Health Declaration: I understand that I am REQUIRED to provide truthful information ask by this institution, any misinformation shall be deemed

neglect in my part and is

PUNISHABLE under RA 11469, Bayanihan to Heal as One Act. Also, I authorize (______________________________________) to process the data and use for the sole purpose of
prevention and control of COVID-19. School OBRERO ELEMENTARY SCHOOL
HEALTH DECLARATION LOG SHEET
Date Aug. 22-26___________ Date _Aug. 29-Sept.. 3______________ Date ____Sept. 3-7___________
Signs and Symptoms (Y/N) Signs and Symptoms (Y/N) Signs and Symptoms (Y/N)
No Name
Temp. Body Sore Temp. Body Sore Temp. Body Sore
Cough Colds Fever Cough Colds Fever Cough Colds Fever
Pains Throat Pains Throat Pains Throat
1 BOLA, REDGIE
2 CABANTO, CASSIE
3 CABRAL, NASH
4 CUESTA, REIGN ALDIN
5 DELA CRUZ, JOEL
6 GARONA, MARK
7 GUALDADA, KHEN II
8 JULATON, MARC LEMER
9 LACABA, JUNE RHENZO
10 LEONES, LUIS MARTIN
11 ORTEGA, JORIX JAKE
12 TAN, JOSEPH
13. ADIE, ASHLY MAY
14 BALENA, RUSLYN
15 BENDANILLO, KRIZZA
16 CALIPES, NATASHA, MARIE
17 CATALAN, CARYL
18 JUANERIO, ASHLY
19 MORAN, SOFIE LOU
20 PALMA, KISHA SHANAYA
21 REFAMONTE, JAYAN
22 SENARIO, AINGENI
23 SAN BUENAVENTURA, LYSY
24 SAYAWAN, HAZEL MAE
25 SORONEL, QUENN
26 TACUBAO, IRISH
27 TALLO, FEDDY
Health Declaration: I understand that I am REQUIRED to provide truthful information ask by this institution, any misinformation shall be deemed neglect in my part and is
PUNISHABLE under RA 11469, Bayanihan to Heal as One Act. Also, I authorize (______________________________________) to process the data and use for the sole purpose of
prevention and control of COVID-19. School
HEALTH DECLARATION LOG SHEET
Date _______________ SIGNATURE Date _______________ SIGNATURE
Signs and Symptoms (Y/N) (for Signs and Symptoms (Y/N) (for
No Name
Temp. Body Sore SECONDARY Temp. Body Sore SECONDARY
Cough Colds Fever Cough Colds Fever
Pains Throat only) Pains Throat only)