Medical Treatment MAM ATA

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Republic of the Phillipines

Province of Maguindanao
Municipality of Datu Paglas
Manindolo Child Development Center

ANNUAL, RECORD FOR FIRST AID ADMINISTERED AND MEDICAL TREATMENT OF CHILDREN

No. Name of Child Age Medication Administered Date Administered Signature of CDW,
Name of Physician

Prepared by:
_________________________
Child Development Worker

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