Department of Social Welfare and Development SFP Form 2

Supplementary Feeding Program

SUMMARY LIST OF BENEFICIARIES
CY 2024-2025

Province: Total Number of Child Development Center:

City/Municipality: Total Number of Children Beneficiaries:
Number of Children Beneficiaries
Weight for Age Weight for Height Height for Age
Severly
Barangay Name of CDC w/ solo Underwei Overweig Severely Overwig Severely Name of CDW/ Authorized Representative Contact Number
PWD 4P's IP's Normal Underwei Wasted Obese Stunted Tall
parent ght ht wasted ht wasted
Male Female Total ght Total Total

2 3 4 5 2 3 4 5 M F M F M F M F M F M F M F M F M F M F M F M F M F M F M F

0 0
1 0
0 0
2 0
0 0
3 0
0 0
4 0
0 0
5 0

6 0 0 0

7 0 0 0

8 0 0 0

9 0 0 0
0 0
10 0
0 0
11 0
0 0
12 0

13 0 0 0
0 0
14 0
0 0
15 0
0 0
16 0
0 0
17 0
0 0
18 0
0 0
19 0

20 0 0 0
TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

GRAND TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Prepared By: Noted By: Approved By:

DCW-COORDINATOR or SWO-1/ECCD FOCAL or SFP Focal C/MSWDO C/Municipal Mayor

Note: Please list barangays alphabetically. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 Department of Social Welfare and Development
Field Office V

Supplementary Feeding Program

MASTERLIST OF BENEFICIARIES
FY 20__-20__

Province: Name of Child Develeopment Center:

C/Municipality: Address of Child Development Center:
Barangay:
SFP Beneficiaries
Date of Weighing:

Weight for Age Weight for Height

Gender Day/Month/ Birthdate Age in Weight in Height in Underwe Severely Overweigh Severely
No. Name of Children M/F Year
Age in mos.
years kgs cm.
Normal
ight
underweigh
t
Wasted
wasted
Overwight Obese
t

M F M F M F M F M F M F M F M F

10

11

12

13

14

15

16

17

18

19

20

TOTAL
Page _____ of _______

Prepared by:
_______________________________________
Child Development Worker BNS / BHW

Note: Please list the children alphabetically and by Gender. You may use additional sheet as necessary. Fill out line provided for the page number (i.e. Page 1 of 2)
 SFP Form 1

REMARKS

(Check if the child belong to the following)

Height for Age
Severely w/ solo
Stunted Tall IPs PWD 4Ps Name of Parent or Guardian
stunted parent

M F M F M F M F M F M F M F

Noted by:
KATRINA L. ORTICIO
CSWDO