VAW Cases Monthly Monitoring Form

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BARANGAY DATA CAPTURE FORM

MONITORING OF INCIDENCE ON VIOLENCE AGAINST WOMEN (VAW)


For the month of JANUARY 2024

Region III
Province BULACAN
City/Municipality CITY OF SAN JOSE DEL MONTE
Barangay GAYA-GAYA

TYPES OF VIOLENCE ACTIONS TAKEN BY THE BARANGAY/BCPC


(4) (6)

NAME OF VAC VICTIMS Psychological/ Referred for Referred for


Referred to Others
Physical Abuse Sexual Abuse Emotional Economic Referred to PNP Referred to NBI Medical Legal
Issued BPO LSWDO (ex: Referred to NGOs, FBOs)
Abuse Abuse (6b) (6c) Treatment Assistance
(6a) (6f)
(4c) (6d) (6e)

VICTIM 1 / / /

VICTIM 2 / BLOTTER ONLY

VICTIM 3 / /

VICTIM 4 / BLOTTER ONLY

VICTIM 5 / BLOTTER ONLY

VICTIM 6 / BLOTTER ONLY

VICTIM 7 / BLOTTER ONLY

/ Direct Filing To Family Court


VICTIM 8 (Malolos)
VICTIM 9 / BLOTTER ONLY
VICTIM 10 / /

TOTAL 3 0 4 3 0 1 2 0 1 0 6 1

*If /, encode "1" on the applicable fields


*If "Others", please specify

Prepared by: Submitted by:

CHERRY ANNE A. OLIDA ENRY L. SANTOS


Barangay Secretary Punong Barangay

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