Republic of the Philippines
Department of Education
Region VII, Central Visayas
Division of Cebu Province
IPHO Building, Sudlon, Lahug, Cebu City
FORM 2
National School Deworming Month ( ) JULY - 1st Dose ( ) JANUARY-2nd DOSE
School Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District:
Name of School:
Grade Level:
CONSOLIDATED ELEMENTARY / SECONDARY DEWORMING REPORT
No. of Enrolled Learners No. of Learners Dewormed
Percentage
Grade Level
(%)
M F T M F T
GRAND TOTAL
Accomplished by:
First - Aid Teacher
Noted:
Date Accomplished
School Head
Republic of the Philippines
Department of Education
Region VII, Central Visayas
Division of Cebu Province
IPHO Building, Sudlon, Lahug, Cebu City
FORM 2A
National School Deworming Month
District Level Reporting Form
Region: VII
Province: CEBU
Division: CEBU
District:
Grade Level:
No. of Enrolled No. of Learners
Learners Dewormed Percentage
No. Name of School
(%)
M F T M F T
GRAND TOTAL
Accomplished by:
First - Aid Teacher
Noted:
Date Accomplished:
District Supervisor
Department of Education
Region VII, Central Visayas
Division of Cebu
LIST OF LEARNERS DEWORMED
S.Y. 20___ - 20___
( ) 1st Dose Date: __________________ ( ) 2nd Dose Date: __________________
Name of School: ALMACEN-TORREVILLAS NHS District: MEDELLIN
Grade Level: Section: Date Dewormed:
Name of Learners Name of Learners
No. AGE REMARKS No. AGE REMARKS
(BOYS) (GIRLS)
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
32 32
33 33
34 34
35 35
SUMMARY M F T
No. of Learners Enrolled
No. of Learners Dewormed
Prepared by:
Class Adviser
Department of Education
Region VII, Central Visayas
Division of Cebu
4 P's LIST OF LEARNERS DEWORMED
S.Y. 20___ - 20___
( ) 1st Dose Date: __________________ ( ) 2nd Dose Date: __________________
Name of School: ALMACEN-TORREVILLAS NHS District: MEDELLIN
Grade Level: Section: Date Dewormed:
Name of Learners Name of Learners
No. AGE REMARKS No. AGE REMARKS
(BOYS) (GIRLS)
1 1
2 2
3 3
4 4
5 5
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
16 16
17 17
18 18
19 19
20 20
21 21
22 22
23 23
24 24
25 25
26 26
27 27
28 28
29 29
30 30
31 31
32 32
33 33
34 34
35 35
SUMMARY M F T
No. of Learners Enrolled
No. of Learners Dewormed
Prepared by:
Class Adviser
