VAW FROM 1
BARANGAY DATA CAPTURE FORM
                           MONITORING OF INCIDENCE ON VIOLENCE AGAINST CHILDREN (VAC) DURING THE COVID-19 PANDEMIC
                                                                       For the period: January 5, 2022 to February 5, 2022
Region : NCR
Province: NCR
City/Municipality: MANILA
Barangay: 608 ZONE 61 DISTRICT VI
             GENDER (2)                       TYPE OF VIOLENCE(3)                                          PERPETRATORS (5)                                                       ACTIONS TAKEN BY THE BARANGAY (6)
                                                                                                                                            Others (ex.                                                                          Others (ex.
                                                                                                                                            Guardian)                                              Referred for
   VAC                                                                             Immediate    Other                                                       Referred                                              Referred for    Referred
            Male   Female          Physical   Sexual   Psychologica     Neglect                                       Local        Law                                 Referred                      Medical
 VICTIM/S                                                                            Family     Close     Acquainta                                            to                    Referred to                     Legal         NGOs,
                                    Abuse     Abuse     l/ Emotional                                                  Official   Enforcer      (5g)                     to PNP                      Treatment
    (1)                      Age                                                    Member     Relative    nce (5c)                                         LSWDO                     NBI (3c)                    Assistance       FBOs)
            (2A)    (2B)             (4a)      (4b)      Abuse (4c)      (4d)                                          (5e)        (5f)                                   (3c)
                             (3)                                                      (5a)       (5b)                                                         (3b)                                                    (3f)
                                                                                                                                                                                                       (3e)
                                                                                                                                                                                                                                    (3h)
            / =1    / =1             / =1      / =1        / =1          / =1        / =1        / =1       / =1       / =1        / =1     Pls. Specify.     / =1       / =1           / =1           / =1           / =1       Pls. Specify.
 Child 1
 Child 1                                                                          AS OF TODAY, FEBRUARY 5, 2022 NO VAC CASE REPORTED
 Child 1
 TOTAL       0       0       0                  0           0             0           0           0          0           0          0            0             0          0              0              0              0              0
*If , encode “1” on the applicable fields                     *Immediate family Member/s - parents and siblings
* If “Others,”, please specify                                   *Other Close Relative/s- uncles, aunts, grandparents, cousins, etc.
                                                                                                                                                                              Submitted by :
                                                                                                                                                                                      MA. CRISTINA D. ZARA
                                                                                                                                                                                               PUNONG BARANGAY