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  • Deworming Form 1

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    Rosalie Ariola
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    The document is a form from the Department of Education in the Philippines documenting the deworming of students at Juan Sumulong Elementary School. It shows that all students were dewormed and consent was given as indicated on the consent forms. No students refused deworming or had adverse events. The form was completed by the class adviser and noted by the school deworming coordinator.

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    Deworming-Form-1.xlsx

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    The document is a form from the Department of Education in the Philippines documenting the deworming of students at Juan Sumulong Elementary School. It shows that all students were dewormed and consent was given as indicated on the consent forms. No students refused deworming or had adverse events. The form was completed by the class adviser and noted by the school deworming coordinator.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    92 views2 pages

    Deworming Form 1

    Uploaded by

    Rosalie Ariola
    The document is a form from the Department of Education in the Philippines documenting the deworming of students at Juan Sumulong Elementary School. It shows that all students were dewormed and consent was given as indicated on the consent forms. No students refused deworming or had adverse events. The form was completed by the class adviser and noted by the school deworming coordinator.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xlsx, pdf, or txt
    of 2

    Republic of the Philippines

    Department of Education
    Region IV - A CALABARZON
    Form 1 - Classroom Level
    National School Deworming Month (NSDM) Round 1
    July 12, 2019
    District: II-A
    Name of School: JUAN SUMULONG ELEMENTARY School ID: 109327
    Enrolment: MALE - __ , FEMALE - __ , TOTAL = __ Grade /Section: ____________
    Dewormed Consented to Not Dewormed
    Deworming
    No. Name of Child Refused No consent Precautionary
    4Ps Non - 4Ps (as indicated in
    consent form) deworming form returned Measure

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    Accomplished by:
    PURIFICACION A. ABAD
    Class Adviser N O T E D:
    MANUEL V. BRUDO JR.
    School Deworming Coordinator
    _________

    Adverse
    Event

    UDO JR.
    Coordinator

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