School Level NS-Form 1

Department of Education
Region
Division of
School Nutritional Status Record
District:
School: Date of Weighing: June 15, 2017
Grade & Section:

Date of Weight Height BMI

Learner's Name Age (Height)² (m²) Nutritional Status
Birth (kg) (m) (kg/m²)
MALE
6/15/2001 16.00 30 1.3 1.69 17.75 #REF!
7/6/2002 14.11 28 1.4 1.96 14.29 Severely Wasted
8/22/2003 13.09 26 1.6 2.56 10.16 #REF!
10/6/2003 13.08 37 1.35 1.82 20.33 #REF!
2/25/2002 15.03 20 1.11 1.23 16.26 #REF!
8/14/1999 17.10 40 1.14 1.3 30.77 #REF!
7 test 10/6/2003 13.08 37 1.35 1.82 20.33 #REF!
2/25/2002 15.03 20 1.11 1.23 16.26 #REF!
8/14/1999 17.10 40 1.14 1.3 30.77 #REF!
10/6/2003 13.08 37 1.35 1.82 20.33 #REF!
2/25/2002 15.03 20 1.11 1.23 16.26 #REF!
8/14/1999 17.10 40 1.14 1.3 30.77 #REF!
10/6/2003 13.08 37 1.35 1.82 20.33 #REF!
2/25/2002 15.03 20 1.11 1.23 16.26 #REF!
8/14/1999 17.10 40 1.14 1.3 30.77 #REF!
10/6/2003 13.08 37 1.35 1.82 20.33 #REF!
2/25/2002 15.03 20 1.11 1.23 16.26 #REF!
8/14/1999 17.10 40 1.14 1.3 30.77 #REF!
FEMALE
5/15/2003 14.01 10 1.12 1.25 8 #REF!
12/1/2002 14.06 40 1.35 1.82 21.98 #REF!
11/20/2001 15.06 35 1.11 1.23 28.46 #REF!
10/6/2003 13.08 24 1.14 1.3 18.46 #REF!
2/25/2002 15.03 20 1.35 1.82 10.99 #REF!
8/14/1999 17.10 20 1.11 1.23 16.26 #REF!
10/6/2003 13.08 40 1.14 1.3 30.77 #REF!
2/25/2002 15.03 37 1.35 1.82 20.33 #REF!
8/14/1999 17.10 20 1.11 1.23 16.26 #REF!
10/6/2003 13.08 40 3.14 9.86 4.06 #REF!
2/25/2002 15.03 37 2.12 4.49 8.24 #REF!
8/14/1999 17.10 20 5.01 25.1 0.8 #REF!
10/6/2003 13.08 40 1.14 1.3 30.77 #REF!
2/25/2002 15.03 37 1.35 1.82 20.33 #REF!
8/14/1999 17.10 20 1.11 1.23 16.26 #REF!
10/6/2003 13.08 40 1.14 1.3 30.77 #REF!
2/25/2002 15.03 37 1.35 1.82 20.33 #REF!
8/14/1999 17.10 20 1.11 1.23 16.26 #REF!
10/6/2003 13.08 40 1.14 1.3 30.77 #REF!
2/25/2002 15.03 37 1.35 1.82 20.33 #REF!
8/14/1999 17.10 20 1.11 1.23 16.26 #REF!
5/15/2003 14.01 10 1.12 1.25 8 #REF!
12/1/2002 14.06 40 1.35 1.82 21.98 #REF!
11/20/2001 15.06 35 1.11 1.23 28.46 #REF!
10/6/2003 13.08 24 1.14 1.3 18.46 #REF!
 WedzmerDesigns

Severely
Summary Table Wasted Normal Overweight Obese TOTAL
Wasted
MALE 1 0 0 0 0 1
FEMALE 0 0 0 0 0 0
TOTAL 1 0 0 0 0 1

Severely
Percentage Summary Wasted Normal Overweight Obese TOTAL
Wasted
MALE 100.00 0.00 0.00 0.00 0.00 100
FEMALE #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
TOTAL #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade Levels)
School Name Guitnangbayan ELEMENTARY SCHOOL District SAN MATEO Division RIZAL Region IV-A CALABARZON

School ID 109487 Grade 5 Section POLITE Track/Strand (SHS) NA School Year 2018-2019

Learner's Name Nutritional Status

Birthdate Weight Height Height² Height for Age
No. LRN (Last Name, First Name, Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category (HFA)
Name Extension, Middle Name) (kg/m²)
MALE
1 109323140053 ANONAS, AKIHIRO E. 09/30/2008 22.80 136.50 18632.25 0.00 #N/A
2 109487140103 ANTIPALA,ZYREN RUZZ M. 10/1/2008
3 109487130370 BLANES, DAN GABRIEL Y. 05/23/2008 27.50 133.70 17875.69 0.00 #N/A
4 109487130261 BALOLOY, JOHN MARTIN F. 07/24/08 9.1
5 BISNAR,KYLE ENZY N.
6 BOCATCAT, BENITO G. 08/27/2007 11 38.00 137.50 18906.25 0.00 Tall
7 109487130190 CATINA, MARK ANTHONY 4/8/2008 10.01 39.30 134.30 18036.49 0.00 Severely Wasted Tall
8 CENTENO, FRANCIS NICKO
9 136667140373 CENTILLAS, JOHN KENNETH 04/13/2006 12.01 35.40 148.80 22141.44 0.00 Severely Wasted Tall
10 109487130479 CRISTITUTO,RUSSEL A. 4/4/2008 10.02
11 DAMAYO,ROMMEL A.
12 109494140078 DE ASIS,JOHNVINCENT B.
13 117442120015 DELA CRUZ,WINJEE H. 12/30/2006 11.05 38.50 151.00 22801.00 0.00 Severely Wasted Tall
14 109487140481 DE LEON, PRINCE YURIE A.
15 109487140281 DE LOS SANTOS,JHUNTY L. 06/14/08 25.70 135.80 18441.64 0.00 #N/A
16 109487130482 FERNANDEZ,ARJAY MARK P. 11/20/07 10.06
17 MANUEL, RIELY B.
18 115564140089 MOLINA, KENT DAVID B. 07/23/08 9.10
19 136557140320 MOZO, PRINCE MILBERT 10/26/08 9.07
20 107142140188 ORDONEZ,QUINCY LORENZ
21 PASCUAL,PATRICK JOHN G. 09/17/07 10.08 53.70 143.00 20449.00 0.00 Severely Wasted Tall
22 10590313019 PICARDAL,JR. RODEL M. 09/17/06 11.08
23 10844113009 PIZAL, JUSTIN G.
24 RAMIREZ, DENVER V.
25 109487130034 REFUGIO,JOHN RIEVH 02/23/08 10.03
26 109487140433 SALVADOR,SHAWN HARVEY 11/1/2008 9.07
27 136677140835 SAMANIEGO,ZAIRONEDHANE 12/16/2007 10.05
 Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for Age
No. LRN (Last Name, First Name, Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category (HFA)
Name Extension, Middle Name) (kg/m²)
28 109487140374 SARILE,JOSH KIMBERLY A. 01/27/07 11.04
29 108161140057 STA MARIA, GIAN JUSTINE
30 109491120355 VERGARA, JEWEL V. 07/18/05 12.10
31 YBANEZ,ELIJAH STAN O. 9/4/2008 9.09 57.00 149.00 22201.00 0.00 Severely Wasted Tall
32 YLAGAN,MATTHEW ANDREI 12/22/2007 10.05 35.60 140.00 19600.00 0.00 Severely Wasted Tall
33
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37
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 Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for Age
No. LRN (Last Name, First Name, Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category (HFA)
Name Extension, Middle Name) (kg/m²)
FEMALE
1 109487130149 ANDAL,PRINCESS MIA V. 08/072008
2 109487140108 ARIOLA,ABEGAIL B. 04/25/2008 10.01
3 BAJARO,KIESHA FAYE Q.
4 109487130248 BARDINAS,CHARLOTTE 04/24/08 10.01
5 BERINGUEL,MARY ANN M.
6 DALID,ABEGAIL
7 136679140594 DATUL,JANNAH MARIE C.
8 DELORINO,RHEALYN A.
9 109487140419 DELIZO,FIONA MARIE M. 10/1/2008
10 DEMATAWARAN,CLARA E.
11 DUMANGAS,JURY V.
12 GUYOD,GABRIELLE KATE
13 GRAVELA,MICHAELLA
14 LORELLA,JHYMARIE C.
15 MARTINEZ,DALIA B.
16 MEDINA,LOVELY JOY G.
17 MEJIA,SAMANTHA JOY H.
18 MOLINA,ASHLEYJANE,H.
19 PAYAD,ERIKA DENISE C.
20 RACELIS,HASHANA JOY A.
21 PALIHAGAO,CHARMIE D.
22 ROSALEJOS,EUNICE V.
23 SAN ANDRES,ARABELLA
24 SAN ANDRES,LOVELY S.
25 SOLIS,KARELE CHARMIE C.
26 VALENZUELA,FATIMA C.
27 VERGARA, JEWEL Y.
28
29 6/30/2008 9.11
30
31 7/4/2008 9.11
32 12/31/2007 10.05
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 Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for Age
No. LRN (Last Name, First Name, Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category (HFA)
Name Extension, Middle Name) (kg/m²)
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SUMMARY TABLE

Nutritional Status Height for Age (HFA)

Summary Table Summary Table
SEX
Severely Severely
Wasted Normal Overweight Obese TOTAL Stunted Normal Tall Total
Wasted Stunted
MALE 6 0 0 0 0 6 0 0 0 7 7
FEMALE 0 0 0 0 0 0 0 0 0 0 0
TOTAL 6 0 0 0 0 6 0 0 0 7 7

Date of Assessment: Conducted/Assessed By: Certified Correct By: Reviewed By:

6/7/2018 RIZALINA M. VALDULLA

SFRT 2017
 Growth reference 5-19 yea
Links for BMI Tables in P
z-scores
BOYS http://www.who.int/entity/growthref/sft_bmifa_boys_z_5_19years.pdf?ua=1

GIRLS http://www.who.int/entity/growthref/sft_bmifa_girls_z_5_19years.pdf?ua=1

Growth reference 5-19 yea

Links for Height-for-Age Table
z-scores
BOYS http://www.who.int/entity/growthref/sft_hfa_boys_z_5_19years.pdf?ua=1

GIRLS http://www.who.int/entity/growthref/sft_hfa_girls_z_5_19years.pdf?ua=1

Table retrieved from http://www.who.int/growthref

ference 5-19 years
s for BMI Tables in PDF
precentile
http://www.who.int/entity/growthref/sft_bmifa_boys_perc_5_19year.pdf?ua=1

http://www.who.int/entity/growthref/sft_bmifa_girls_perc_5_19years.pdf?ua=1

ference 5-19 years

Height-for-Age Tables in PDF
precentile
http://www.who.int/entity/growthref/sft_hfa_boys_perc_5_19years.pdf?ua=1

http://www.who.int/entity/growthref/sft_hfa_girls_perc_5_19years.pdf?ua=1