: ____________________________________

REGION: ____________________________________
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizen

Sex
HH. No. /
Family Name of Child Name of Mother Address Age Birthday
Serial No.
Male Female

Part 1: Newborns (0-28 days old)


Adults & Senior Citizens

Education Status (put


SE Status NA if not applicable)

Out of
NHTS Non-NHTS In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizen

Sex
HH. No. /
Family Name of Child Name of Mother Address Age Birthday
Serial No.
Male Female

Part 2: Infants (29 days—11 months old)


Adults & Senior Citizens

Education Status (put


SE Status NA if not applicable)

Out of
NHTS Non-NHTS In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizen

Sex
HH. No. /
Family Name of Child Name of Mother Address Age Birthday
Serial No.
Male Female
Part 3: Under-Five Children (1-4 years old)
Adults & Senior Citizens

Education Status (put


SE Status NA if not applicable)

Out of
NHTS Non-NHTS In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizen

Sex
HH. No. /
Family Name of Child Name of Mother Address Age Birthday
Serial No.
Male Female

Part 4: School-Aged Children (5-9 years old)


Adults & Senior Citizens

Education Status (put


SE Status NA if not applicable)

Out of
NHTS Non-NHTS In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizen

Sex
HH. No. /
Family Name of Adolescent Name of Mother Address Age Birthday
Serial No.
Male Female
Part 5: Adolescents (10-14 years old)
Adults & Senior Citizens

Education Status (put


SE Status NA if not applicable)

Out of
NHTS Non-NHTS In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizen

Sex
HH. No. /
Family Name of Adolescent Name of Mother Address Age Birthday
Serial No.
Male Female
Part 6: Adolescents (15-19 years old)
Adults & Senior Citizens

Education Status (put


SE Status NA if not applicable)

Out of
NHTS Non-NHTS In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizens

HH. No. / Sex


Family Name Address Age Birthday
Serial No.
Part 7: Adults (20-59 years old)
Male Female
nior Citizens

SE Status

NHTS Non-NHTS
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizens

HH. No. / Sex


Family Name Address Age Birthday
Serial No.
Part 8: Senior Citizens (60 years old & above)
Male Female
nior Citizens

SE Status

NHTS Non-NHTS
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizens

SE Status
HH. No. /
Family Name of Adolescent Name of Mother Address Age Birthday
Serial No.
NHTS Non-NHTS
Part 9: Pregnant Women (10-14 years old)
Senior Citizens

Education Status (put


NA if not applicable)

Out of
In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizens

SE Status
HH. No. /
Family Name of Adolescent Name of Mother Address Age Birthday
Serial No.
NHTS Non-NHTS
Part 10: Pregnant Women (15-19 years old)
Senior Citizens

Education Status (put


NA if not applicable)

Out of
In School School
Youth
Master List of Newborns, Infants, Under-Five Children, School Age-Children, Adolescents, Adults & Senior Citizens

HH. No. / SE Status


Family Name Address Age Birthday
Serial
Part 11:No.
Pregnant Women (20-49 years old)
NHTS Non-NHTS

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