SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade Levels)

School Name District Division

School ID Grade Section Track/Strand (SHS)

Learner's Name
Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name)
MALE
2 103774120001 Ballesteros, Jordan J. 02/23/2007 10 31.6 1.345 1.809
 Learner's Name
Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name)

FEMALE
 Learner's Name
Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name)

SUMMARY TABLE
Nutritional Status
Summary Table
SEX Severely Severely
Wasted Normal Overweight Obese TOTAL Stunted
Wasted Stunted
MALE
FEMALE
TOTAL

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

5-Jun-17
)

Region

School Year

Nutritional Status
Height for
BMI BMI Remarks
Age (HFA)
(kg/m²) Category

17.4
 Nutritional Status
Height for
BMI BMI Remarks
Age (HFA)
(kg/m²) Category
 Nutritional Status
Height for
BMI BMI Remarks
Age (HFA)
(kg/m²) Category

Height for Age (HFA)

Summary Table
Normal Tall Total

Reviewed By:

SFRT 2017