REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: ___________

NO. OF HOUSEHOLD

Banrangay: GORAN
NO. SEEN AND REFERED CURRENT MODERN FP USERS SENIOR CITIZEN PERSON W/ DIABILITIY MEN WOMEN WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

HOUSEHOLD Assigned

PREGNANT WOMEN

POSTPARTUM

NEWBORN

INFANT

UNDERFIVE

PHC MEMBERS

Maria Acorda Elisa Banutan Marisa Basa Jenny Bautista Romel Bawit Anitha Buyuga Myra Castro Cherry Ann Castro Vinia Gutierez Leonila Mabatan Rowena Mabatan Nora Modes Analyn M. Munzon Analyn P. Munzon Girly Munzon Lenilda Munzon Reyma Munzon Rose Quinagoran Armohena Ramos Jonalyn Sabban TOTAL PREPARED BY:

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: ___________
NO. OF HOUSEHOLD

Banrangay: GORAN
NO. SEEN AND REFERED CURRENT MODERN FP USERS SENIOR CITIZEN PERSON W/ DIABILITIY MEN WOMEN WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

HOUSEHOLD Assigned

PREGNANT WOMEN

POSTPARTUM

NEWBORN

INFANT

UNDERFIVE

PHC MEMBERS

Precy Sabbabn Edinatabisora Gerlin Tabisora Lesly Tabisora Marites Tamayao Gregoria Vergara Marissa Zalun

TOTAL PREPARED BY:

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM NO. SEEN AND REFERED NEWBORN INFANT UNDERFIVE SENIOR CITIZEN PERSON W/ DIABILITIY CURRENT MODERN FP USERS MEN WOMEN PHC MEMBERS WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

Banrangay: NABBIALAN

Sagun, Christine C. Gose, Marites B. Castro, Marilou D.

Pamittan, Marygrace S.

Balqui, Gemma C. Balaqui, Herminia B. Sarmiento, Susan C. Alejandre Teresita B. Banan, Jhemalyn B. Martirez, Marilou B. Sagun, Esperanza Castro, Arlene S. Vargas, Diana Pea, Meloni Diaz, Rorita Gumabong, Jenalyn Agustin, Marivic Puyot, Florante Paragua, Reynaldos TOTAL PREPARED BY:

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD

Banrangay: NABBIALAN
NO. SEEN AND REFERED CURRENT MODERN FP USERS SENIOR CITIZEN PERSON W/ DIABILITIY MEN WOMEN WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM

NEWBORN

INFANT

UNDERFIVE

PHC MEMBERS

Castillo, Teresita Basa, Aurora Rabuya, Vernie Bartolome, Emillia Andress, Elizabeth Tuliao, Eva Senido, Rowena Macalinao, Gemma Arquero, Erlinda Ruma, Merly Castro, Jerry Dela Cruz, Vanessa Battung, Nida Abutan, Tessie Ruam, Jerry Serrano, Gilibeth Bargado, Jonathan Uday, Rowena

TOTAL PREPARED BY:

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD
HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM NO. SEEN AND REFERED NEWBORN INFANT UNDERFIVE SENIOR CITIZEN PERSON W/ DIABILITIY CURRENT MODERN FP USERS MEN WOMEN PHC MEMBERS WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

Banrangay: AGGUIRIT

Tangaro, Leonita Doca, Susan Escatron, Virginia Mateo, Roben Elchico, Lizalyn Sabban, Myrna Mateo, Romeo Taguiam, Feliciano Sabban, Orlando Mateo, Veronica Galletes, Bernardo Galletes, Virgilio TOTAL PREPARED BY:

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD

Barangay: NANGALASAUAN
NO. SEEN AND REFERED CURRENT MODERN FP USERS SENIOR CITIZEN PERSON W/ DIABILITIY MEN WOMEN WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM

NEWBORN

INFANT

UNDERFIVE

PHC MEMBERS

Alonzo, Marites Gosi, Chrisstina Trinidad, Cornella Castro, Merlinda, Castro, Merlita Gosi, Leticia Daraway, Natividad Gosi, Perlita Castro, Lita Duran, Mary Grace Bargado, Merlita Castro, Norma Castro, Susana Doca, Adelaida Castro, Vicky Estrada, Lolita Castro, Claudia Doca, Julieta Molina, Precy Castro, Antonio TOTAL

PREPARED BY:

ALONZO, MARITES
CHT PARTNER

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD

Banrangay: NANGALASAUAN
NO. SEEN AND REFERED CURRENT MODERN FP USERS SENIOR CITIZEN PERSON W/ DIABILITIY MEN WOMEN WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM

NEWBORN

INFANT

UNDERFIVE

PHC MEMBERS

Soliva, Janet Gosi, Maricar Ledda, Emigine Ledda, Lorna Castro, Cersario

TOTAL

PREPARED BY:

ALONZO, MARITES
CHT PARTNER

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD

Barangay: NANGALASAUAN
NO. SEEN AND REFERED CURRENT MODERN FP USERS SENIOR CITIZEN PERSON W/ DIABILITIY MEN WOMEN WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM

NEWBORN

INFANT

UNDERFIVE

PHC MEMBERS

Gosi, Solidad Conag, Alma Doca, Estela Doca, Maria Doca, Mylene Tacloban, Reymalyn Malazzab, Florencia Duran, Geraldin Bargado, Merly Bargado, Elvira Trinidad, Gladys Pamittan, Letty Laydo, Sofia Laydo, Noreen Malazzab, Zoraida Malazzab, Rosalyn Basa, Celia Manuel, Josephine Ocampo, Joel Ocampo, Marilou TOTAL

PREPARED BY:

MAXIMA D. TRINIDAD
CHT PARTNER

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD
HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM NO. SEEN AND REFERED NEWBORN INFANT UNDERFIVE SENIOR CITIZEN PERSON W/ DIABILITIY CURRENT MODERN FP USERS MEN WOMEN PHC MEMBERS WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

Barangay: NANGALASAUAN

Ordales, Celia Serano, Myla Castro, Julita Corsino, Luzviminda Manaligod, Cherry

TOTAL

PREPARED BY:

MAXIMA D. TRINIDAD
CHT PARTNER

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD

Barangay: CORDOVA
NO. SEEN AND REFERED CURRENT MODERN FP USERS SENIOR CITIZEN PERSON W/ DIABILITIY MEN WOMEN WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM

NEWBORN

INFANT

UNDERFIVE

PHC MEMBERS

Agpaua, Jocelyn Adriano, Anita Ancheta, Rosalinda Basa, Dominga Batulan, Myrna Cabalza, Elena Cambric, Sally Canapi, Melante Dalicon, Emma Dalicun, Gina Dayag, Vilma Dolores, Maribel Enrique, Ines Esguerra, Jenina Estrada, Regina Laurente, Edna Laurente, Mary Grace Laurente, Marilyn Laurente, Sofia Lazo, Avelina TOTAL

PREPARED BY:

ESTRELLA G. LAURENTE
CHT PARTNER

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD
HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM NO. SEEN AND REFERED NEWBORN INFANT UNDERFIVE SENIOR CITIZEN PERSON W/ DIABILITIY CURRENT MODERN FP USERS MEN WOMEN PHC MEMBERS WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

Banrangay: CORDOVA

Liggayu, Mary Jane Liggayu, Rowena Manaligod, Jesusa Manaligod, Zenaida Manuel, Merlita Mico, Mary-Ann Munzon, Marites Pascua, Emelita Sabban, Anastacia Trinidad, Reny Trinidad, Vilma Trinidad, Wina Tuliao, Florida Yala, Lorybeth

TOTAL

PREPARED BY:

ESTRELLA G. LAURENTE
CHT PARTNER

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD
HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM NO. SEEN AND REFERED NEWBORN INFANT UNDERFIVE SENIOR CITIZEN PERSON W/ DIABILITIY CURRENT MODERN FP USERS MEN WOMEN PHC MEMBERS WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

Barangay: CORDOVA

Alverez, Tessie Basa, Raquel Dominador Basa, Evelyn Basa, Francisco Basa, Jenalyn Basa, Luvie Basa, Marcelino Basa, Marivic Basa, Necy Basa, Rio Buyugan, Edelina Cordova, Ronilo Emperador, Venus Estrada, Lydia Fernando, Teresita Galingdon, Ralph Gangan, Erlinda Gasmen, Milagros Laurente, Jennifer Laurente, Shirley TOTAL

PREPARED BY:

FLORA C. LAURENTE
CHT PARTNER

REPORTING FORM FOR BHW Municipality of AMULUNG For the month of: SEPTEMBER
NO. OF HOUSEHOLD
HOUSEHOLD Assigned
PREGNANT WOMEN POSTPARTUM NO. SEEN AND REFERED NEWBORN INFANT UNDERFIVE SENIOR CITIZEN PERSON W/ DIABILITIY CURRENT MODERN FP USERS MEN WOMEN PHC MEMBERS WITH ACCESS TO SAFE WATER WITH SANITARY TOILET FAMILIES WITH RISK FACTORS FOR TB MAL NCDs NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS

Barangay: CORDOVA
DEVELOPED HEALTH PLANS COMPLIED TO HEALTH PLANS

Libunao, Helen Libunao, Marlyn Libunao, Rema Maladrigo, Judith Meman, Josephine Ramos, Christy Recuyo, Emilia Sabban Jeofrey Sabban, Jessie Sabban, Rosalinda Sabban, William Agris, Marivic

TOTAL

PREPARED BY:

FLORA C. LAURENTE
CHT PARTNER

REPORTING FORM FOR RHM

Municipality of AMULUNG For the month of: SEPTEMBER

NO. OF HOUSEHOLD
CATCHMENT BARANGAY NO. SEEN AND REFERED
PREGNANT WOMEN POSTPARTUM NEWBORN INFANT UNDERFIVE SENIOR CITIZEN PERSON W/ DIABILITIY

CURRENT MODERN FP USERS

MEN WOMEN

PHC MEMBERS

WITH ACCESS TO SAFE WATER

WITH SANITARY TOILET FAMILIES

WITH RISK FACTORS

TB MAL NCDs

NO. OF MATERNAL DEATHS

NO. OF NEONATAL DEATHS

DEVELOPED HEALTH PLANS

COMPLIED TO HEALTH PLANS

AGUIRIT CORDOVA GORAN NANGALASAUAN NABBIALAN

TOTAL

PREPARED BY:

LEA MARIE S. ROYO RN HEALS

ARISTOTLE EDILLO RN HEALS

LOURDES SIMANGAN RHM-AMULUNG