Department of Social Welfare and Development

Field Office 1
Quezon Avenue, City of San Fernando, La Union 2500

MASTERLIST OF CHILDREN
City/Municipality of Bautista Province of Pangasinan
CY 2023-2024
Name of Child Development Center:
Time of Feeding:
Location:
Barangay:
District:
AM/PM SESSION (Separate am and pm session masterlist)
No. ADDRESS NAME OF FULL SEX DATE OF ACTUAL WEIGHT HEIGHT AGE IN
PARENTS/ NAME OF BIRTH DATE MONTHS
(kg) (cm)
GUARDIA CHILD (m/d/y) WEIGHIN
N (Surname, G (m/d/y)
(Surname, Given
Given Name, MI)
Name, MI)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Total Number of Undernourished Children
Nutritional Status Legend: Prepared by:
Weight for Age Height foWeight for Height
N - Normal N - NormaN - Normal
UW - Underweight St - Stunt W - Wasted
SUW - Severely UndSst - SeveSW - Severely Wasted Name/Position
OW - Overweight T - Tall OW - Overweight
Ob - Obese
e and Development
e1
rnando, La Union 2500

CHILDREN
ovince of Pangasinan
024

Pantawid PWD (pls put a Child of Solo

NUTRITIONAL STATUS Member (pls check mark) Parent (pls put
specify RCCT / a check mark)
Weight Weight Height Summary 4p's or MCCT
for Age for for Age of and indicate
reference
Height Underno number)
urished
Children

Noted by:
City/Municipal Social Welfare and Development Officer