OVERALL TALLY

BARANGAY ORA
TOTAL POPULATION 44
NUMBER OF HOUSEHOLDS 7

I. FAMILY MEMBERS AND CHARACTERISTICS

AGE
0-3 y/o
4-5 y/o /
6-14 y/o ////////
15-18 y/o //////
19-25 y/o //////
26-35 y/o ////
36-45 y/o /////
46-55 y/o /////
56 y/o and above /////////
TOTAL 44
SEX
MALE //////////////////
FEMALE //////////////////////////
TOTAL 44
CIVIL STATUS
MARRIED ////////////
SINGLE //////////////////////////
WIDOWED //////
SEPARATED
COMMON LAW
DIVORCED
TOTAL 44

EDUCATIONAL ATTAINMENT
Post graduate
College graduate ///////
College level /////
College undergraduate ///
High school graduate /////////
High school level ///////////
High school undergraduate
Elementary graduate ///
Elementary level ///
Elementary undergraduate
Preschool /
Non-Formal Education /
TOTAL 44
 OCCUPATION/EMPLOYMENT STATUS
PROFESSIONAL
SKILLED ////////////
NON- SKILLED //////////
UNEMPLOYED
RETIRED /
STUDENT ///////////
NONE ///
TOTAL 37

RELIGION
ROMAN CATHOLIC ////////////////////////////////////////////
MUSLIM
INC
BORN AGAIN
BAPTIST
JEHOVAH’S WITNESS
METHODIST
AGLIPAYAN
TOTAL 44

II. FAMILY HEATH STATUS AND PRACTICES

A. Immunization and Nutritional Status
YELLOW CARD Severely Wasted Normal Overweight Obese TOTAL
wasted
Yes / 1
No

B. Morbidity and Mortality

MORBIDITY
ILLNESSES
HYPERTENSION
DIABETES
FEVER
COUGH AND
COLDS
ASTHMA
VOMITING
HEADACHE
KIDNEY STONE
DENGUE
ALLERGY
COMMUNICABLE
NON-
COMMUNICABLE

CAUSES
LIFESTYLE
HEREDITARY
TRANSMITTED
UNKNOWN

SEX
MALE
FEMALE
TOTAL

AGE
(0-2)
(3-7)
(8-12)
(13-17)
(18-35)
(36-55)
(56 ABOVE)
TOTAL

WHO ATTENDED
HOSPITAL
RHU
DID NOT SEEK
MEDICAL
ATTENTION
TOTAL

MORTALITY:
DECEASED MEBERS OF FAMILY
YES ///
NONE
TOTAL 3

CAUSE OF DEATH
ILLNESSES
HEART ATTACK
TUBERCULOSIS
ACCIDENT
 SUICIDE
DROWNING
OTHERS /// 3

AGE
(0-2)
(3-7)
(8-12)
(13-17)
(18-35)
(36-55)
(56 ABOVE) ///
TOTAL 3

SEX
MALE ///
FEMALE /
TOTAL 4

WHO ATTENDED
HOSPITAL //
RHU
DID NOT SEEK /
MEDICAL
ATTENTION
TOTAL 3

C. Nutrition
1. BREASTFEEDING
YES
NO
TOTAL

2. AGE OR MONTHS
0-6 MOS.
7-12 MOS.
13-24 MOS.
48 MOS.
ONGOING
TOTAL

3. REASONS FOR NOT BREASTFEEDING

NO BREASTMILK
SICK
GROWN CHILD
WORKING
PREGNANT
OTHERS

4. FOODS SUBSTITUTE FOR BREASTFEEDING

AM/SEGGET
LUGAW / 1
INNAPOY / 1
KAMOTE
BANANA
SQUASH / 1
EVAPORADA
INFANT
FORMULA
WATER WITH
SUGAR
MILK
PRODUCTION
OTHES

D. Family Planning
Women of
Reproductive Age

AGE DURING PRIMIGRAVIDA

15-17 Y/O /
18-35 Y/O /////
36-55 Y/O
TOTAL 6

NO. OF CHILDREN
0
1
2 ///
3 /
4 /
5 /
6
7
8
9
10
TOTAL 6

NO. OF PREGNANCIES
 0
1
2 /
3 //
4 //
5 /
6
7
8
9
10
TOTAL 7

NO. OF MISCARRIAGE
1
2 / 1
3

CHILDBIRTH TYPES
NATURAL /////// 7
ARTIFICIAL

FAMILY PLANNING METHODS

ABSTINENCE
PILLS /// 3
IUD
RHYTHM
CONDOM
LIGATION // 2
VASECTOMY
INJECTION
WITHDRAWAL // 2
OTHERS
NONE

DOES RELIGION AFFECTS YOUR DECISION IN USING ANY

FAMILY PLANNING METHODS?
YES
NO //////
TOTAL 6

E. BELIEFS AND PRACTICES

1. CHOICE OF
FOOD FOR THE
FAMILY
Financial Capacity
Family Preference
Availability
Street Foods // 2
Location
Religious Doctrine
Nutritious Foods ////// 6
None / 1
Others //// 4

2. PREGNANCY
AND BIRTH
Superstitious
Beliefs
Hospitalizations
Cravings ///// 5
Normal Delivery / 1
Nutritious Foods ////// 6
Avoid Vices
None / 1

3. CARE OF THE
SICK
Herbal Medicine ////// 6
Hospital Care / 1
Faith Healer
Superstitious
Beliefs
Home Care ////// 6

4. CHILD
FEEDING
Beliefs
Nutritious Foods ////// 6
Preference of the
Child
Supervision
Bottle Feeding / 1
Breastfeeding
Religious Doctrine
Availability of
Resources
Less meat
5. FOODS
DISLIKES OF
THE FAMILY
Raw Foods
Oily Foods
Unhealthy Foods /// 3
Salty Foods
None ///// 5
Religious Doctrine
Vegetable
Seafoods
Meat

F. ENVIRONMENTAL CONDITIONS
Type of Toilet
FLUSH TOILET //// 4
WATER SEALED //// 4
ANTIPOLO TYPE
OVERHANG
NONE
TOTAL

Type of Kitchen Sink

OPEN /// 3
BLIND //// 4
TOTAL

GARBAGE COLLECTION
OPEN //// 4
RECEPTACLE
COVERED /// 3
RECEPTACLE
TOTAL

WAYS OF DISPOSING
COMPOSTING /// 3
BURNING /// 3
BURYING / 1
RIVERSIDE
DUMPING
OPEN DUMPING
OTHERS
DOMESTIC ANIMALS AND LIVESTOCK
DOG /////
CAT ///
NONE //
TOTAL 10

LEFT A STRAY?
Yes
No ///////
TOTAL 7

WATER SOURCES
NAWASA / 1
WATER PUMP / 1
DEEP WELL
SHALLOW DUG
WELL
PROTECTED
SPRING
UNPROTECTED
SPRING
TAP WATER
MINERAL ///// 5
WATER
PUMP WELL

WATER CONTAINER
JUG ///// 5
PITCHER / 1
BOTTLE
WATER // 2
DISPENSER
TUMBLER
DRUM

WATER CONTAINER WITH COVER

YES /////// 7
NO
TOTAL

DO YOU DRINK THE WATER DIRECTLY FROM THE WATER

SOURCES?
YES /////// 7
 NO
TOTAL

WATER TREATMENT
CHLORINATE
BOILING
TOTAL

FOOD STORAGE
CABINET /// 3
COVERED PLATE / 1
CHEST
REFRIGERATOR ///// 5
HANGING / 1
BASKET
CONTAINER

III. SOCIO-ECONOMIC, POLITICAL AND CULTURAL FACTORS

Primary Cost of Living
FARMING /// 3
Owned /// 3
Tenanted
FISHING
LABORER //// 4
EMPLOYEE
Government // 2
Private
CARPENTER
VENDOR / 1
BRGY. OFFICIAL
OTHERS
MONTHLY FAMILY INCOME
Below 5000 // 2
5,001-10,000 // 2
10,001-20,000 // 2
20,001-30,000 / 1
30,001 and above
TOTAL

Food Production Activities

A. GARDEN FAMILY FOR SELLING
USE
PIGGERY / 1
 POULTRY / 1
VEGETABLE /// // 5
GARDEN
FRUIT TREES
FISHERY
OTHERS
NONE

Real Property
A. HOUSE OWNER
WIFE AND THE // 2
SPOUSE
SPOUSE’S ///// 5
RELATIVE
RENTED
TENANTED
COMMUNAL/
GOVERNMENT
PROPERTY
FAMILY HOUSE
Total

B. TYPE OF HOUSE
CONSTRUCTION
LIGHT
MEDIUM / 1
HEAVY ////// 6
TOTAL

C. ADEQUACY OF
LIVING SPACE
No. of Bedrooms
0
1
2 // 2
3 /// 3
4 / 1
5
6 / 1
7
TOTAL

Utilities
A. PRESENCE OF
ELECTRICITY
 YES /////// 7
NO
TOTAL

Appliances
RADIO ///// 5
REFRIGERATOR ////// 6
ELECTRIC FAN /////// 7
GAS RANGE ///// 5
TELEVISION ////// 6
RICE COOKER
AIRCON
WATER DISPENSER
OTHERS ///

Decision Making Head Wife Head of the Others Did Not Total
of the family/Wife Answer
Family
A. FAMILY /// /// / 7
EXPENSES
B. DAILY EXPENSES // /// // 7
C. EDUCATION / //// // 7
D. BARANGAY // //// / 7
ACTIVITIES

Community Needs And

Problems
A. IMPROPER WASTE //// 4
DISPOSAL
B. PANAGAWAN TI
KURYENTE
C. STAGNANT WATER // 2
D. PUNDIDO KEN
AWANAN SILAW
KALSADA
E. AIR POLLUTION
F. DADAEL A // 2
KALSADA
G. DRAINAGE CANAL
H. INADEQUATE
HEALTH SERVICES
I. NOISE /// 3
J. AGUBOR A
KARRUBA
 K. NANGINA NGA
MAGATANG
L. AWAN TI
PAGSAPULAN
M. NO PUBLIC TOILET
N. DENGUE
O. COVID-19
P. PANAGKAYWARA
TI DINGWEN ITI
KALSADA
Q. ASIDEG TI
CONSTRUCTION
SITE

Community resources
A. RECOMMENDED
MATERIALS
PALA ////// 6
MARTILYO ////// 6
LANSA //// 4
PANG WELDING
BARRETA ////// 6
KAYO
SEMENTO
DARAT
PARTENG
RAGADI
BUNENG
RAGADI
PLIERS //// 4
METRO
DARAT
PLANER
BARUT
LANDOK
HOLLOW BLOCKS

B. SUGGESTED BRGY.
OFFICIALS
BRGY. CAPTAIN ////// 6
BRGY. KAGAWAD // 2
OTHERS

C. AFFILIATED
ORGANIZATIONS
 RIC / 1
4Ps / 1
INDIGENT
SARANAY
FARMERS
SISA
KABABAIHAN
KASAMBAYANAN
NONE ///// 5