BNSP FORM No.

4
Philippine Plan of Action for Nutrition

MONTHLY ACCOMPLISHMENT REPORT

For the Month of __________________
Province:BILIRAN Municipality: CULABA Barangay:

NO. OF REACHED THIS MONTH

LAST MONTHS THIS MONTH TOTAL
TOTAL
ACTIVITY TARGET
NUMBER OLD CASES (as stated NEW CASES (Cases
(Write the entry from 6 of last
in the BHS Actlon reached for the first months report)
(Add column 4 and 5)
Plan) time)

A. WEIGHING ACTIViTiES
1. Full weighing all
preschoolers (PS)

2. Monthly re-weighing 0-24 months PS

3.Quarterly re-weighing 25-71 mos.old

PS
B.REFERRALS
1.TO FEEDING CENTER -Below
Normal(Low)
-Below Normal ( Very Low)
-Prenant/Lactating Mothers
Others(Specify)
2. To Health Center -Below Normal
(Low)
-Below Normal ( Very Low)
-Prenant/ Lactating Mothers
Others (Specify)
3. To Office of Municipal
Agriculturist for distribution of
seeds andseedlings -Familles w/
Preschoolers whose weights is
below normal
others (specify)

4. For Attendance to Mother's

Class -Mothers w/ PS whose
weight is Below Normal

>Pregnant/ Lactating Mothers

Others(Specify)
C.OTHER ACTIVITIES
1.organization/ Reactivation of the
BNC
2. Attendance to BNS meetings
3. Income Generating Projetcs
4. Information Campaign
-Immunization
- Environmental Sanitation
- Selective Food Production
-Family Planning
- Others specify
D. RESULTS OF FOI.LOW UP WEIGHING
PARTICULARS 0-24 MONTHS
NUMBER WEIGHED - Number Normal

-Number Below Normal a.) Number Below Normal (Low)

b. ) Number Below Normal ( Very Low)
-Number Improved in Weight Status

NUMBER NOT WEIGHED -Number Overage

-Number Move Out

-Number Died
BNS Form No. 1C
Barangay Nutrition Profile

*BARANGAY SITUATIONAL ANALYSIS , CY__________

Barangay: _________________ City/Municipality: __________________ Province: __________________

Total Number of Puroks: __________

Indicators Number
1. Total Population
2. Number of Households
3. Households surveyed during Family Profile Survey
4. Total number of women who are:
a. Pregnant
b. Lactating
5. Total number of households with preschool children aged 0-71 months old
6. Actual Population of preschool children 0-59 months old
7. Total number of preschool children 0-59 months old measured during OPT Plus
a. Percent (%) measured coveraged (OPT Plus)
b. Number and Percent (%) of preschool children according to Nutritional Status No. %
1) Severely underweight
2) Underweight
3)Normal Weight
4) Severely Wasted/ SAM
5) Moderately Wasted/ MAM
6) Overweight**
7) Obese
8)Severely Stunted
9) Moderately Stunted
8. Total number of infants 0-5 months old
9. Total number of infants 6-11 months old
10. Total number of preschoolers 0-23 months old
11. Total number of preschool children aged 12-59 months old
12. Total number of preschoolers 24-59 months old
13. Total number of families with severely wasted and wasted preschool children
14. Total number of families with stunted and severely stunted preschool children
15. Total number of Educational Institutions Public Private
a. Number of Day Care Centers
b. Number of Elementary Schools
16. Total number of children enrolled in Kindergarten (DepED-Supervised)
17. Total number of schoolchildren (Grade 1-6)
18. Total number of school children weighed at the start of the school year (K-Grade 6)
19. Percent (%) coverage of school children measured
20. Number and percent (%) of school children according to Nutritional Status No. %

a. Severely Wasted
b. Wasted
c. Normal
d. Overweight
e. Obese
* Referred as " Barangay Nutrition Profile" in the BNS Handbook
** Refers to weighht-for-length/height
 Indicators Number
21. 0-5 month old infants who are exclusively breastfeed
22. Households with severely wasted and wasted school children
23. School children dewormed at the start of the school year
24. Fully Immunized Children (FIC)
25. Households, by type toilet facility: No. %
a. Water-sealed toilet
b. Other types, specify :___________________
c. No toilet
26. Households, by type of garbage disposal: No. %
a. Barangay or Municipal garbage collection
b. Own Compost pit
c. Others, specify: ____________________
27. Households, by Source of drinking water: No. %
a. Piped Water System (Level III)
b. Communal source piped water system
c.Mineral water/water dispensing stores
d. Others, specify
28. Households with: No. %
a. Vegetables garden
b. Livestock/poultry
c. Fishpond
29. Households according to type of dwelling unit: No. %
a. Concrete
b. Semi-concrete
c. Wood
d. Makeshift/barong-barong
30. Total number of households using iodized salt
31. Total number of eateries/carinderia
32. Total number of sari-sari stores
33. Total number of Botika sa Barangay
34. Number of health and nutrition workers: No. %
a. Barangay Nutrition Scholar
b. Barangay Health Worker
35. Total number of household beneficiaries of Pantawid Pamilya Pilipino Program
 THE BARANGAY NUTRITION COMMITTEE
CY 20____

Printed Name Agency / Office Designation Signature

Chairman:
Co-Chairman:
BNS:

Members:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Barangay Nutrition Action Plan
CY _______________

Barangay:_______________________________________________
CULABA
City/Municipality:________________________________________
 FORMAT A
BARANGAY PROFILE-1. Health and Nutrition Situation

Name of Barangay:_____________________________________________________ City/Municipality:_____________________________ Region:__________________

Part A.
Total No. of Puroks:_________________________________ SCHOOL CHILDREN (SC) Latest Period of OPT:__________________________
Total Population:___________________________________ No. with Normal Weight:_______________________ % OPT Coverage of Preschoolers:________________
Total No. of Households:____________________________ No. of Wasted/Severely Wastec SC:______________ Age Specific Proportionate Mortality Rate:________
Total No. of Pres-School Children (0-71 months):____________ No. of Overweight/Obese SC:___________________ No. of Households withHome Gardens:___________
Total No. of School Children:_________________________ Total No. of SC weighed:________________________ Common Occupation of Household Heads:________
Total No. of Pregnant Women:_______________________ Total No. of Families with:
Total No. of Lactating Women:_______________________ a. PS with weight UW & SUW:__________
PRESCHOOL CHILDREN (PS) b. SC with weight W & SW:____________
No. with Normal Weight:____________________________ MICRONUTRIENT DEFICIENCES (TOTAL NO.)
No. of Underweight:________________________________ PS SC P/L 15 yrs. & over
No. of Severely Underweight:________________________ Nightblindness
Total No. of SUW and SUW:__________________________ Anemia
NO. with weight Overweight:_________________________ Goiter
Total of PS weighed:________________________________

Part B.

Total Number Pres-School Children (0-71 months) School Children Nutritional Deficiences
Wasted & Nigt- Anemia Goiter R
Preschool Children

Total PS Severely Total SC blindness

Pregnant Women

Lactating Women

Purok UW & SUW weighed Wasted weighed A

School Children

(Name or Number) N
Underweight

Underweight

Overweight

Overweight
K
Population

Household

15 yrs. I
Severely

No. % No. % No. % No. % PS SC SC P/L SC

Normal

Normal
& over
N
G
BNS Form No. 3B
Philippine Plan of Action for Nutrition
MONTHLY RECORD OF WEIGHT AND WEIGHT STATUS
UNDERWEIGHT AND SEVERELY UNDERWEIGHT CASES

PROVINCE: BILIRAN CITY/MUNICIPALITY: CULABA

Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
DATE OF BIRTH
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DATE ACCOMPLISHED:
ACCOMPLISHED BY:
SUMMARY (Accomplished after 6 months):
No. Identified Underweight and Severely Underweight:
 AGUSTIN,
EMMANU
AGUSTIN, EMMANUEL JOSHUA M 19 SUW SSt MW
EL
JOSHUA

ROSARIO,
ROSARIO, JACKIELYN JACKIELY F 57 N St N
N

ROSARIO,
ROSARIO, JHON JR. M 41 N SSt N
JHON JR.

CADA,
CADA, NEITHAN M 5 SUW N SW
NEITHAN
DELANTA
DELANTAR, JOSH KENT R, JOSH M 37 N St N
KENT

ELMUND
ELMUNDO, ALJHON O, M 24 N St N
ALJHON

BAULA,
BAULA, MARY HOPE MARY F 57 N St N
HOPE
AGUIRRE,
AGUIRRE, ALDRIN M 53 N St N
ALDRIN
TAGARO,
TAGARO, ARIANA F 12 N St N
ARIANA
LACABE,
LACABE, GILLIANT F 30 N St N
GILLIANT

DEVIO,
AQUINAS
DEVIO, AQUINAS ALEXANDRE M 22 N St N
ALEXAND
RE

PENREJIT
PENREJITO, JHON RIEL O, JHON M 37 UW N MW
RIEL

PENREJIT
PENREJITO. JHON RANIEL O. JHON M 1 N T MW
RANIEL
LUAÑA,
LUAÑA, RUSSEL M 32 N St N
RUSSEL
EBORDE,
EBORDE, EDGAR M 32 N St N
EDGAR
BNS Form No. 3A
Philippine Plan of Action for Nutrition
MONTHLY RECORD OF WEIGHT AND WEIGHT STATUS
INFANTS 0-23 MONTHS

PROVINCE: CITY/MUNICIPALITY:
DATE OF BIRTH Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status

NO. OF SEVERELY UNDERWEIGHT: DATE ACCOMPLISHED:

NO. OF UNDERWEIGHT: ACCOMPLISHED BY:
BNS Form No. 3A
Philippine Plan of Action for Nutrition
MONTHLY RECORD OF WEIGHT AND WEIGHT STATUS
0-59 MONTHS OLD

PROVINCE: CITY/MUNICIPALITY:
DATE OF BIRTH Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status
1 RAMIREZ, FRANCE LIAM 2018 1 23
2 RAMIREZ, LIAHNA FAITH 2021 6 7
3 RAMIREZ, JAMES IAN 2018 6 8
4 VERUNTIAO, LESTER CLENT 2019 9 5
5 ALVIOR, JERSON 2020 1 13
6 TRAPAL, PRENCE CRISTOF 2019 6 28
7 COLOBONG, JERRY CHRIS 2023 1 14
8 CRUZ, FEBE ATARAH 2018 2 15
9 BERENIO, JEREMIAH FAITH 2019 10 13
10 LONGABELLA, ERICA 2019 6 28
11 LONGABELLA, MA. ELLISE 2022 7 21
12 CABUQUIN, RICKY 2018 12 27
13 VERADOR, NINO 2019 1 3
14 VERADOR, PRENCES MAE 2021 1 16
15 BANAL, MITCH KYZIA 2018 8 12
16 ARPON, JOHN UNO 2021 1 1
17 VILLAREAL, LIAM 2022 1 3
18 OLEDAN, NATHAN RYL 2021 8 12
19 BERINGGA, JHON MARK 2019 10 18
20 ENDONG, BRYLE LAYNARD 2018 8 2
21 ENDONG, NATHANIEL 2022 7 21
22 ABIA, KEM IAN 2019 8 28
23 ARPON, JHON MOISES 2022 5 20
24 ALVIOR, JOHN FRANCE 2022 7 3
25 NICDAO, CAITLYN 2020 4 9
26 MAHINAY, MARK RANDEL 2020 5 28
 DATE OF BIRTH Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status
27 MONZALES, PRINCESS THEA 2019 4 22
28 HINUNANGAN, BRYLE 2021 10 17
29 HINUNANGAN, CJ 2018 10 14
30 TRAPAL, GIX ZARICO 2020 6 7
31 AGUSTIN, EMMANUEL JOSHUA 2021 5 27
32 GAMBOA, LEILANIE 2019 7 5
33 CASAQUIT,RON MATHEW 2020 2 15
34 PACAMPARA, BENXELL 2018 10 27
35 PACAMPARA, SAMANTHA 2021 5 21
36 VIENES, SOFIA MARIE 2020 12 5
37 SANGARIOS, ATHALIA ZAHARA 2021 9 21
38 SANGARIOS, KURT DAVIN JAY 2019 3 17
39 LUNA, MARIELA ROXIE 2018 11 15
40 ARAULLO, AMIRA 2021 5 14
41 ANGEL, DANICA 2018 9 21
42 AVILA, URIEL 2021 6 5
43 SACARE, ELISHA KATE 2020 7 23
44 VILLORENTE, MARCO 2020 1 20
45 MAHINAY, ACE YURI 2019 7 23
46 BONITA, PRINCESS 2021 8 10
47 RAMIREZ, LEALYN 2022 6 5
48 SANGARIOS, BELLA LEXY 2022 8 31
49 SANGARIOS, HAZEL MAE 2022 10 27
50 MACABENTA, JACK 2021 5 28
51 DAVID, ANGEL SUN 2018 4 7
52 SANICO, ELIANNA BELLA 2023 1 4
53 AÑANO, JANETH 2019 7 28
54 AÑANO, ASHLEY 2023 1 7
55 CAWALING, ALISHARIF 2019 9 7
56 CAWALING, ALI IBRAHIM 2020 6 10
 DATE OF BIRTH Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status
57 GLER, LINDSAY 2018 8 1
58 GLER, LHANZ 2022 8 24
59 TADIFA, MOREEN KHEIZELLA 2020 4 4
60 BORROMEO, MICA 2018 7 12
61 AZUELO, RAPHAEL JAYDEN 2021 8 17
62 SALAZAR, NHEL KRISTIAN 2022 3 1
63 AVELINO, ZEKE ADRIEL 2022 6 30
64 GLER, RONNEL JR 2021 10 22
65 MARTINEZ, GILLIAN 2018 4 4
66 LANZAROTE, DAMOS JR. 2020 2 10
67 LANZAROTE, DAVE 2022 8 1
68 GUARINO, ROMEO JR. 2018 7 27
69 NARRIDO, KRISTOFF RYNEL 2020 3 1
70 SUNGAHID THEODOR 2018 5 8
71 CLARIZA, ALSHIFA 2018 10 28
72 OLIMBA, HAILEY JAZLENE 2019 5 6
73 CONDES, FRANCINE 2019 12 19
74 CUYOS, KELVIN DHRAKE 2023 1 18
75 MAHINAY, DAREN 2018 6 3
76 TAN, JHIYAH EUNICE 2020 9 7
77 NUNEZ, KYLE BRYAN 2020 7 8
78 ROSARIO, JACKIELYN 2018 4 28
79 ROSARIO, ATHENA AMBERLIEG 2019 8 2
80 ASTORGA, ALTHEA ROSE 2019 7 11
81 MARAYA, BRYLLE JOSHUA 2019 6 23
82 MONZALES, JONARD 2019 4 7
83 NARITA, PETER JHON 2018 8 8
84 HORFILLA, ALINA 2020 4 21
85 ROSARIO, MARYJEAN 2021 1 15
86 ROSARIO, JHON JR. 2019 8 4
 DATE OF BIRTH Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status
87 ROSARIO, JAKE 2023 1 5
88 TAN, RYLLE ZEN ANDREI 2021 9 27
89 ANGOB, NICKELA 2021 6 25
90 REMANDABAN, DIRK 2021 12 9
91 POLIGRATES, CAMILA LOISE 2022 5 13
92 VILLEGAS, AMBROSE 2022 5 26
93 SILVANO, CARLITO III 2022 12 31
94 CADA, NEITHAN 2022 8 25
95 ALITAPTAP, AVERY DWAYNE 2022 11 2
96 LANZAROTE, BLESSY 2022 11 17
97 GUARINO, ROCO 2022 12 1
98 GREMIO, JAY KEIZER 2022 12 21
99 VILLAFRANCA, LIANNE MAE 2018 6 26
100 MARTINEZ, MARYLEE 2022 6 20
101 MATURAN, DIVINE KRYSTEL 2018 4 15
102 MATURAN, TYRON JOSH 2020 5 25
103 DELANTAR, JOSH KENT 2019 12 16
104 ROSARIO, GIN GRENOULLE 2018 11 4
105 MONZALES, JELLO 2019 12 24
106 MONZALES, ELAISA MAE 2022 10 27
107 LONGSOD, JACK DANIEL 2021 4 23
108 HORFILLA, CANDICE LAURIEL 2020 10 13
109 ELMUNDO, ALJHON 2021 1 20
110 ELMUNDO, ALJHEA 2022 12 30
111 BAULA, MARY HOPE 2018 4 17
112 AGUIRRE, ALDRIN 2018 8 27
113 TAGARO, ARIANA 2022 1 16
114 ELMUNDO, ZYREL JOY 2018 3 14
115 LACABE, CZYRA MAE 2018 5 29
116 LACABE, GILLIANT 2020 7 7
 DATE OF BIRTH Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status
117 DEVIO, AQUINAS ALEXANDRE 2021 3 6
118 DEVIO, OLETHEA 2022 12 8
119 ROBLE, NATHANIEL 2020 5 19
120 PADECIO, TRISHA MAE 2022 8 31
121 EFSOR, DEVON LOUISE 2022 9 26
122 HABITAN, XIAN TERRUS 2019 9 27
123 PENREJITO, JHON RIEL 2019 12 16
124 PENREJITO. JHON RANIEL 2022 12 9
125 LUAÑA, RUSSEL 2020 5 5
126 LUAÑA ROCETE DWAYNE 2022 1 21
127 EBORDE, EDGAR 2020 5 10
128 EBANEZ, ADRIAN 2022 10 15
129 ALVIOR, JAY ROZEN 2021 7 4
130 EBRADO, SOPHIA JANE 2018 6 5
131 ARELLANO, CRISLY AMBER 2022 11 28
132 BERINO, ATARAH THURANE 2019 6 25
133 BAWE, JEHYEON LUKE 2020 9 10
134 MACARIOLA, RYAN ANDRIE 2019 12 1
135 TRAPAL, ELYCA CRISLY 2019 8 16
136 DEVIO, RUXALEN 2022 9 30
137 MONZALES, MARY ANN 2018 5 14
138 LANZAROTE, ARVIE CHRIS 2019 8 5
139 SANTILLAN, SANDER 2022 6 23
BNS Form No. 3A
Philippine Plan of Action for Nutrition
MONTHLY RECORD OF WEIGHT AND WEIGHT STATUS
24-59 MONTHS OLD

PROVINCE: CITY/MUNICIPALITY:
DATE OF BIRTH Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing: Date of Weighing:
No. Name of Child
Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight Age Weight Weight
Year Mo. Day months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status months (Kgs.) Status

NO. OF SEVERELY UNDERWEIGHT: DATE ACCOMPLISHED:

NO. OF UNDERWEIGHT: ACCOMPLISHED BY:
MUNICIPALITY:________________
BARANGAY:___________________
YEAR:________________________
AGE GROUPING
Gender
Age Male Female Total
0-5 months
6-11 months
12-23 months
24-35 months
36-47 months
48-59 months
60-71 months
Total
6-9 years old
10-14 years old
15-19 years old
20-24 years old
25-29 years old
30-34 years old
35-39 years old
40-44 years old
45-49 years old
50-54 years old
55-59 years old
60-64 years old
65-69 years old
70-74 years old
75-79 years old
80-84 years old
85-89 years old
90-94 years old
95-99 years old
100 years old & above
Total
GRAND TOTAL
BNS Form No. 1A
Philippine Plan of Action for Nutrition
FAMILY PROFILE
Purok/ Sitio:________________________ Municipality:_____________________________
Barangay:__________________________ City/Provice:_____________________________

No. of Children Check if: Check if: Fill in: Check if:
No.of Food
HH Educational Couple
HH No. <6 6-23 25-59 >60 Name of Household Head/Spouse Occupation Nursing < 6 mos. child Toilet type Water Production HH using
mem- mos. mos. mos. mos. attainment Mother Practice HH using
(WS, OP, O, Source Activity iodized
bers pregnant Family Mixed Bottle- IFR
Old Old Old Old EBF Others N) (P,W, S) (VG,P/L, salt
Planning feeding fed FP)

(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)
(M)
Abbreviations
CF-Complementary IFR-IROn Fortified Rice Educational Attainment Toilet Water source Food ProductionActivity
EBF-Exclusive (F)-Father EU-Elem. Undergaraduate CU-College WS-Water sealed P-Pipe VG-Vegetable garden
HH- Household (M)-Mother EG-Elem. Graduate CG-College OP-Open pit W-Well P/L-Poultry/ Livestock
HU-HS Undergaraduate V-Vocational O-Others S-Spring FP-Fishpond
HG-HS Graduate O-Others N-None
BNS Form No. 1A
Philippine Plan of Action for Nutrition
FAMILY PROFILE
Purok/ Sitio:________________________ Municipality:_____________________________
Barangay:__________________________ City/Provice:_____________________________

No. of Children Check if: Check if: Fill in: Check if:
Nursing < 6 mos. child
No.of HH Educational Couple
HH No. mem- <6 mos. Name of Household Head/Spouse Occupation Toilet type Water
6-23 25-59 >60 mos. attainment Mother Practice Food HH using HH using
bers Mixed (WS, OP, O, Source
Old mos. Old mos. Old Old pregnant Family EBF Bottle-fed Others Production iodized salt IFR
feeding N) (P,W, S)
Planning Activity
(VG,P/L, FP)
CATIENZA WILFREDO UDTOHAN
1
CATIENZA LUZ FIN
CLARO TEOTIMO SR. BORROMEO
2
CLARO MARILYN VILLA
ROMUALDEZ MAXIMO CATIENZA
3
ROMUALDEZ ARACELIE BULASA
ROMUALDEZ ARNEL BULASA
4
CABINIAN ALLYSA MERCADO
BORROMEO RICKY CABESAS
5
MALINAO MYRNA ALMEN
ANGELLO VICENTE DELA CRUZ
6
COLOBONG ROSE MARIE COLOBONG
ROSENDE ROSITA LACABE
7
DELA CRUZ EFREN BORROMEO
GOLE ROWENA YAZAR
8
VERE ARIEANE MALANA
DESAMERO RALF ARENDAIN
9
DESAMERO MARICHE VERE
DELA CRUZ EDWIN JERCAN
10
DELA CRUZ EVELYN MENDOZA
VILLA ROGILIO SR. CABESAS
11
VILLA ALBENA LABHANAN
BORROMEO EDGAR SULLANO
12
BITARA MARY ANN PAHAYAHAY
LAGARAS JUSTIN BOROL
13
CABELING APRIL VERE
DUMAYO TERESITA CATIENZA
14
 No. of Children Check if: Check if: Fill in: Check if:
Nursing < 6 mos. child
No.of HH Educational Couple
HH No. mem- <6 mos. Name of Household Head/Spouse Occupation Toilet type Water
6-23 25-59 >60 mos. attainment Mother Practice Food HH using HH using
bers Mixed (WS, OP, O, Source
Old mos. Old mos. Old Old pregnant Family EBF Bottle-fed Others Production iodized salt IFR
feeding N) (P,W, S)
Planning Activity
(VG,P/L, FP)
14
LAGARAS JONEL BOROL
ROSARIO JELYN ALMEN
15
BRAGAS ERLITO MONTANO
BRAGAS LUCY MATAGANAS
16
VERE BENJAMIN DELA CRUZ
VERE ARLINA MALANA
17
DELA CRUZ GUILLERMO
RAMIREZ BRENDO JERCAN
18
DELA CRUZ MAIDA JERCAN
JABUIN RODOLFO GUTTIEREZ
19
JABUIN LEONILA DELA CRUZ
BORROMEO VERGILIO SULLANO
20
BORROMEO ANETA MEDALLA
AGUSTIN LOLITA REPASA
21
JOBETAÑA CARMELITA MEDALLA
LACABE SALVADOR MEKAYDOR
22
LACABE CARLOTA VERE
MATAGANAS CLAUDIO ALMEN
23
MATAGANAS RUTH ELMUNDO
MATAGANAS CHARLES ELMUNDO
24
MATAGANAS CRIZELLE RAGA
LACABE JULAN VILLA
25
ZAIDE ROSALINDA TOLEDO
CATIENZA GILBERT ROXAS
26
BORMATE LOIDA APABLE
CATIENZA JOBERT ROXAS
27
MANTUA ROBELYN JABON
CABELING RENATO MALANA
28
CABELING NILDA VERE
PIELAGO FELICIDAD PARMIS
29
LACABE JODITO VILLA
 No. of Children Check if: Check if: Fill in: Check if:
Nursing < 6 mos. child
No.of HH Educational Couple
HH No. mem- <6 mos. Name of Household Head/Spouse Occupation Toilet type Water
6-23 25-59 >60 mos. attainment Mother Practice Food HH using HH using
bers Mixed (WS, OP, O, Source
Old mos. Old mos. Old Old pregnant Family EBF Bottle-fed Others Production iodized salt IFR
feeding N) (P,W, S)
Planning Activity
(VG,P/L, FP)
LACABE LYDIA SANO
30
CATIENZA MARY JEAN DELA CRUZ
ROSEL ROLAND CATIENZA
31
BORROMEO JOMAR BACARESAS
CANDELARIA KIMBERLY TOMAJEJO
32
CATIENZA FEDIRICO MAHUSAY
CATIENZA VIRGINIA ROXAS
33
BERE MARIANO VILLA
BERE ESTRELLA VILLA
34
DELA CRUZ NICO DOHINOG
DARIA JOVIE CANETE
35
LAGAHAN DOMINADOR OMITIN
LAGAHAN LUVEMIN DELA CRUZ
36
LAGAHAN LODY DELA CRUZ
GOLIAS GINA PAALINAWAN
37
LACABE SONNY TAN
BORROMEO MARILOU REEL
38
LODRIPAS RODEL GENTE
LODRIPAS MICHELLE ANN SULLANO
39
SULLANO HELBERT MEDALLA
SULLANO VERMINDA DELA CRUZ
40
VILLA MATRUNILLO VIRAJA
VILLA MARIVIC VILLAR
41
HIPONA FRANCIS AMOROTO
PREGUA NAOMIE PEPITO
42
DELA CRUZ EDUARDO GERCAN
DELA CRUZ FLOREDA CARCELAR
43
HIBAYA CONRADO BACALAÑOS
CATENZA PILAR MAHUSAY
44
PAA RANDY MIRCORERA
CATENZA MARJORIE ROXAS
45
 No. of Children Check if: Check if: Fill in: Check if:
Nursing < 6 mos. child
No.of HH Educational Couple
HH No. mem- <6 mos. Name of Household Head/Spouse Occupation Toilet type Water
6-23 25-59 >60 mos. attainment Mother Practice Food HH using HH using
bers Mixed (WS, OP, O, Source
Old mos. Old mos. Old Old pregnant Family EBF Bottle-fed Others Production iodized salt IFR
feeding N) (P,W, S)
Planning Activity
(VG,P/L, FP)
45
ABIERTAS MACKY GUANDE
VERE BETTY BAYLAR
46
VILLA RODOLFO VIRAJA
DELA CRUZ MARIA LACABE
47
JABUEN JR DELA CRUZ
RAMIREZ LYZA MAE ROSTATA
48
VILLA SANTIAGO VIRAJA
ANGELLO ROSALIO DELA CRUZ
49
ANGELLO MARIA
MATAGANAS ROSITA NUEVA ESPAÑA
50
VERE ARVEN MALANA
VERE MARY SALVE GAVIOLA
51
BORROMEO ALEX
SANO
52
BERE CHRISTY MARIE
CABUQUIN LITA
53
BOTAYA JAQUELINE LUIZA MAHUSAY
SANO DAVID CATIENZA
54
AUNZO ANNA MAY
BONITA BERNARDO
55
BONITA CENESIA VILLA
RAMIREZ EMERSON
56
BONITA BERNADETH
FRANCISCO DOMINGO GALOLO
57
FRANCISCO CRESENCIA TOLEROSO
DE JESUS SANTIAGO RAMIRES
58
FRANCISCO MARY GRACE TOLEROSO
CABESAS JUDITO MATAGANAS
59
CABESAS RINA ARCON-VENTAJA
GANAHAN JOSE JR. BROHAN
60
GANAHAN VIRGINIA ESTRADA
 No. of Children Check if: Check if: Fill in: Check if:
Nursing < 6 mos. child
No.of HH Educational Couple
HH No. mem- <6 mos. Name of Household Head/Spouse Occupation Toilet type Water
6-23 25-59 >60 mos. attainment Mother Practice Food HH using HH using
bers Mixed (WS, OP, O, Source
Old mos. Old mos. Old Old pregnant Family EBF Bottle-fed Others Production iodized salt IFR
feeding N) (P,W, S)
Planning Activity
(VG,P/L, FP)
DELA CRUZ JERICO DOHINOG
61
ABAIGAR REALYN PENARANDA
DELA CRUZ AMILITO HERCAN
62
DELA CRUZ MARIA RINA DOHINOG
DELA CRUZ MICHAEL DOHINOG
63
BAYLON SAIR MEDALLA
OLARTE LIMUEL CATIENZA
64
OLARTE MICHELLE RODRIQUE
DELA CRUZ GERRY LACABE
65
VERE CAROLINA TOLEDO
CANANE JEAR ANGELIO
66
UMPAD JOCELYN AGOSTO
VERE MERLITO DELA CRUZ
67
VERE REBONNETE NAVARRO
VERE BRYAN MALANA
68
VERE POPS LAGARAS
CABELING JOMAR VERE
69
CABELING VANESSA TUMBAGA
ELMUNDO ISAAC MEDALLA
70
NUNES HELEN ROMERO
ROSENDE MARK JHON LACABE
71
ALMEN LEA NUNES
DELA CRUZ EMAR DOHINOG
72
NUNES MICHELLE
DELA CRUZ NICO DOHINOG
73
DARIA JOVIE
MATAGANAS ROMEO
74
MATAGANAS ADELAIDA GUTTIEREZ
CALAGOS ALBERTO MEDALLA
75
CALAGOS CLEOFE QUI
LAYON DENNIS ATOK
76
ALMEN MERLYN NUNEZ
DELA CRUZ WILLIAM BORROMEO
77
DELA CRUZ GEMMA BOLICATING
BACUNAWA SAMUEL BORROMEO
78
TRANGIA SARAH SAPIOT
CATENZA JYVICAR BORROMEO
79
VERE KAREN MALANA
BORROMEO JESUS SR. MEDALLA
80
BORROMEO MARIA VILLA
 No. of Children Check if: Check if: Fill in: Check if:
Nursing < 6 mos. child
No.of HH Educational Couple
HH No. mem- <6 mos. Name of Household Head/Spouse Occupation Toilet type Water
6-23 25-59 >60 mos. attainment Mother Practice Food HH using HH using
bers Mixed (WS, OP, O, Source
Old mos. Old mos. Old Old pregnant Family EBF Bottle-fed Others Production iodized salt IFR
feeding N) (P,W, S)
Planning Activity
(VG,P/L, FP)
CARCELLAR JONEL
81
DELOY BIVIAN BORROMEO
CABUQUIN AEROSMITH
82
CABOBOY WENDELYN FLORES
CATENZA RANDY BORROMEO
83
CATENZA ALMA JAVIOLA
MATANSICO JUNILA ANGELIO
84
PANTAS MARIA AMPARO PENARANDA
ROSILLON LECERIA NAING
85
LAGARAS LOWIE LABHANAN
LAGARAS RUCTHEL ROTAIRO
86
CABUQUIN ROSITA OTEDA
CABUQUIN EDGAR OTEDA
87
ALMEN MARIBEL NUNES
CATENZA JEFFREY BORROMEO
88
TAROLA RISA MEDALLA
PENARANDA ANTONIO LAGARAS
89
PENARANDA MARILOU YADAWON
CABESAS JUANITO JR. MATAGANAS
90
ARNADO HONORATA CABATINGAN
VERE JENNY DELA CRUZ
91
MEDALLA MYRA CORPIN
NAING VIVENCIO
92
RUBENECIA HERMILITA VERE
ALMEN DANILO MEDALLA
93
ALMEN NORMA VERE
DELA CRUZ EDMAR LACABE
94
CARREON MELODIE RANIAGA
ROSILLON RONSON ABACIAL
95
BORROMEO ANIKA CRISTIL ANN
VERE PAULITA CATIENZA
96
PARIENTES FEDERICO ROMERO
COMBINE JOCELYN ABAD
97
GARING ROLLY
VERE GERLIE UDTOHAN
98