BNS Form No.

1A
Philippine Plan of Action for Nutrition
FAMILY PROFILE
Purok/Sitio: _______________________ Municipality: _________________________
Barangay: _______________________ City/Province: _________________________
HH No. No. of No. of Children Name of Household Head/Spouse Occupation Educa- Check if: Check if: Fill in: Check if:
HH <6 mos. 6-23 mos. 24-59 >60 tional Mother Couple Nursing ≤6 mos. Child Toilet Water Food HH Hh
Mem- old old mos. old mos. Attain- preg- Practice type (WS, Source (P, Production using using
bers ment EBF Mixed Others
old nant Family OP, O, N) W, S) Activity (VG, iodized IFR
Planning
feeding P/L, FP) salt

Abbreviations
CF – Complementary Feeding IFR – Iron Fortified Rice Educational Attainment Water Source Food Production Activity
EBF – Exclusive Breastfeeding (F) – Father EU – Elem. Undergraduate CU- College Undergraduate P – Pipe VG – Vegetable garden
HH – Household (M) – Mother EG – Elem. Graduate CG – College Graduate W – Well P/L – Poultry/Livestock
HU – HS Undergraduate V – Vocational S – Spring FP – Fishpond
HG – HS Graduate O – Others