SFP Form 2.
a
DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Supplemental Feeding Program
MASTERLIST OF BENEFICIARIES
Name of DCC: _________________________________________ Date of Weighing: October 2020
Name of DCW: ________________________________________
Location: _____________________________________________
BIRTHDATE AGE HEIGH Nut. WEI Nut. H FOR W/ NAME OF
No. Name of Child SEX (year/month/day) (in mos.) T Status GHT Status Nut. Status PARENT/ GUARDIAN
1 Juan De la Cruz M 1/12/2017 36 101 N 14.08 N N JANA DELA CRUZ
2 Peter Loreno M 12/15/2016 39 94 S 9.0 SU SW JOSEPH LORENO
Nutritional Status: (Using CGS as reference) Prepared by:
SU- Severely Underweight
UW- Underweight ____________________________________
N- Normal Name/Position
OW- Overweight
____________________________________
Date
DEPARTMENT OF SO