SBFP Form 1

Department of Education
Region III

Master List Beneficiaries for School-Based Feeding Program (SBFP)

Division/Province: _________________ ZAMBALES Name of Principal : _ ELSIE T. RAMOS

City/ Municipality/Barangay : _________ BOTOLAN Name of Feeding Focal Person : JONAFLOR D. CABEZON
Name of School / School District BELBEL ELEMENTARY SCHOOL/ BOTOLAN DISTRICT

BMI for Beneficiary of SBFP

Date of Weighing / Age in Weight Height 6 y.o. Nutritional 4Ps ID
Date of Birth
No. Name Sex (MM/DD/YYYY) Measuring Years /
and Status (NS) Ethnicity Disability Number Name of Parents in Previous Years
(MM/DD/YYYY) Months (Kg) (cm)
(yes or no)
above

KINDERGARTEN
1 Cabalic , Dionisio M. M 12/5/2005 June 8, 2018 13,3 30 142 14.8 wasted Aeta Orlando Cabalic NO
2 Cabalic, Gitgit M. M 9/9/2008 June 8, 2018 9,9 20 123 13.2 wasted Aeta Tsok Cabalic NO
3 Cabalic, Inggo M 11/27/2012 June 8, 2018 5,8 14 110 wasted Aeta Merlit Cabalic NO
4 Cabalic, Julius M. M 10/7/2011 June 8, 2018 7,7 21 100 13 wasted Aeta Tsok Cabalic NO
5 Cabalic, Jury C. M 7/8/2012 June 8, 2018 5,10 13 120 wasted Aeta Ikoy Cabalic NO
6 Cabalic, Morol M. M 10/18/2010 June 8, 2018 7,0 14 129 12.6 wasted Aeta Tsok Cabalic NO
7 Cabalic, Tebaw C. M 6/6/2012 June 8, 2018 ,0 14 105 12.6 wasted Aeta Rowena Cabalic NO
8 Cabalic, Tonton B. M 12/23/2013 June 8, 2018 5,3 12 100 wasted Aeta Tengteng CabalicNO
9 Cabalic, Warsak C. M 08/25/2013 June 8, 2018 5,7 13 111 wasted Aeta Lolit Candule NO
10 Hapda, Singkol H. M 01/20/2013 June 8, 2018 5,7 14 110 wasted Aeta Arman Hapda NO
11 Magtanong, Teroy H. M 08/21/2013 June 8, 2018 5,11 13 100 wasted Aeta Toroy magtanongNO
12 Mangatuliran, Lapacito M 01/24/2003 June 8, 2018 14,6 27 142 13.3 wasted Aeta Rosie Mangatulir NO
13 Soria, Bontsik J. M 05/21/2009 June 8, 2018 9,2 20 123 13.2 wasted Aeta Jacklyn Jugatan NO
14 Soria, Piolo J. M 08/13/2012 June 8, 2018 5,11 15 115 wasted Aeta Jacklyn Jugatan NO
15 Soria, Rubin J. M 11/6/2010 June 8, 2018 8,0 15 114 11.5 s. wasted Aeta Jacklyn Jugatan NO
16 Antonio, Salaminda H. F 07/25/2010 June 8, 2018 7,11 18 120 12.5 wasted Aeta Elsa Hapda NO
17 Cabalic, Lotlot D. F 03/18/2012 June 8, 2018 6,2 10 100 10 s. wasted Aeta Rosa Dela Cruz NO
18 Cabalic, Shayra H. F 01/21/2009 June 8, 2018 9,4 20 127 12.4 wasted Aeta Sharon Hapda NO
19 Cabalic, Sherille H. F 06/15/2010 June 8, 2018 8,0 18 120 12.5 wasted Aeta Sokael cabalic NO
20 Dela Cruz, Judy Ann J. F 09/17/2011 June 8, 2018 6,11 15 123 wasted Aeta Burger Dela CruzNO
21 Dela Cruz,Lasing J. F 06/29/2011 June 8, 2018 7,0 18 123 11.8 wasted Aeta Burger Dela CruzNO
22 Dela Cruz, Maya J. F 07/26/2012 June 8, 2018 5,11 15 120 wasted Aeta Burger Dela CruzNO
23 Hapda, Boseng F 5/6/2011 June 8, 2018 7,0 17 119 12 wasted Aeta Arman Hapda NO
24 Hapda, Miessy B. F 08/13/2013 June 8, 2018 4,11 13 100 wasted Aeta Joseph Hapda NO
25 Magtanong, Teresa H. F 10/24/2010 June 8, 2018 7,7 18 123 11.8 wasted Aeta Toroy MagtanongNO
GRADE ONE
26 Cabalic, Bakyo D. M 05/31/2010 June 8, 2018 8,0 18 119 12.7 wasted Aeta Tarak cabalic NO
27 Cabalic, Belly D. M 04/25/2009 June 8, 2018 9,3 17 120 11.8 wasted Aeta Ric Cabalic NO
28 Cabalic, Felipe M 06/25/2010 June 8, 2018 7,11 16 110 13.2 wasted Aeta Ngongo Cabalic NO
29 Cabalic, Jiric C. M 06/21/2010 June 8, 2018 8,0 16 106 14.2 wasted Aeta Rex Cabalic NO
30 Cabalic,Josue M 3/9/2011 June 8, 2018 6,9 16 11 12.9 wasted Aeta Ngongo Cabalic NO
31 Cabalic, Meteh D. M 7/2/2008 June 8, 2018 9,11 21 126 13.2 wasted Aeta Tarak cabalic NO
32 Jugatan Lotuk C. M 2/2/2010 June 8, 2018 8,4 16 110 13.2 wasted Aeta Karenyo Jugatan NO
33 Antonio, Deborah C. F 09/25/2011 June 8, 2018 6,8 17 118 12.2 wasted Aeta David Antonio NO
34 Cabalic, Angelica C. F 03/31/2010 June 8, 2018 8,2 14 105 12.6 wasted Aeta Otong Cabalic NO
35 Cabalic, Janet M. F 9/4/2009 June 8, 2018 9,2 19 123 12.5 wasted Aeta Corean Cabalic NO
36 Cabalic, Jessica C. F 05/31/2004 June 8, 2018 14,0 32 145 15.2 wasted Aeta Ikoy Cabalic NO
37 Cabalic, Marchela C. F 03/23/2011 June 8, 2018 7,2 12 97 12.7 wasted Aeta Jose Cabalic NO
38 Cabalic , Myneng M. F 5/6/2011 June 8, 2018 7,0 12 98 12.4 wasted Aeta Corean Cabalic NO
39 Carino, Jessica J. F 07/29/2011 June 8, 2018 6,10 14 109 11.7 wasted Aeta Jesie Carino NO
40 Soria ,Eisel C. F 12/22/2010 June 8, 2018 7,5 13 106 11.5 s. wasted Aeta Binoy Soria NO
GRADE TWO
41 Cabalic, El-law D. M 12/23/2010 June 8, 2018 7,5 20 125 12.8 wasted Aeta Gerap Cabalic NO
42 Cabalic, Noe A. M 01/19/2008 June 8, 2018 10,4 20 124 13 wasted Aeta Ngongo Cabalic NO
43 Cabalic, Rojames D. M 08/25/2010 June 8, 2018 7,9 18 119 12.7 wasted Aeta Rudy cabalic NO
44 Cabalic, Teleberey D. M 08/14/2008 June 8, 2018 9,10 20 123 13.2 wasted Aeta Gerap Cabalic NO
45 Cabalic, Zaldy O. M 06/18/2008 June 8, 2018 10,11 21 126 13.2 wasted Aeta Labong cabalic NO
46 Soria, Joven C. M 03/16/2009 June 8, 2018 9,2 17 115 12.8 wasted Aeta Binoy Soria NO
47 Soria, Lumanay C. M 12/24/2008 June 8, 2018 9,5 22 130 13 wasted Aeta Binoy Soria NO
48 Candule, Mary Rose C. F 12/1/2009 June 8, 2018 9,5 18 119 12.7 wasted Aeta Lolit Candule NO
49 Dela Cruz, Cyndia C. F 09/18/2010 June 8, 2018 7,8 15 110 12.3 wasted Aeta David Soria NO
50 Dela Cruz, Dikay C. F 3/5/2009 June 8, 2018 9,1 12 111 9.7 s. wasted Aeta Gasolina Cabalic NO
51 Jugatan, Jesie C. F 05/22/2010 June 8, 2018 8,0 18 121 12.2 wasted Aeta Labong Jugatan NO
52 Jugatan , Mebill C. F 10/8/2009 June 8, 2018 8,10 19 124 12.3 wasted Aeta Gasolina Cabalic NO
53 Tabunday, Kathryn H. F 8/6/2004 June 8, 2018 14,0 29 139 15 wasted Aeta Rosie Hapda NO
GRADE THREE
54 Cabalic, Isko D. M 09/18/2004 June 8, 2018 13,8 26 135 14.2 wasted Aeta Singkamas CabalNO
55 Cabalic, Rudy Boy D. M 5/6/2003 June 8, 2018 15,1 32 142 15.8 wasted Aeta Rudy Cabalic NO
56 Mangatuliran, Mike B. M 02/15/2003 June 8, 2018 15,5 30 143 14.7 wasted Aeta Bernido MangatulNO
57 Soria , Alvin D. M 08/13/2009 June 8, 2018 8,10 23 134 12.8 wasted Aeta David Soria NO
58 Cabalic, Ella D. F 01/22/2006 June 8, 2018 12,4 23 130 13.6 wasted Aeta Singkamas CabalNO
59 Cabalic, Jocel M. F 09/15/2005 June 8, 2018 12,9 27 139 13.9 wasted Aeta Corea Cabalic NO
60 Cabalic, Kikay M. F 05/16/2003 June 8, 2018 15,0 30 142 14.8 wasted Aeta Tsok Cabalic NO
61 Cabalic, Lovelyn D. F 11/25/2005 June 8, 2018 12,6 28 142 13.8 wasted Aeta Rudy Cabalic NO
62 Cabalic, Lyka C. F 04/27/2007 June 8, 2018 11,1 25 139 12.9 wasted Aeta Jose Cabalic NO
63 Cabalic, Lyssa Lyn C. F 04/29/2005 June 8, 2018 13,1 29 142 14.3 wasted Aeta Jose Cabalic NO
64 Cabalic, Ma. Rhea D. F 03/22/2008 June 8, 2018 10,2 21 129 12.6 wasted Aeta Rudy Cabalic NO
65 Cabalic, Michelle J. F 12/8/2007 June 8, 2018 10,10 21 126 13.2 wasted Aeta Lisa Cabalic NO
66 Cabalic, Nieves C. F 04/28/2010 June 8, 2018 8,1 13 118 9.3 s. wasted Aeta Jose Cabalic NO
67 Cablic, Rikita C. F 03/16/2005 June 8, 2018 13,2 28 137 14.9 wasted Aeta Tengteng CabalicNO
68 Cabalic, Suzette M. F 12/9/2010 June 8, 2018 7,9 19 123 12.5 wasted Aeta Corea Cabalic NO
69 Candule, Payungan D. F 4/1/2003 June 8, 2018 15,5 24 125 15.3 wasted Aeta Gasin Candule NO
70 Magtanong, Embing H. F 02/25/2007 June 8, 2018 11,3 24 134 13.3 wasted Aeta Toroy MagtanongNO
GRADE FOUR
71 Cabalic, Salvador O. M 10/4/2003 June 8, 2018 14,8 28 135 15,3 wasted Aeta Bong Cabalic NO
Prepared by: Noted :

JONAFLOR D. CABEZON ELSIE T. RAMOS

Feeding Focal Person School Principal / Officer-in-Charge

Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
SBFP Form 2
Department of Education
Region ___III

SCHOOL-BASED FEEDING PROGRAM (SBFP)

Division/Province: ___________ Zambales
City/ Municipality/Barangay : ___ Botolan
Name of School / School District Santiago Elementary School
Nutritional Status at Start of Feeding Ethnicity 4 Ps Beneficiaries
Number of Undernourished School
Children by Grade Level No. of No. of Pupils who
Severely No. of Total are beneficiaries in
Wasted Wasted Beneficiaries No. of Ethnic Ben. No. of 4 Ps Ben. previous years Remarks

1. Kinder 2 23 25 25 0

2. Grade I 1 14 15 15 0

3. Grade II 1 12 13 13 1 0

4. Grade III 1 16 17 17 0

5. Grade IV 0 1 1 1 1 0

Total 5 66 71 71 2 0

Prepared by: Noted by:

JONAFLOR D. CABEZON ELSIE T. RAMOS

SBFP DepEd Focal Unit Chief

Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-
HNC
SBFP Form 3
Department of Education
Region _III

Division/Province: ____________ Zambales

School District/City/ Municipality Belbel ES/Botolan South

Name of District
Name of Schools BEIS ID No. School Address Name of Barangay Contact Number Total
Supervisors/
Beneficiaries
School Principal or OICs

Belbel Elementary School 281504 Belbel,Botolan , Zambales Belbel Blesilda D. Fontanilla 9971429332 71

Prepared by: Noted by:

JONAFLOR D. CABEZON ELSIE T. RAMOS

SBFP School Focal Unit Chief

Note: This form shall be prepared by the DO, for final consolidation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
 Prepared by:
LEGEND
JONAFLOR D. CABEZON A. Nutritional Status
B. Deworming D. Actual Feeding
Feeding Teacher For 6-19 y.o For below 6 y.o
SW - Severely wastedSU - Severely underweight ( x ) - not dewormed ( √ ) - Present, served
W - Wasted U - Underweight ( √ ) - dewormed ( A ) - Absent, not served
N - Normal N - Normal (√√ ) - Present, served twice
Ow - Overwieght Ow - Overwieght
O - Obese

Note: This form shall be prepared by the school to be consolidated using SBFP Form 5

Noted:

LLOYD ALBERT M.YAP

0 Head Teacher I

Page 7
### SBFP Form 4

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF_DECEMBER_,SY_ 2020-2021_

Region ____________________III
Region ____________________ZAMBALES School: ___ BELBEL ELEMENTARY SCHOOL
Region ____________________BOTOLAN NORTH Grade: ____ KINDERGARTEN - GRADE SIX

ACTUAL FEEDING
NAME OF PUPIL

WEEK 1 WEEK 2
KINDERGARTEN M T W TH F M T W TH F
1 BELLA,SANA, HAPDA / / / / / / / / / /
2 HAPDA, LEON / / / / / / / / / /
3 CABALIC,BRYAN ADAMS, D. / / / / / / / / / /
4 CABALIC,LUCKY, HAPDA / / / / / / / / / /
5 CABALIC,MOISES, M. / / / / / / / / / /
6 Dela Cruz,PJ, Cabalic / / / / / / / / / /
7 MAGTANONG,DANDOY, S. / / / / / / / / / /
8 TABUNDAY,SAMUEL, HAPDA / / / / / / / / / /
9 BELLA,JUDY ANN, HAPDA / / / / / / / / / /
10 CABALIC,BEVERLY, JUGATAN / / / / / / / / / /
11 CABALIC,JERELYN, - / / / / / / / / / /
12 HAPDA,CHERYL, HAPDA / / / / / / / / / /
SORIA,JUDELYN, DELA CRUZ / / / / / / / / / /
13 TABUNDAY,KAREN, HAPDA / / / / / / / / / /
14 GRADE I
15 Cabalic, Christ John Robert C. / / / / / / / / / /
16 Cabalic, Jerick D. / / / / / / / / / /
17 Cabalic , Salvador / / / / / / / / / /
18 Cabalic, Julius M. / / / / / / / / / /
19 Cabalic, Tonton / / / / / / / / / /
20 Dela Cruz , Edmar H. / / / / / / / / / /
21 Hapda ,Arnold H. / / / / / / / / / /
22 Jugatan,Piskal C. / / / / / / / / / /
23 Soria, Arbie D. / / / / / / / / / /
24 Mangatuliran, Romeo Jr. / / / / / / / / / /
25 Soria, Piolo / / / / / / / / / /
26 Cabalic , Esther / / / / / / / / / /
Cabalic,Lotlot / / / / / / / / / /

page 2
27 Cabalic, Rudylyn / / / / / / / / / /
28 Cabalic, Sherille / / / / / / / / / /
29 Dela Cruz , Coleen / / / / / / / / / /
30 GradeII
31 CABALIC,FELIPE, - / / / / / / / / / /
32 CABALIC,GITGIT, HAPDA / / / / / / / / / /
33 CABALIC,JOSUE, ANTONIO / / / / / / / / / /
34 CABALIC,MOROL, HAPDA / / / / / / / / / /
35 SORIA,BONTSIK, JUGATAN / / / / / / / / / /
36 SORIA,RUBIN, JUGATAN / / / / / / / / / /
37 CABALIC,BUNSAY, HAPDA / / / / / / / / / /
38 CABALIC,MARCHELA, CAPIZ / / / / / / / / / /
39 CABALIC,SHAYRA, HAPDA / / / / / / / / / /
DELA CRUZ,MAYA, JUGATAN / / / / / / / / / /
40 MAGTANONG,TERESA, H. / / / / / / / / / /
41 GRADE III
42 CABALIC,BAKYO, DELA CRUZ / / / / / / / / / /
43 CABALIC,METEH, DELA CRUZ / / / / / / / / / /
44 CABALIC,ROJAMES, D. / / / / / / / / / /
45 JUGATAN,LUTOK, CABALIC / / / / / / / / / /
46 CABALIC,DIKAY, CABALIC / / / / / / / / / /
47 CABALIC,JANET, M. / / / / / / / / / /
48 CABALIC,JESSICA, CANDULE / / / / / / / / / /
49 CABALIC,MYNENG, M. / / / / / / / / / /
50 CARIÑO,JESSICA, JUGATAN / / / / / / / / / /
JUGATAN,ANGELICA, J. / / / / / / / / / /
51 SORIA,EISEL, CABALIC / / / / / / / / / /
52 GRADE IV
53 CABALIC,NOE, ANTONIO / / / / / / / / / /
54 CABALIC,ZALDY, OSASA / / / / / / / / / /
55 JUGATAN,DANIEL, CABALIC / / / / / / / / / /
56 SORIA,JOVEN, CABALIC / / / / / / / / / /
57 CANDULE,MARY ROSE, C. / / / / / / / / / /
58 JUGATAN,JESIE, CABALIC / / / / / / / / / /
59 JUGATAN,MEBILL, CABALIC / / / / / / / / / /
60 MANGATULIRAN,LORIEN, M. / / / / / / / / / /
61 SORIA,CYNDIA, DELA CRUZ / / / / / / / / / /
62 TABUNDAY,KATHRYN, HAPDA / / / / / / / / / /
63 GRADE V
64 Cabalic, Isko D. / / / / / / / / / /
65 Cabalic, Rudy Boy D. / / / / / / / / / /
Soria , Alvin D. / / / / / / / / / /
66 Cabalic, Ella D. / / / / / / / / / /

page 2
Cabalic, Kikay M. / / / / / / / / / /
Cabalic, Lovelyn D. / / / / / / / / / /
Cabalic, Lyka C. / / / / / / / / / /
Cabalic, Ma. Rhea D. / / / / / / / / / /
Cabalic, Nieves C. / / / / / / / / / /
Cablic, Rikita C. / / / / / / / / / /
Cabalic, Suzette M. / / / / / / / / / /
Candule, Payungan D. / / / / / / / / / /
Magtanong, Embing H. / / / / / / / / / /
GRADE VI
Cabalic,Salvador Osasa / / / / / / / / / /

D. Actual Feeding

( √ ) - Present, served
( A ) - Absent, not served
(√√ ) - Present, served twice

Noted:
Prpared by:

JULIE L. BUNDANG
JONAFLOR D. CABEZON School Head I
School Feeding Teacher

page 2
 SBFP Form 4

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF __ __ , SY __2017-2018

Region _____________________III
Division ___________________ ZAMBALES School: ___ SANTIAGO ELEMENTARY SCHOOL
District ____________________ BOTOLAN NORTH Grade: ____ KINDERGARTEN - GRADE SIX

ACTUAL FEEDING

NAME OF PUPIL

61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
KINDERGARTEN
1 Castillo,Yxekel
2 Dela Cruz,Jan Rey
3 Galang ,Jhon Jhon
4 Sison,Yuan Kiel
5 Yap,David
6 Malto,Aladin
7 Cantones,Chandie Mae
8 Devera,Rachelle
9 Diñoso,Rose Mae
10 Fernandez,Katelyn
11 Madredejo,Mariel
12 Santos,Joanna
GRADE ONE
13 Apilado,Allen Alfred
14 Arandia, John Alfred
15 Corum,John Kenneth
16 Dante, Darryl
17 Ebilane, Daniel D.
18 Feria, Rudy C.
19 Arandia, Samantha D.
20 Bagat, Rowena A.
21 Bulatao,Jelyn C.
22 Dante, Althea Jane B.
23 De Luna, Angela C.
24 Fabrigar,Zaidee Polinn S.
25 Mendoza,Myka Jane
GRADE TWO
26 Dolin,JR R.
27 Esposo,Mark Angelo
28 Felarca,Jhuvan Ghi Khyle
29 Elaugos,Ayanna Mycah D.
30 Laura,Vera Joyce
31 Merador, Mary Rose
GRADE THREE

page 3
32 Agabao,Michael Jay
GRADE FOUR
33 Ramos, Ely C.
34 Ramos, Ramil C.
35 Dizon, Ronalyn L.
36 Araucto, Mary Salvacion
37 Mangatuliran, Jona
GRADE FIVE
38 Calimlim, Travis Ian
39 Dizon, John Christopher
40 Arandia, Arielle Mae
41 Mendoza, TCY.
42 Dolin,Laurence Nathaniel
GRADE SIX
43 Araucto, Jan Arvie M.
44 Basa, Rubby D.
45 Degollado, Russ Alec
46 Metran, Andrew F.

TOTAL:

D. Actual Feeding

( √ ) - Present, served
( A ) - Absent, not served
(√√ ) - Present, served twice

Prpared by: Noted:

NELIA D.DOCUYANAN ELSIE T. RAMOS

School Feeding Teacher School Head

page 3
 SBFP Form 4

SCHOOL-BASED FEEDING PROGRAM

FOR THE MONTH OF __________ _ , SY __2017-2018

Region ______________________III
Division ____________________ ZAMBALES School: ___ LOOB BUNGA III ELEMENTARY SCHOOL
District _____________________ BOTOLAN NORTH Grade: _KINDERGARTEN-GRADE VI

ACTUAL FEEDING POST FEEDING

ATTENDANCE
NAME OF PUPIL Nutritional Status Days Feeding
Percentage
Ht Wt Date Present Days
101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 cm kg Taken NS (A) (B) (A/B)*100
KINDERGARTEN
1 Castillo,Yxekel 1.01 13 N 119 99%
2 Dela Cruz,Jan Rey 1.03 12 W 119 99%
3 Galang ,Jhon Jhon 1.06 12 W 120 100%
4 Sison,Yuan Kiel 1.08 13 N 120 100%
5 Yap,David 1.01 13 N 120 100%
6 Malto,Aladin 1.03 13 W 119 99%
7 Cantones,Chandie Mae 1.03 13 N 120 100%
8 Devera,Rachelle 1.05 12 N 120 100%
9 Diñoso,Rose Mae 1.02 13 N 118 99%
10 Fernandez,Katelyn 1.04 13 N 120 100%
11 Madredejo,Mariel 1.01 12 W 119 99%
12 Santos,Joanna 1.00 13 N 120 100%
GRADE ONE 1.03 13 N 120 100%
13 Apilado,Allen Alfred 1.02 13 N 120 100%
14 Arandia, John Alfred 1.04 13 N 120 100%
15 Corum,John Kenneth
16 Dante, Darryl 1.15 14 N 120 100%
17 Ebilane, Daniel D. 1.08 13 N 120 100%
18 Feria, Rudy C. 1.10 13 N 120 100%
19 Arandia, Samantha D. 1.15 13 N 120 100%
20 Bagat, Rowena A. 1.15 13 N 120 100%
21 Bulatao,Jelyn C. 1.03 13 N 120 100%
22 Dante, Althea Jane B. 1.16 13 N 120 100%
23 De Luna, Angela C. 1.05 14 N 120 100%
24 Fabrigar,Zaidee Polinn S. 1.15 12 N 120 100%
25 Mendoza,Myka Jane 1.19 13 N 120 100%
GRADE TWO
26 Dolin,JR R. 1.16 14 N 120 100%
27 Esposo,Mark Angelo 1.18 14 N 119 100%
28 Felarca,Jhuvan Ghi Khyle 1.19 12 N 120 100%
29 Elaugos,Ayanna Mycah D. 1.25 ### N 120 100%
30 Laura,Vera Joyce 1.18 13 N 120 100%
31 Merador, Mary Rose 1.20 12 N 120 100%
GRADE THREE
page 4
32 Agabao,Michael Jay 1.11 14 N 120 100%
GRADE FOUR 1.8 16 N 120 100%
33 Ramos, Ely C. 1.10 14 N 120 100%
34 Ramos, Ramil C. 1.10 14 N 120 100%
35 Dizon, Ronalyn L. 1.25 14 N 120 100%
36 Araucto, Mary Salvacion 1.27 14 N 120 100%
37 Mangatuliran, Jona 1.22 14 N 120 100%
GRADE FIVE 1.07 13 N 120 100%
38 Calimlim, Travis Ian
39 Dizon, John Christopher 1.35 15 N 119 99%
40 Arandia, Arielle Mae
41 Mendoza, TCY. 1.28 15 N 120 100%
42 Dolin,Laurence Nathaniel
GRADE SIX 1.40 ### N 120 100%
43 Araucto, Jan Arvie M. 1.38 16 N 120 100%
44 Basa, Rubby D. 1.8 20 N 120 100%
45 Degollado, Russ Alec 1.57 27 N 120 100%
46 Metran, Andrew F.
TOTAL: AVERAGE: 99.89%

D. Actual Feeding

( √ ) - Present, served
( A ) - Absent, not served
(√√ ) - Present, served twice

page 4
SBFP Form 5

SCHOOL-BASED FEEDING PROGRAM

CONSOLIDATED NUTRITIONAL STATUS AND ATTENDANCE REPORT

Region: _______ III
Division/District: _____________ Zambales/Botolan North
School: ______________________Loob Bunga III Elementary School
BEIS ID No.: _________________ 106805
NUTRITIONAL STATUS
No. of Pupils PERCENTAGE
GRADES AND SECTIONS BEFORE AFTER
Dewormed ATTENDANCE
SW/SU W/U N Ow Ob Total SW/SU W/U N Ow O Total
1 Kindergarten 15 10 5 15 0 4 11 15 99.67%
2 Grade One 10 10 10 10 10 100%
3 Grade Two 6 2 4 6 6 6 100%
4 Grade Three 8 8 8 8 8 100%
5 Grade Four 1 1 1 1 1 100%
6 Grade Five 1 1 1 1 1 100%
7 Grade Six 4 1 3 4 4 4 100%
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL AVERAGE: 99.95%
Legend:
For 6-19 y.o For below 6 y.o
SW - Severely Wasted SU - Severely Underweight
W - Wasted U - Underweight
N - Normal N - Normal
Ow - Overweight Ow - Overweight
O - Obese
Prepared by: Noted by:
ROSALIE S. UMIPIG ELSIE T. RAMOS
Classroom Adviser / School Nurse School Head

Note: This form shall be prepared by the school using the data from SBFP Form 4.