Department of Social Welfare and Development

Field Office 1 FO1-SFP-001

REV 00 / 02-12-2020
Quezon Avenue, City of San Fernando, La Union 2500

MASTERLIST OF CHILDREN
City of Laoag Province of Ilocos Norte
CY 2021-2022
Name of Child Development Center:
Time of Feeding:
Location:
Barangay:
District:
AM/PM SESSION (Separate am and pm session masterlist)
No. ADDRESS NAME OF PARENTS/GUARDIAN FULL NAME OF CHILD (Surname, SEX DATE OF ACTUAL WEIGHT HEIGHT AGE IN NUTRITIONAL STATUS Pantawid
Member (pls
PWD (pls put a Child of Solo
check mark) Parent (pls put
(Surname, Given Name, MI) Given Name, MI) MONTHS
BIRTH DATE (kg) (cm) Weight Weight Height Summary
specify RCCT / a check mark)
4p's or MCCT
(m/d/y) WEIGHING and indicate
(m/d/y)
for Age for for Age of reference
Height Undernour number)

ished
Children
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Total Number of Undernourished Children
Nutritional Status Legend: Prepared by: Noted by:
Weight for Age Height for Age Weight for Height
N - Normal N - Normal N - Normal
UW - Underweight St - Stunted W - Wasted PERLITA B. CABELLO,RSW
SUW - Severely Underweight Sst - Severely Stunted SW - Severely Wasted Child Development Worker OIC-City Social Welfare and Development Officer
OW - Overweight T - Tall OW - Overweight
Ob - Obese
 Department of Social Welfare and D
Field Office 1
Quezon Avenue, City of San Fernando,

WEIGHT MONITORING F
City of Laoag Province of Ilocos
City Social Welfare and Developm
CY 2021-2022

Name of DCC/SNP: _______________

Name of DCW/Volunteer: _____________
Location: __________________________

Baseline
Name of Children (Surname, Sex Date of Age in Height Weight Nutritional Status
No. Given Name Middle Initial) Weighing Mos (cm) (kg) Weight Weight for
(m/d/y) for Age Height

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Total Number of Undernourished Children

Nutritional Status Legend: Prepared by:

Weight for Age
N - Normal SUW: Severly Underweight
UW - Underweight
SUW - Severely Underweight Child Development Worker
OW - Overweight
Height for Age
N - Normal
St - Stunted
Sst - Severely Stunted
T - Tall

Weight for Height

N - Normal
W - Wasted
SW - Severely Wasted
OW - Overweight
Ob - Obese
 ent of Social Welfare and Development
FO1-SFP-002
Field Office 1 REV 00 / 02-12-2020
enue, City of San Fernando, La Union 2500

IGHT MONITORING FORM

y of Laoag Province of Ilocos Norte
ocial Welfare and Development Office
CY 2021-2022

Endline
Nutritional Status Date of Age Height Weight Nutritional Status
Height for Summary Weighing in (cm) (kg) Weight Weight for Height for Summary
Age of (m/d/y) Mos for Age Height Age of
Undernouri Undernouri
shed shed
Children Children

Noted by:

PERLITA B. CABELLO,RSW
Child Development Worker OIC-CSWDO
 FO1-SFP-002
REV 00 / 02-12-2020

Remarks

O,RSW
 D

Quez

CON

Weight for Age

Normal Underweight Severely Underweight
No. of No. of Total % No. of No. of Total % No. of No. of Total
Baseline Male Female Share Male Female Share Male Female

Endline

Height for Age

Normal Severely Stunted Stunted
No. of No. of Total % No. of No. of Total % No. of No. of Total
Baseline Male Female Share Male Female Share Male Female

Endline

Prepared by:

Child Development Worker

 Department of Social Welfare and Development
Field Office 1
Quezon Avenue, City of San Fernando, La Union 2500

CONSOLIDATED NUTRITIONAL STATUS

City of Laoag Province of Ilocos Norte
CY 2021-2022

Weight for He
Underweight Overweight Normal Wasted
% No. of No. of Total % No. of No. of Total % No. of No. of Total
Share Male Female Share Male Female Share Male Female

TOTAL NUMBER OF UNDERNOURISHED

tunted Tall CHILDREN
% No. of No. of Total % No. of No. of Total % Share
Share Male Female Share Male Female

Noted by:

PERLITA B. CABELLO,RSW
OIC-City Social Welfare and Development Officer
 FO1-SFP-003
REV 00 / 02-12-2020

Weight for Height

Wasted Severely Wasted Overweight/Obese
% No. of No. of Total % No. of No. of Total %
Share Male Female Share Male Female Share

OURISHED

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