National School Deworming Day

ANNEX C
Form 1
National School Deworming Day

Deworming Checklist
Province: SULTAN KUDARAT District: ESPERANZA I

Division : SULTAN KUDARAT School Address: Ugis, Margues, Esperanza, Sul. Kud.
Name of School: UGIS ELEMENTARY SCHOOL Grade and Section : IV
Total Enrolment : 23
Hand Feeding Dewormed Tooth Action

Enrolment washing Done brushin Remarks Taken
Name of Child Done g Done
4Ps Non 4ps 4Ps Non 4ps
Boys
1. Algan, Mark
2. Andilon, Janel M.
3. Andilon, Reynald P.
4. Angias, Babyrack M.
5. Aquino, Jonard A.
6. Ato, Joven D.
7. Bago, Ramil G.
8. Bantal, Jan Jan A.
9. Bantal, Jerky A.
10. Dimantukay, Nasser A.
Girls
1. Ato, Marites B.
2. Buludan, Jennifer A.
3. Catuyan, Jenny D.
4. Datuwata Jonah A.
5. Dimantukay, Jenle M.
6. Jumbo Sarah A.
7. Lamigan,Jea A.
8. Mariano, Annabelle D.
9. Mountal, Apple Jean M.
10. Mountal, Regine A.
11. Pacas, Elvie D.
12. Undo, Alyca D.
13. Urangkaya, Bailao U.
Accomplished by: Noted:
MARIA JENELYN S. LLAMO MARIANO M. SUGAGIL

Class Adviser TIC
ANNEX C
Form 1

Deworming Checklist

Name of School: UGIS ELEMENTARY SCHOOL Grade and Section : KINDER

BOYS
1. Dado, Elboy S.
2. Dimantukay, Steven A.
3. Endal, Elboy A.
4. Labina, Justin A.
5. Magto, Daniel K.
6. Santiago, Gabriel L.
7. Santiago, Mark A.
8. Sinorio, Alvin Tumbao
9. Tumbao, Jully A.
10. Undo, Jeric A.
11. Undo, Jan Lee D.
12. Undo, Jan Rey D.
GIRLS
1. Angias, Johanie M.
2. Aquino, Agnes A.
3. Baktot, Jolina P.
4. Catu, Judy Ann S.
5. Datuwata, Annie D.
6. Dimantukay, Cute Yam A.
7. Diwan, Jasmin S.
8. Mountal, Meljean P.
9. Pakas, Ivy U.
10. Santiago, Andrea T.
11. Unday,Jasmin A.
12. Undo, Stella G.
13. Urangkaya, Olivie U.
MARIA JENELYN S. LLAMO MARIANO M. SUGAGIL

Class Adviser TIC
ANNEX C
Form 1

Deworming Checklist

Name of School: UGIS ELEMENTARY SCHOOL Grade and Section : _VI

Boys
1. Aquino, Jerome A.
2. Bago, Jonas G.
3. Bongon, Anthony S.
4. Datuwata, Bryan L.
5. Datuwata, Joshua T.
6. Dimantukay, John M.
7. Dimantukay, Rusty C.
8. Lamigan, Alvin P.
9. Pakas, Mariel L.
10. Sumil, Macmac A.
11. Tumbao, Wowie G.
12. Urangkaya, Rodrigo A.
1. Andilon, Jaysa M.
2. Ato, Yayi T.
3. Basalan, Cristela B.
4. Pakas, Abegail S.
5. Sumil, Maylin T.
6. Tawilan, Dadang G.
ROWELL B. REBITO MARIANO M. SUGAGIL

Class Adviser TIC
Form 6
Rapid Coverage Assesment Form

Region : XII Date: July 29, 2015

Division: Sultan Kudarat
District: Esperanza I
School: Ugis Elementary School
Location (Municipality, Province): Esperanza, Sultan Kudarat Grade & Sec.: VI
4Ps Non Dewormed

No Name of Child 4Ps YES NO If NO, indicate reason
.
Boys
1. Algan, Mark U.
2. Andilon, Janel M.
3. Andilon, Reynald P.
4. Angias, Babyrack M.
5. Aquino, Jonard A.
6. Ato, Joven D.
7. Bago, Ramil G.
8. Bantal, Jan Jan A.
9. Bantal, Jerkie A.
10. Dimantukay, Nasser A.
Girls
1. Ato, Marites B.
2. Buludan, Jenefer A.
3. Catuyan, Jenny D.
4. Datuwata Jonah A.
5. Dimantukay, Jenle M.
6. Jumbo Sarah A.
7. Lamigan,Jea A.
8. Mariano, Annabelle D.
9. Mountal, Apple Jean M.
10. Mountal, Regine A.
11. Pacas, Elvie D.
12. Undo, Alyca D.
13. Urangkaya, Bailao U.
Accomplished by:
MARIA JENELYN S. LLAMO

Class Adviser
Form 6


Location (Municipality, Province): Esperanza, Sultan Kudarat Grade & Sec.: KINDER
4Ps Non Dewormed

.
BOYS
1. Dado, Elboy S.
2. Dimantukay, Steven A.
3. Endal, Elboy A.
4. Labina, Justin A.
5. Magto, Daniel K.
6. Santiago, Gabriel L.
7. Santiago, Mark A.
8. Sinorio, Alvin Tumbao
9. Tumbao, Jully A.
10. Undo, Jeric A.
11. Undo, Jan Lee D.
12. Undo, Jan Rey D.
GIRLS
1. Angias, Johanie M.
2. Aquino, Agnes A.
3. Baktot, Jolina P.
4. Catu, Judy Ann S.
5. Datuwata, Annie D.
6. Dimantukay, Cute Yam A.
7. Diwan, Jasmin S.
8. Mountal, Meljean P.
9. Pakas, Ivy U.
10. Santiago, Andrea T.
11. Unday,Jasmin A.
12. Undo, Stella G.
13. Urangkaya, Olivie U.
Accomplished by:
MARIA JENELYN S. LLAMO

Class Adviser
Form 6


Location (Municipality, Province): Esperanza, Sultan Kudarat Grade & Sec.: V
4Ps Non Dewormed

.
Boys
1. Aquino, Jerome A.
2. Bago, Jonas G.
3. Bongon, Anthony S.
4. Datuwata, Bryan L.
5. Datuwata, Joshua T.
6. Dimantukay, John M.
7. Dimantukay, Rusty C.
8. Lamigan, Alvin P.
9. Pakas, Mariel L.
10. Sumil, Macmac A.
11. Tumbao, Wowie G.
12. Urangkaya, Rodrigo A.
1. Andilon, Jaysa M.
2. Ato, Yayi T.
3. Basalan, Cristela B.
4. Pakas, Abegail S.
5. Sumil, Maylin T.
6. Tawilan, Dadang G.
Accomplished by:
ROWELL B. REBITO
Class Adviser

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ANNEX C