Republic of the Philippines

Department of Education
Region XII
Division of Sultan Kudarat
Kalamansig I District
ARTEMIO L. MARTIN INTEGRATED SCHOOL
“ARIBA ALMIS” 500946
(Attain with Response to Innovation with Bolder Ambitions)
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STUDENT PROFILE
GRADE 11 – HUMSS LEARNERS
Vaccination Consent
Contact Mode of
LRN Name Sex Birthday Age Address Parents Name Status Comorbidities Form
Number Transportation
Yes No
131030100001 Brgy. Obial, 1st 2nd None No
ABDULLAH,BOBBY ABDULLAH,
SABUERO
M 02/13/2003 18 Kalamansig, Sultan IBRAHIM I'M
Dose- Dose- Yes Private
Kudarat Transportation
131030100003 Brgy. Obial, No
ABENES,ALBERT ABENES, ALBERT D
JR PUTIS
M 03/14/2004 17 Kalamansig, Sultan SR
Yes Walking
Kudarat
131030100005 Brgy. Obial, No
ABUTAZIL,ASRAF ABUTAZIL, DANTE
OLIVO
M 04/13/2005 16 Kalamansig, Sultan PAGAYAO
Walking
Kudarat
512041904570 Brgy. Obial, No
ANGKAS,SAMSUDI AYUNAN, AMER
N AYUNAN
M 08/11/1997 24 Kalamansig, Sultan GANI
Private
Kudarat Transportation
131030090004 Brgy. Obial, No
ATONG,NORHAN ATONG, MADATU
DABPIL
M 09/28/2003 18 Kalamansig, Sultan ESMAEL
Yes Walking
Kudarat
131030080008 Brgy. Obial, No
BANSAO,NASRUDI BANSAO, SATUR
N PANIMBANGAN
M 06/03/2002 19 Kalamansig, Sultan BELLO
Yes Private
Kudarat Transportation
512041904572 Brgy. Obial, No
BRAHIM,RONALD BRAHIM, ZACARIA
SANIPA
M 11/11/1980 40 Kalamansig, Sultan SALI
Kudarat

Prepared by:

RINGO B. NAVARRO
Class Adviser

Noted:

MARLON S. PALMES
School Principal I