Republic of the Philippines

Department of Education
REGION III- CENTRAL LUZON
SCHOOL DIVISION OF BATAAN
BASECO NATIONAL HIGH SCHOOL
ROMUALDEZ ST. BASECO, MARIVELES, BATAAN, 2105

CLASSROOM DAILY HEALTH MONITORING TOOL – SET A

Grade Level: 9 Section: ROSE QUARTZ

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 or their classmates. Refer to the list of
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/RNColds/runny nose N Nausea LoS Loss of smell Others

Symptoms Observed/ Reported - Temperature

Name
Mon Temp Tues Temp Wed Temp Thurs Temp Fri Temp
AMOTO, KEI SHIN P.
AQUINO, ROCHEAL MAE
N.
DELA CRUZ, AHLEIA A.
GUEVARRA, KIM SHEI N.
MANGALINDAN, MARY
ALYSSA B.
NACION, JUSTINE P.
ROQUE, JANICE ANNE M.
SANTOS, KATE ALYSSON
Z.
TAGUDIN, CZARINA
MAYE B.
VALENA, MARIA
YSAVELLE R.
AGDIGOS, JUSTINE LEY L.
CANLAPAN, RICHARD
LOURENZ B.
MANSOJER, MARK IAN
MARCIAL, AHRON

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.

Prepared by: Noted by:

SUNSHINE A. LAMAYRA

`
BASECO NATIONAL HIGH SCHOOL
Address: Romualdez St. Baseco Country, Mariveles, Bataan, 2105
Mobile: 09190938675
Email: 305629@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III- CENTRAL LUZON
SCHOOL DIVISION OF BATAAN
BASECO NATIONAL HIGH SCHOOL
ROMUALDEZ ST. BASECO, MARIVELES, BATAAN, 2105

Teacher I Clinic Teacher

`
BASECO NATIONAL HIGH SCHOOL
Address: Romualdez St. Baseco Country, Mariveles, Bataan, 2105
Mobile: 09190938675
Email: 305629@deped.gov.ph
 Republic of the Philippines
Department of Education
REGION III- CENTRAL LUZON
SCHOOL DIVISION OF BATAAN
BASECO NATIONAL HIGH SCHOOL
ROMUALDEZ ST. BASECO, MARIVELES, BATAAN, 2105

CLASSROOM DAILY HEALTH MONITORING TOOL – SET B

Grade Level: 9 Section: ROSE QUARTZ

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 or their classmates. Refer to the list of
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/RNColds/runny nose N Nausea LoS Loss of smell Others

Symptoms Observed/ Reported - Temperature

Name
Mon Temp Tues Temp Wed Temp Thurs Temp Fri Temp
ALATA, ANGELINE
BENITEZ, BLESSIE DEYN
B.
CANING, CHRISTINE ANN
LORENZO, ANGELICA
DELOS REYES
SINDON, JAMAICA S.
TIBAYAN, NATHALIE
BATERINA, HAROLD
BINUYA, VINCE AXLE
MAGQUILAT, LOUIE
GLENN OCAMPO
MEDIARIO, SHERWIN L.
MEDIARIO REDEN L
MOJAR, JOMAR
SALAS, XIAN AHSEF L.
YABUT, ERICKSON

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.

Prepared by: Noted by:

SUNSHINE A. LAMAYRA
Teacher I Clinic Teacher

`
BASECO NATIONAL HIGH SCHOOL
Address: Romualdez St. Baseco Country, Mariveles, Bataan, 2105
Mobile: 09190938675
Email: 305629@deped.gov.ph