REPUBLIC OF THE PHILIPPINES

PROVINCE OF RIZAL
MUNICIPALITY OF TANAY
BARANGAY TANDANG KUTYO

BRGY. TANDANG KUTYO

CHILD RECORD
Child’s Name: _______________________________________________ Sex: __________
Birth Date: _______________________________ Birth Weight: ______________________
Place of Delivery: _________________________ Time: ____________________________
Attendant at Birth: _____________________________________________________________
Type of Delivery: ______________ Birth Order: ____________ Contact No: _____________
Mother: ______________________ Age: ___________ Type of Feeding: ______________
Father: ______________________ Age: ___________ TT status: ___________________
Complete Address: ____________________________________________________________
Family Planning: ______________________________________________________________

IMMUNIZATION 1st
RECORD within 24 hrs after 24 hrs
2nd 3rd
NEW BORN SCREENING
BCG
HEPA B
PENTA
OPV
PCV
IPV 1
ROTA
MEASLES
IPV 2
MMR
EXCLUSIVELY BRESFED UNTIL 6 MOS
DATE FULLY IMMUNIZED

DATE AGE IN MONTHS WEIGHT HEIGHT NUTRITIONAL STATUS

REPUBLIC OF THE PHILIPPINES
PROVINCE OF RIZAL
MUNICIPALITY OF TANAY
BARANGAY TANDANG KUTYO

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