INDIVIDUAL BMI MONITORING FORM ANNEX “C”

Rank/Name: Pat Winston S Parre UNIT/ OFFICE: PRS, ARMD, AVSEGROUP

Age: 33
Height: 1.68 m
Weight:
Waist: 37 in
Hip: 40
Wrist: 6.5 in
Gender: Male
Date Taken:
BMI Result: 29.4
Normal Weight: 52.5-70.4 kg
Weight to Lose:

Right View Front View Left View Intervention Package: Certified Correct Signature:
BMI CLASSIFICATION
PNP BMI Acceptable WHO Standard: (Refer to Package C
Standard WHO Classification)

OVERWEIGHT OVERWEIGHT

MONTHLY WEIGHT MONITORING

YEAR 2021 2022
MONTH Nov Dec Jan Feb Mar April May Jun July Aug Sept Oct Nov. Dec.

WEIGHT (kg) 73.5 79.2 80.5 83 kg 78 kg 78 kg 77.5 75 kg 80 kg 75kgs 74kgs 73kgs

kg kg kg kg