BULANGIT ELEMENTARY SCHOOL

SAN NICOLAS I
CLASSROOM DAILY HEALTH MONITORING TOOL FOR COVID-19
Grade Level: KINDERGARTEN Section: A

Instruction: Write under each column date the code(s) of the symptom(s) observed in the learner during the routine inspection, during the conduct of the class, or as reported by the learner on their classmates. Refer
to the list symptoms below and their respective codes:

Fv Fever F/T Fatigue/Tiredness ST Sore throat LoA Loss of appetite D Diarrhea R Rashes

C Cough HA Headache C/RN Colds/runny nose N Nausea LoS Loss of smell Others

SYMPTOMS OBSERVED/REPORTED
Name April 18, 2022 April 19, 2022 April 20, 2022 April 21, 2022
Temperature Monday Temperature Tuesday Temperature Wednesday Temperature Thursday
BRIQUILLO, MARK LOUIE S.

FEROLINO, JAKE ISAIAH L.

KINANSAN, ERNESTO III S.

LAGUA, NOEL JR. B.

TRINIDAD, SANDER M.

CASTILLO, MARIA SOPIA S.

DELA ROSA, DIMPLE JOY P.

DURAN, ROSELYN P.

GARABILES, ZIA JADE S.

MADAS, AYISHA MAE A.

Note: As soon as any of the listed symptoms is observed among any of the learners, the teacher is expected to send the learner to the School Clinic immediately for the proper management by the School Clinic
Teacher or health personnel.
Submitted by: Noted:

MARY JANE S. CASTULO ISAGANI N. MARZAN

Adviser School Clinic Teacher
 BULANGIT ELEMENTARY SCHOOL
SAN NICOLAS I
CLASSROOM DAILY HEALTH MONITORING TOOL FOR COVID -19
Grade Level: KINDERGARTEN Section: B

Instruction: Write under each column date the code(s) of the symptom (s) observed in the learner during the routine inspection, during the conduct of the class, or as reported by the learner on their classmates. Refer
to the list symptoms below and their respective codes:

Fv Fever F/T Fatigue/Tiredness ST Sore throat LoA Loss of appetite D Diarrhea R Rashes

C Cough HA Headache C/RN Colds/runny nose N Nausea LoS Loss of smell Others

SYMPTOMS OBSERVED/REPORTED
Name May 23, 2022 May 24, 2022 May 25, 2022 May 26, 2022
Temperature Monday Temperature Tuesday Temperature Wednesday Temperature Thursday
BRIQUILLO, MARK LOUIE S.

GULLA, JOMAR JR. S.

PAYON, PRINCE JOSHUA

RIGONAN, GODFREY B.

ALBAY, JENNY S.

ALBAY, JOYCE C.

BAÑ AGA, MARIFEL P.

COLLADO, KATHLEANNA D.

ETCHANO, ALTHEA JOY B.

PEDRO, BABYLYN S.
Note: As soon as any of the listed symptoms is observed among any of the learners, the teacher is expected to send the learner to the School Clinic immediately for the proper management by the School Clinic
Teacher or health personnel.

Submitted by: Noted:

MARY JANE S. CASTULO ISAGANI N. MARZAN

Adviser School Clinic Teacher