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    Teacher'S Profile District: School

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    Rd David
    This document contains a teacher's profile template to collect information from school personnel like their name, age, gender, contact number, designation, current residence, and medical information. It also includes log sheets to record COVID-19 symptoms of close contacts during their quarantine period, and a monitoring form to track the status of individuals under investigation or monitoring for COVID-19.

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    © All Rights Reserved
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    Teacher'S Profile District: School

    Uploaded by

    Rd David
    50 views7 pages
    This document contains a teacher's profile template to collect information from school personnel like their name, age, gender, contact number, designation, current residence, and medical information. It also includes log sheets to record COVID-19 symptoms of close contacts during their quarantine period, and a monitoring form to track the status of individuals under investigation or monitoring for COVID-19.

    Original Description:

    covid

    Original Title

    Covid-Accomplishment

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    This document contains a teacher's profile template to collect information from school personnel like their name, age, gender, contact number, designation, current residence, and medical information. It also includes log sheets to record COVID-19 symptoms of close contacts during their quarantine period, and a monitoring form to track the status of individuals under investigation or monitoring for COVID-19.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    50 views7 pages

    Teacher'S Profile District: School

    Uploaded by

    Rd David
    This document contains a teacher's profile template to collect information from school personnel like their name, age, gender, contact number, designation, current residence, and medical information. It also includes log sheets to record COVID-19 symptoms of close contacts during their quarantine period, and a monitoring form to track the status of individuals under investigation or monitoring for COVID-19.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    of 7

    Republic of the Philippines

    Department of Education
    Region III
    Schools Division Office of Pampanga
    TEACHER'S PROFILE

    District: School:

    No. COMPLETE NAME AGE GENDER CONTACT NUMBER DESIGNATION CURRENT RESIDENCE
    (Surname, First Name, Middle Initial) (Street, Purok/Sitio, Zone, Barangay, Municipality)

    10

    11

    12

    13

    14

    15

    16

    17

    18

    19

    20

    Note: Please include all school personnel (include guard, utility, etc.)

    Date Accomplished: RHU:


    Division Nurse: RHU Covid Contact Person:
    Contact No.
    School Year:

    COMORBIDITY MEDICATION/ TREATMENT


    NOVEL CORONAVIRUS (nCoV) SYMPTOM LOG

    CATEGORY: DATE OF EXPOSURE:


    NAME OF CLOSE CONTACT: DATE OF QUARANTINE PERIOD ENDS:

    DATE DATE DATE DATE DATE DATE


    SYMPTOM
    (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)
    No symptom

    Fever (temperature)

    Cough

    Colds

    Shortness of Breath

    Difficulty of Breathing

    Body Pain/Muscle Pain/Joint Pain

    Other Symptom:

    Actions done by NOD

    Prepared by:
    ____________________________________________
    AVIRUS (nCoV) SYMPTOM LOG SHEET

    PROVINCE:
    TINE PERIOD ENDS:

    DATE DATE DATE DATE DATE DATE DATE DATE


    (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY) (MM/DD/YYYY)
    District/Cluster

    Residence Nature and Date Date


    CATEGORY (Other
    Address of Last Quarantine
    PUM - with exposure to
    DATE Exposure Period Ends
    Covid area, Close contact Known Medical
    CONTACTED (Building, Age Sex Pregnant (Workplace, (mm/dd/yyyy)
    No. to confirmed case,
    /REPORTED (Start
    Last Name First Name Middle Name School
    Street, (years) (M/F)
    Contact No.
    (Y/N)
    Civil Status Conditions/Medical
    household, or 14 days post-
    Suspect, Probable, History
    of monitoring) Purok/Sitio, other public exposure or
    Confirmed) N/A
    Zone, area) until without
    if not Covid case
    Municipality) symptoms

    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    16
    17
    18
    19
    20

    Prepared________________________________________________
    by:
    Week: ___________________________________
    Weekly basis monitoring/update for non - Covid 19 cases, Daily monitoring for Covid - 19 cases (Close con

    Agencies Where
    Date First
    Rsponsible for Quarantined Laboratory Results
    Asympt Sign/ Sign
    Monitoring (Home/ Date Admitted Name of Referral (dates specimen
    (DepEd nurse, Quarantine
    omatic Symptom /Symptom Actions Taken
    /Consulatation Facility taken and result Date Date Date Date Date Date Date
    (Y/N) Developed Present
    RHU, BHERT) Facility/Hospital released)
    (mm/dd)
    Pls specify )
    d 19 cases, Daily monitoring for Covid - 19 cases (Close contact, Suspect, Probable, Confirmed)

    Date Date Date Date Date Date Date

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