Name: Ella Marie M.

Retiza
Section: BSN 2 – A11

NUR 102 LECTURE

ACTIVITY 3

SAMPLE FORMAT

NAME OF THE FAMILY RELATIONSHIP BODY PREVIOUS CURRENT WAIST

MEMBER MASS WEIGHT WEIGHT CIRCUMFERENCE
(NO NEED TO PUT MIDDLE INDEX
NAME OR MIDDLE INITIAL)

1. Elvie M. Retiza MOTHER 24.91 66 72 40 inches

2. Junil I. Retiza FATHER 23.03 63 65 33 inches

3. Eljohn Kyle M. Retiza BROTHER 25.65 72 75 41 inches

4. John Dwaine M. Retiza BROTHER 25.61 71 74 34 inches