DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT

SUPPLEMENTAL FEEDING PROGRAM

WEIGHT MONITORING FORM

SFP Form:3a
Name of CDC: CARANIOGAN CHILD DEVELOPMENT CENTER
Name of CDW: MARY ANN D. GUZON
Location: CARANIOGAN, SAN MANUEL, ISABELA
NUTRITIONAL STATUS
NAME OF CHILDREN Date of SE REMARKS
UPON ENTRY 1 MONTH 2 MONTHS
Birth X VIT. A WEIGH
DATE OF AGE HEIGHT WEIGH Weight Height Weight DEWORM SUPLEMENTA DATE OF AGE HEIGHT T Weight Height Weight DATE OF AGE HEIGHT WEIGHT NUTRITIONAL
for height WEIGHING
WEIGHING
(in. mos.)
(in. cm.) T for age for age
status
ING TION (in (in cm.) (in for age for age for height weighing (in (in cm.) (in kilos) STATUS
(in kilos) ST mos.)
status status (1 DOSE) (1ST DOSE) mos.) kilos) status status status

1. Aeron Jhay M. Alejadro 12-03-03 M 06-15-16 51 37 13 N N N

2. Zaimar R. Antonio 11-09-18 M 06-15-16 50 40 15 N N N
3. Luis Andrei D. Cauguiran 11-08-19 M 06-15-16 56 42 16 N N N
4. Eldrich Prince S. Espiritu 12-07-10 M 06-15-16 57 41 17 N N N
5. Keith James P. Gambol 13-10-02 M 06-15-16 49 36 12 N N N
6. John Prince E. Guico 12-09-05 M 06-15-16 32 39 19 N N N
7. Adriane D. Guzon 12-02-05 M 06-15-16 44 37 13 N N N
8. Charles Darwin C. Laureta 13-10-30 M 06-15-16 52 38 13 N N N
9.Meljay C. Mayes 12-03-29 M 06-15-16 32 37 12 N N N
10. Matteo Miguel M. Pablo 12-04-29 M 06-15-16 51 39 15 N N N
11. James Conan S. Peralta 12-03-22 M 06-15-16 48 37 12 N N N
12. Joshua Rozelle T. Maneja 12-24-06 M 06-15-16 49 37 13 N N N
13. Jimsen Gior S. Zamora 11-12-02 M 06-15-16 56 40 15 N N N
14. John Daniel F. Siblawan 13-06-22 M 06-15-16 51 38 20 OW N O
15. John Vincent S. Gambol 13-10-02 M 06-15-16 36 40 19 OW N O
This form shall be used every month by the DCW in recording weight and height of the child to determine the improvement in childs nutritional status
*DCW should indicate date or month & year when the child was dewormed & provided Vit. A
SU Severly Underweight
Nutritional Status
UW Underweight
N Normal
OW Overweight

Prepared by: Noted by:

MARY ANN D. GUZON MYRNA E. MAPATAC DATE: ____________

CDW Consultant on SWD
 DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
SUPPLEMENTAL FEEDING PROGRAM
WEIGHT MONITORING FORM

SFP Form:3a
Name of CDC: CARANIOGAN CHILD DEVELOPMENT CENTER
Name of CDW: MARY ANN D. GUZON
Location: CARANIOGAN, SAN MANUEL, ISABELA
NUTRITIONAL STATUS
NAME OF CHILDREN Date of SE REMARKS
UPON ENTRY 1 MONTH 2 MONTHS
Birth X VIT. A WEIGH
DATE OF AGE HEIGHT WEIGH Weight Height Weight DEWORM SUPLEMENTA DATE OF AGE HEIGHT T Weight Height Weight DATE OF AGE HEIGHT WEIGHT NUTRITIONAL
for height WEIGHING
WEIGHING
(in. mos.)
(in. cm.) T for age for age
status
ING TION (in (in cm.) (in for age for age for height weighing (in (in cm.) (in kilos) STATUS
(in kilos) ST mos.)
status status (1 DOSE) (1ST DOSE) mos.) kilos) status status status

1. Rhea J. Baybado 12-12-12 F 06-15-16 42 35 11 N N N

2.Jennifer S. Bangcod 12-10-31 F 06-15-16 45 35 11 N N N
3. Angel D. Canlas 12-09-13 F 06-15-16 45 38 14 N N N
4. Kelsey S. Cauguiran 13-07-10 F 06-15-16 35 37 12 N N N
5. Jessabell D. Cauguiran 12-04-21 F 06-15-16 52 39 17 N N N
6. Kerby Jane S. Diaz 12-09-12 F 06-15-16 45 37 13 N N N
7. Jerose M. Donquito 11-09-07 F 06-15-16 54 41 16 N N N
8. Anabel G. Duco 12-09-30 F 06-15-16 40 37 12 N N N
9. Angeline G. Estelong 12-12-01 F 06-15-16 42 35 11 UW N O
10. Eddelyn G. Fernandez 11-08-02 F 06-15-16 58 39 15 N N N
11. Mikhaela Sophea M. Fontanilla 13-08-20 F 06-15-16 34 35 13 N N N
12. Tiffanie Brielle J. Guico 13-09-23 F 06-15-16 33 37 17 OW N N
13. Catherine Kate C. Laureta 13-08-29 F 06-15-16 34 34 13 N N N
14. Lyka Joy A. Liban 12-01-21 F 06-15-16 53 39 15 N N N
15. Krizza Mae Mapili 11-04-06 F 06-15-16 62 39 13 N N N
16. Ryana Mae C. Pascua 12-07-03 F 06-15-16 40 37 12 N N N
17. Maejane A. Salvador 12-06-12 F 06-15-16 48 38 12 N N N
18. Kemberly D. Supnet 12-10-07 F 06-15-16 54 39 12 N N N
19. Angel Rich E. Tolentino 12-11-22 F 06-15-16 43 31 11 UW N N
20. Llaureen P. Umali 13-01-01 F 06-15-16 41 38 16 OB N N
This form shall be used every month by the DCW in recording weight and height of the child to determine the improvement in childs nutritional status
*DCW should indicate date or month & year when the child was dewormed & provided Vit. A
SU Severly Underweight
Nutritional Status
UW Underweight
N Normal Prepared by: Noted by:
OW Overweight
MARY ANN D. GUZON MYRNA E. MAPATAC DATE: ____________
CDW Consultant on SWD