TEMPLATE ON MONITORING OF LINELIST

MUNICIPALITY/ CITY/BARANGAY: CITY OF IMUS/ALAPAN 2A

NAME OF SUSPECTED COVID- 19 CASE

NO LAST NAME FIRST NAME MIDDLE NAME

24 BARCILLA MONALIZA GONZALES

2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
27
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
MONITORING OF LINELIST FOR CONTACT TRACING

NO. OF NO. OF NO. OF

DATE CONDUCTED
CONTACT TRACING NO. OF PUMS SUSPECTED PROBABLE POSITIVE
CASES CASES CASES

11/10/2021 2 0 0 0
 REMARKS

CONTACTS SWABBED BARANGAY CHO CONTACT TRACER

0 POBLACION 3-A CHO-1 NAWAFEL M. MASANGGUILA

Name of Positive Case 1: BARCILLA MONALIZA GONZALES (IMUS, CAVIT
Name Address Birthday
138 A GEN. MASCARDO ST. POBLACION 3-A IMUS
RAYVIN B. FLORES 3/10/2002
CAVITE
ANDREA B. FLORES 138 A GEN. MASCARDO ST. POBLACION 3-A IMUS CAV 11/30/2007

138 A GEN. MASCARDO ST. POBLACION 3-A IMUS CAVITE

138 A GEN. MASCARDO ST. POBLACION 3-A IMUS

CAVITE
S (IMUS, CAVITE)
Nature of
Age Sex Nationality Contact Number Date of Last Exposure
Contact
19 M FILIPINO 9164506152 7/10/2021 HH
13 F FILIPINO 9164506152 7/10/2021 HH
 Being Onset of Signs and Date Quarantine Date Case
Monitored Symptoms Symptoms Period Ends Closed
YES NONE NONE 10/20/2021
YES NONE NONE 10/20/2021
 Remarks

14 DAYS HOME QUARANTINE

14 DAYS HOME QUARANTINE
 PATIENT UPDATE
DATE: SURNAME:
FIRST NAME:
MIDDLE NAME:
STATUS:
REMARKS:

DATE: SURNAME:
FIRST NAME:
MIDDLE NAME:
STATUS:
REMARKS:

DATE: SURNAME:
FIRST NAME:
MIDDLE NAME:
STATUS:
REMARKS:

DATE: SURNAME:
FIRST NAME:
MIDDLE NAME:
STATUS:
REMARKS: