Republic of the Philippines

DEPARTMENT OF EDUCATION
Region XI
Division of Panabo City
KAUSWAGAN NATIONAL HIGH SCHOOL
Brgy. Kauswagan, Panabo City, Davao del Norte

Contact No. (+63)948-247-8106

Email Address: kauswagan.nhs@deped.gov.ph
FB Page: https://www.facebook.com/KauswaganNHSPanabo

Form 1- Classroom Level Annex AI

School- based Weekly Iron Folic Acid (WIFA) Supplementation

Region: XI Division : Panabo City Date: August 30, 2019 School Year: 2019-2020
School ID: 316403 Name of School: Kauswagan National High School Grade Level/Section: 9-Aries
No. of Students Enrolled: 39 No. of Female Learners: 19 Address: Kauswagan, Panabo City

LRN NAME OF LEARNER CONSENT PROVIDED WITH IRON FOLIC ACID SUPPLEMENTS REMAR
KS
Y N 1ST ROUND 2ND ROUND
JULY AUGUST SEPTEMBER JANUARY FEBRUARY MARCH

W W W W W W W W W W W W W W W W W W W W W W W W
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

129814090007 ALBIT, LOREFEL C. /

118206100004 ANCOG, EZA JN A. / /
129822100012 CABALES, ADELYN S. /
129809100017 CASTANTE, KATHLEEN S. / /
129802100017 CUARTO, RONIELYM L (Transferred out) 07/17/2019
128943100041 EGOS, LOREN E. / / /
129809100028 GREGANA, RHEA C. / /
129814100048 GUDMALIN, QUENCIE B. /
129815100019 JADRAQUE, BIA D. /
129809100033 MANUALES, OLIVE ASHLEY G. / /
129806100068 NAVASQUEZ, PAULINE F. / /
132825100029 OLIVA, CHRISTINE JANE C. /

KAUSWAGAN NATIONAL HIGH SCHOOL Towards a progressive tomorrow.

 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
Division of Panabo City
KAUSWAGAN NATIONAL HIGH SCHOOL
Brgy. Kauswagan, Panabo City, Davao del Norte

Contact No. (+63)948-247-8106

Email Address: kauswagan.nhs@deped.gov.ph
FB Page: https://www.facebook.com/KauswaganNHSPanabo

Form 1- Classroom Level Annex AI

School- based Weekly Iron Folic Acid (WIFA) Supplementation

129802100030 PAME, LELIESE C. /

129802100031 PANGAN, CHERELYN MAE B. /
129822100027 PANGANDUYON, AG DIANE A. /
129793100138 RAZON, IRISH MAE D. / /
129809100039 REMONDE, ALAEKA SHANE P. /
129809100042 SALADIN, EZYL T. /
129802100037 SILVANO, LOISA MAE A. / /

ARIEHMAR A. BARDOQUILLO JESSIELYN L. ALICAWAY

Class Adviser Date: Clinic- In- Charge Date

Round 1 Round 2

KAUSWAGAN NATIONAL HIGH SCHOOL Towards a progressive tomorrow.

 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
Division of Panabo City
KAUSWAGAN NATIONAL HIGH SCHOOL
Brgy. Kauswagan, Panabo City, Davao del Norte

Contact No. (+63)948-247-8106

Email Address: kauswagan.nhs@deped.gov.ph
FB Page: https://www.facebook.com/KauswaganNHSPanabo

Form 1- Classroom Level Annex AI

School- based Weekly Iron Folic Acid (WIFA) Supplementation

Grade Level 7 8 9 10

Region: XI Division : Panabo City Date: School Year: 2018-2019

School ID: 316403 Name of School: KAUSWAGAN NATIONAL HIGH SCHOOL Address: KAUSWAGAN, PANABO CITY

SECTION ENROLMENT GIVEN WIFA SUPPLEMENT NOT GIVEN WIFA REMARKS

SUPPLEMENT
TOTAL NO. OF TOTAL NO. NUMBER % NUMBER % (REASONS
ENROLLED OF FEMALE WHY WIFA IS
LEARNERS LEARNERS NOT GIVEN)
9 - ARIES 39 19

Administered by: Noted by:

ARIEHMAR A. BARDOQUILLO JESSIELYN L. ALICAWAY

Class Adviser Date Clinic In- charge Date

KAUSWAGAN NATIONAL HIGH SCHOOL Towards a progressive tomorrow.

 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
Division of Panabo City
KAUSWAGAN NATIONAL HIGH SCHOOL
Brgy. Kauswagan, Panabo City, Davao del Norte

Contact No. (+63)948-247-8106

Email Address: kauswagan.nhs@deped.gov.ph
FB Page: https://www.facebook.com/KauswaganNHSPanabo

Form 1- Classroom Level Annex AI

School- based Weekly Iron Folic Acid (WIFA) Supplementation

KAUSWAGAN NATIONAL HIGH SCHOOL Towards a progressive tomorrow.

 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XI
Division of Panabo City
KAUSWAGAN NATIONAL HIGH SCHOOL
Brgy. Kauswagan, Panabo City, Davao del Norte

Contact No. (+63)948-247-8106

Email Address: kauswagan.nhs@deped.gov.ph
FB Page: https://www.facebook.com/KauswaganNHSPanabo

Form 1- Classroom Level Annex AI

School- based Weekly Iron Folic Acid (WIFA) Supplementation

KAUSWAGAN NATIONAL HIGH SCHOOL Towards a progressive tomorrow.