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SFP Form 2

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brgycorazonsaq
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27 views1 page

SFP Form 2

Uploaded by

brgycorazonsaq
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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SFP Form 2.

a
DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Supplementary Feeding Program
MASTERLIST OF BENEFICIARIES

Name of Day Care Center : ___________________________________


Name of Day Care Worker : ___________________________________ Date of Weighing: ___________________
Location : ___________________________________
City/Municipality/Province : _____________________________________
NUTRITIONAL
4P's ID Age NUTRITIONAL NUTRITIONAL
NAME OF THE CHILD BIRTHDATE HEIGHT WEIGHT STATUS (using NAME OF
No. SEX Ethnicity Disability Number (If (in STATUS (using STATUS (using
(in cm) (in Kilos) weight-for- PARENT/GUARDIAN
applicabe) mos.) weight-for-age) height-for-age)
First Name Middle Name Last Name Ext. Name Year Month Day height)
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Legend for Nutritional Status: PREPARED BY:
Weight-for-Age Indicator Height-for-Age Indicator Weight-for-Height Indicator
SU- Severely Underweight SS- Severely Stunted SW- Severely Wasted
UW- Underweight S – Stunted W – Wasted
N – Normal N – Normal N – Normal NAME / POSITION
OW- Overweight T – Tall OW- Overweight

Date

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