SBFP Form 1: Master List Beneficiaries For School-Based Feeding Program (SBFP)

SBFP Form 1
Department of Education
Region I
Master List Beneficiaries for School-Based Feeding Program (SBFP)

Division/Province: Dagupan City / Pangasinan
Name of Principal : Margoth B. Calulut
City/ Municipality/Barangay : Dagupan City / Bonuan Gueset
Name of Feeding Focal Person : Lorena G. Calma
Name of School / School District : General Gregorio Del Pilar Elementary School / District III
No.
Name
Sex
Date of
Date of Birth
Weighing /
(MM/DD/YYY
Measuring
Y)
(MM/DD/YYYY
)
Age in
Years /
Months
Weight
(Kg)
Height
(cm)
6/16/2015
60 mos
13
1/13/2010 6/16/2015
65 mos
14
6/16/2015
64 mos
14
1/24/2010 6/16/2015
64 mos
13
Disabil
ity
4Ps ID
Number
Nutritional Status (NS)
Ethnicity
Name of Parents
1.05
Underweight
Pangasinense
Ofelia R. Manangan
0.96
Underweight
Pangasinense
Rebecca G. Bianan
No
1.08
Underweight
Pangasinense
Aderida C. Manaois
No
1.05
Severely Underweight
Pangasinense
Martina D. Milo
No
Merly Forteza
No
1 Aquino, Tyron M.
2 Manalo, Maryllee B.
3 Manaois III, Valeriano C.
4 Milo, Aaron Macky DG.
5 Villanueva, Alexander Q.
###
6/16/2015
6,6
16
1.12
Wasted
Pangasinense
6 Foronda, Jamecha Jasmin
9/5/2010
6/16/2015
57 mos
12
1.02
Underweight
Pangasinense
7 Generao, Jasmine S.
56 mos
13
1.02
Underweight
Pangasinense
Regilyn M. Generao
No
8 Paras, Andrea Lorreine E.
###
6/16/2015
66 mos.
14
1.07
Underweight
Pangasinense
Cristie E. Paras
No
9 Santos, Romma G.
7/7/2010
6/16/2015
59 mos
12
Pangasinense
Rebecca G. Bianan
No
10 Torio, Kylie Janine N.
7/11/2010 6/16/2015
59 mos
0.98
Pangasinense
Jennifer N. Torio
No
11 Ventenilla, Rhianne S.
9/10/2010 6/16/2015
57 mos
12
0.98
Underweight
Pangasinense
Diana A. Ventenilla
No
12 Vidal, Danica Z.
7/20/2010 6/16/2015
58 mos
12
Underweight
Pangasinense
Diana Z. Vidal
No
13 Zamora, Chezka Marniel J.
8/29/2009 6/16/2015
69 mos.
14
1.06
Underweight
Pangasinense
Nielda J. Zamora
No
14 Agillo,
3/10/2010 6/16/2015
Angelo
15 Javier, John Joseph M.
16 Quinones, Roel M.
17 Vidal, Rickyen C.
6/7/2010
BMI for 6
y.o. and
above
Beneficia
ry of
SBFP in
Previous
Years
(yes or
no)
2/5/2010
9/22/2010 6/16/2015
No
No
63 mos
14
Underweight
Pangasinense
Rodamine Surbano
No
6/16/2015
65 mos
14
1.08
Underweight
Pangasinense
Joseph Javier
No
9/22/2009 6/16/2015
68 mos
15
1.05
Underweight
Pangasinense
Rogelio Z. Quinones
No
6/16/2015
65 mos
13
Pangasinense
Ricky D. Vidal
No
###
###
18 Clores, Janilla Mae V.
8/19/2009 6/16/2015
69 mos.
14
1.01
Underweight
Pangasinense
Mary Joy L. Clores
No
19 Abejuela, Randale Josh M.
3/11/2010 6/16/2015
63 mos
14
1.01
Underweight
Pangasinense
Randall Abejuela
No
20 Landingin, Louie Jake S.
9/26/2010 6/16/2015
56 mos
11
0.97
Pangasinense
Jennifer Soria
No
21 Pastor, John Paul G.
22 Samson, Venedick S.
23 Arenas, Princess L.
4/20/2009 6/16/2015
24 Cruz, Apple P.
25 Diaz, Denryl Joeci B.
26 Jimenez, Angeline
###
6/16/2015
27 Landingin, Diana Rose C.
###
28 Mirong, Jamaica S.
###
6/16/2015
66 mos.
12
0.99
Pangasinense
Marissa Pastor
No
###
6/16/2015
55 mos
13
0.92
Underweight
Pangasinense
Rosario Samson
No
6,1
13
1.05
Wasted
Pangasinense
Virginia Arenas
No
3/25/2010 6/16/2015
62 mos
12
0.94
Pangasinense
Alma Cruz
No
6/30/2010 6/16/2015
59 mos
12
0.96
Pangasinense
Joana Rose Bordios
No
65 mos
14
1.02
Underweight
Pangasinense
Kathlyn Jimenez
No
6/16/2015
55 mos
13
0.98
Underweight
Pangasinense
Diana Landingin
No
2/14/2010 6/16/2015
64 mos
12
0.94
Pangasinense
Jasmine Mirong
No
29 Parayaoan, Jean Ysabel D.
3/27/2010 6/16/2015
62 mos
13
0.99
Underweight
Pangasinense
Michelle Parayaoan
No
30 Rizarre, Jennalyn F.
6/12/2010 6/16/2015
60 mos
12
0.97
Pangasinense
Rosalyn Rizarre
No
31 Lopez, Alejhandro Jet D.
9/24/2010 6/16/2015
56 mos
13
1.01
Underweight
Pangasinense
May Lopez
No
32 Manuel, Marlon S.
6/16/2015
69 mos.
15
Underweight
Pangasinense
Madonna Manuel
No
33 Zabala, Alexander Romel
9/27/2009 6/16/2015
68 mos
14
1.08
Underweight
Pangasinense
9/7/2009
No
No.
Name
Sex
Date of
Date of Birth
Weighing /
(MM/DD/YYY
Measuring
Y)
(MM/DD/YYYY
)
###
Age in
Years /
Months
Weight
(Kg)
Height
(cm)
6/16/2015
56 mos
13
BMI for 6
y.o. and
above
Ethnicity
Underweight
Pangasinense
Disabil
ity
4Ps ID
Number
Name of Parents
34 Bagay, Kristine G.
35 Gabriel, Maria
9/21/2010 6/16/2015
56 mos
13
Underweight
Pangasinense
Aurora Gabriel
No
36 Jimenez, Jasmine
5/25/2010 6/16/2015
60 mos
13
1.02
Underweight
Pangasinense
Kimberly Jimenez
No
37 Mama, Princess Carla B.
6/16/2015
55 mos
11
0.94
Pangasinense
38 Narag, Ma. Jennica R.
5/28/2010 6/16/2015
60 mos
11
Pangasinense
39 Zabala, Marian Irish
5/24/2010 6/16/2015
60 mos
12
1.02
Pangasinense
40 Collado, Jayden Harvey O.
9/7/2009
6/15/2015
69mos.
15
1.06
Wasted
Pangasinense
Christine O. Collado
No
41 Gallardo, Dexhian Matthew
###
6/15/2015
67 mos.
15
1.02
Wasted
Pangasinense
Mark Anthony Gallardo
No
42 Mores, Jhasper Lamod
15
1.13
Pangasinense
Philip Mores
No
43 Alon, Jilian Bombilla
###
6/15/2015
66 mos.
14
1.05
Wasted
Pangasinense
Alejandro Alon
No
44 Dioquino, Jasmine Andrea M.
7/7/2009
6/15/2015
71 mos.
15
1.17
Wasted
Pangasinense
Rowena S. Mejia
No
45 Bernardez Jr., Eduardo
###
6/15/2015
6,6
14
1.16
10.4
Pangasinense
Eduardo Bernardez Sr.
Yes
46 Caballero, Frank Gian M.
10/3/2009 6/15/2015
68 m0s.
14
1.08
Wasted
Pangasinense
Franco Caballero
No
47 Doloque, Jhan Patrick D.
4/18/2009 6/15/2015
6.1
16
1.16
11.8
Severely Wasted
Pangasinense
Enrique Doloque
Yes
48 Garcia, Matthew U.
6/15/2008 6/15/2015
7,0
16
1.13
12.5
Wasted
Pangasinense
Leitrenitz Garcia
No
49 Lazo, Reggie J.
6,3
10
0.97
10.6
Pangasinense
Rito Lazo
No
50 Nacorda, Arjay D.
2/19/2009 6/15/2015
6,3
16
1.14
12.3
Wasted
Pangasinense
Eddie Nacorda
No
51 Anol, Charlina P.
6/25/2009 6/15/2015
71 MOS.
15
1.O3
Wasted
Pangasinense
Carl Anol
No
52 Simbulan, Chloe G.
###
6/15/2015
6,5
15
1.12
11.9
Wasted
Pangasinense
Christopher Simbulan
No
53 Del Monte, Marvic James P.
2/8/2009
6/15/2015
6,4
17
1.17
12.4
Wasted
Pangasinense
Susana P. Del Monte
No
54 Fernandez, Danilo P.
###
6/15/2015
7,7
17
1.14
13
Wasted
Pangasinense
Mercy Fernandez
No
55 Mamaril,Jobert Z.
2/9/2008
6/15/2015
7,4
15
1.09
12.6
Wasted
Pangasinense
Sheryl Ann Zulieta
No
56 Paras, Noah L.
3/17/2009 6/15/2015
6,2
15
1.1
12.3
Wasted
Pangasinense
Miriam Loresco
Yes
57 Paras, Rino F.
1/9/2008
6/16/2015
7,5
19
1.2
13.1
Wasted
Pangasinense
58 Prasmo, Mark Aiken
9/9/2008
6/15/2015
6,9
15
1.13
11.7
Pangasinense
Rossana Prasmo
No
59 Serrano, Ken Louise L.
###
6/15/2015
67 mos.
15
1.08
Wasted
Pangasinense
Nancy Laudencio
No
60 Ferrer, Zyrene A.
8/5/2009
6/15/2015
70 mos.
14
1.02
Wasted
Pangasinense
Rocky Mar Ferrer
No
###
3/11/2009 6/15/2015
3/6/2009
6/15/2015
Arlene Bagay
Beneficia
ry of
SBFP in
Previous
Years
(yes or
no)
No
No
Esmeralda Narag
No
No
35295767
No
61 Zabala, Rhianne
9/10/2009 6/15/2015
69 mos.
14
0.96
Wasted
Pangasinense
62 Almonte, Alwyne R.
5/21/2008 6/19/2015
7,0
17
1.16
12.6
Wasted
Pangasinense
Alexander L. Almonte
No
63 Camacho, Elijah
7,3
18
1.18
12.9
Wasted
Pangasinense
Alfreda C. Camacho
No
64 Macatiag, Dustine John
7/16/2008 6/19/2015
6,11
16
1.17
11.6
Severely Wasted
Pangasinense
Rhodora I. Macatiag
No
65 Munar, Arnold
10/1/2007 6/19/2015
7,8
19
1.2
13.1
Wasted
Pangasinense
Arnold M. Munar
No
66 Ceralde, Jhon Mark J.
9/15/2005 6/17/2015
9,9
17
1.17
12.4
Severely Wasted
Pangasinense
Marivic Ceralde
No
67 Clores, Jun Mark
1/27/2007 6/17/2015
8,4
16
1.1
13.2
Wasted
Pangasinense
Mayet Clores
No
68 De Leon Jiel P.
9/30/2008 6/17/2015
6,8
17
1.14
13
Wasted
Pangasinense
Ryan De Leon
No
69 Mabalot, Justine C.
70 Mirong, Joshua G.
71 Pastor, Carl Marphy
7/9/2008
72 De la Cruz, Angelica
###
73 Delima, Frencess, Jay
3/5/2008
1/3/2007
6/19/2015
6/17/2015
No
35317616
8,5
17
1.13
13.3
Wasted
Pangasinense
Arlene Mabalot
No
6,11
15
1.08
12.8
Wasted
Pangasinense
Jocelyn Pastor
No
6/17/2015
6,11
14
1.06
12.4
Wasted
Pangasinense
Marissa Pastor
No
6/17/2015
7,6
16
1.13
12.5
Wasted
Pangasinense
Wilma Dela Cruz
No
4/10/2008 6/17/2015
7,2
16
1.14
12.3
Wasted
Pangasinense
6/29/2008 6/17/2015
35093171
No
No.
Name
74 Ferrer, Princess A.
Sex
Date of
Date of Birth
Weighing /
(MM/DD/YYY
Measuring
Y)
(MM/DD/YYYY
)
Age in
Years /
Months
Weight
(Kg)
Height
(cm)
BMI for 6
y.o. and
above
Ethnicity
Disabil
ity
4Ps ID
Number
Name of Parents
Beneficia
ry of
SBFP in
Previous
Years
(yes or
no)
###
6/17/2015
7,6
18
1.2
12.5
Wasted
Pangasinense
Jennifer Ferrer
75 Gaspar, Jamila R.
8/8/2008
6/17/2015
6,10
18
1.21
12.2
Wasted
Pangasinense
Maria Gaspar
No
76 Forca, Alexander Melvin
###
6/16/2015
7,6
18
1.17
13.1
Wasted
Pangasinense
Marvin Forca
No
77 Dolorico, Regielsa D.
2/3/2008
6/16/2015
7,4
16
1.16
11.8
Wasted
Pangasinense
Reggie Dolorico
No
78 Luceriana, Carmina N.
3/7/2008
6/16/2015
7,3
18
1.19
12.7
Wasted
Pangasinense
Christopher Luceriana
No
79 Caballero, Christian B.
7,11
16
1.11
12.9
Wasted
Pangasinense
Julie B. Caballero
No
80 Maragana, Angelo E.
10,7
24
1.32
13.7
Wasted
Pangasinense
Ginalyn E. Maragana
Yes
81 Sembrana, Samantha Nicole A.
82 Lumban, Kurt Anthony S.
7/14/2007 6/17/2015
###
6/15/2015
###
6/15/2015
6/27/2004 6/16/2015
35612537
No
7,8
16
1.18
11.4
Severely Wasted
Pangasinense
Rhoda A. Sembrana
No
10,11
19
1.21
12.9
Severely Wasted
Pangasinense
Renante R. Lumban
No
83 Veloso, Rhea Rhose P.
###
6/16/2015
8,8
16
1.13
12.5
Wasted
Pangasinense
Renato Veloso
No
84 Pedrones, Lance Sidrix C.
3/4/2007
6/17/2015
8,3
16
1.16
11.8
Severely Wasted
Pangasinense
Isidro Pedrones
No
85 Luna, Angel A.
3/23/2007 6/17/2015
8,2
15
1.17
10.9
Severely Wasted
Pangasinense
Anna Luna
No
###
35188992
86 Mercado, Edra Jane D.
6/17/2015
9,7
18
1.2
12.5
Wasted
Pangasinense
Edgar Mercado
No
87 Casaa, John Joshua M.
6/17/2006 6/17/2015
9,0
22
1.28
13.4
Wasted
Pangasinense
Criselda Casana
No
88 Nicolas, Mark Angel M.
7/23/2005 6/17/2015
9,10
22
1.31
12.8
Wasted
Pangasinense
Juvelyn Nicolas
No
89 Viray, Zimri Louis F.
9/11/2006 6/17/2015
8,9
22
1.3
13
Wasted
Pangasinense
Editha Viray
No
1/8/2004
35292783
90 Dacer, Codee Jan M.
6/17/2015
11,5
28
1.44
13.5
Wasted
Pangasinense
Perla Dacer
No
91 Abulencia, John Rovic P.
1/15/2004 6/16/2015
11,5
20
1.27
12.4
Severely Wasted
Pangasinense
Marivic Abulencia
No
92 Cayoyong, Mark Jolo V.
12/1/2005 6/16/2015
9,6
22
1.32
12.6
Severely Wasted
Pangasinense
Shiela Cayoyong
No
93 Fallorin, Daniel III F.
6/10/2006 6/16/2015
9,0
21
1.25
13.4
Wasted
Pangasinense
Jenalyn
No
94 Manalo, Shania Erika
6/21/2006 6/16/2015
8,11
20
1.24
13
Wasted
Pangasinense
Sharnie Manalo
No
95 Narcorda, Jamaica Rose D.
2/13/2006 6/16/2015
9,4
20
1.27
12.4
Wasted
Pangasinense
Gina Narcorda
No
96 Bianan, Leiu D.
11/7/2003 6/17/2015
11,7
23
1.32
13.2
Wasted
Pangasinense
Rebecca Bianan
No
97 Jovellanos, Jerry Mill M.
9/17/2005 6/17/2015
9,9
21
1.27
13
Wasted
Pangasinense
Teofilo Jovellanos
No
98 Santillan, Mavin Clark S.
6/2/2006
6/17/2015
9,0
19
1.2
13.1
Wasted
Pangasinense
Crisanto Santillan
No
99 Aquino, Marcilo S.
###
6/19/2015
11,6
20
1.21
13.6
Wasted
Pangasinense
43383224
Mario Aquino
Yes
35115060
Persus Jan Ferrer
No
Mary Liza Torralba
Yes
35197777
Fallorin
100 Ferrer, Jan Loue
12/2/2004 6/19/2015
10,6
21
1.23
13.8
Wasted
Pangasinense
101 Torralba, Jesus Gabrielle C.
3/24/2003 6/16/2015
12,2
27
1.39
13.9
Wasted
Pangasinense
102 Castres, Jan Mico P.
###
6/16/2015
9,7
22
1.3
13
Wasted
Pangasinense
103 Catacutan, Harry M.
###
6/16/2015
10,7
22
1.3
13
Wasted
Pangasinense
104 De Guzman, Darell F.
9/30/2005 6/16/2015
9,8
25
1.36
13.5
Wasted
Pangasinense
Mary Rose C. Ferrer
No
105 De Leon, Jacques M.
3/29/2005 6/16/2015
10,2
25
1.39
12.9
Wasted
Pangasinense
Angelita De Leon
No
106 Paras, Christian Andrei V.
10,7
23
1.29
13.8
Wasted
Pangasinense
Analyn B. Paras
No
107 Yao, Iya Alexa A.
7/27/2004 6/16/2015
10,10
25
1.35
13.7
Wasted
Pangasinense
Rowena Yao
No
108 Ampalayan, Aldrin M.
12/7/2004 6/16/2015
10,6
21
1.33
11.8
Severely Wasted
Pangasinense
Victorina Ampalayan
No
109 Delima Jomar T.
3/28/2005 6/16/2015
10,2
20
1.22
13.4
Wasted
Pangasinense
Jomar Delima
No
110 Manuel Jr. Mark S.
1/29/2003 6/16/2015
12,4
22
1.24
14.3
Wasted
Pangasinense
Mark Manuel
No
111 Millan, Kirvy
2/17/2005 6/16/2015
10,3
25
1.35
13.7
Wasted
Pangasinense
Abraham Millan
No
112 Forca, Natasha Jade S.
3/22/2004 6/16/2015
11,2
23
1.31
13.4
Wasted
Pangasinense
Jolleylen Forca
No
113 Meneses, Honey Rose T.
7/27/2004 6/16/2015
10,10
25
1.35
13.7
Wasted
Pangasinense
Angela Meneses
No
###
6/16/2015
No
No
35314221
35616132
No.
Name
Sex
Date of
Date of Birth
Weighing /
(MM/DD/YYY
Measuring
Y)
(MM/DD/YYYY
)
Age in
Years /
Months
Weight
(Kg)
Height
(cm)
BMI for 6
y.o. and
above
Ethnicity
Disabil
ity
4Ps ID
Number
114 Paras, Mia Fatima B.
###
6/16/2015
9,7
22
1.3
13
Wasted
Pangasinense
115 Trinidad, Charlene Joy
###
6/16/2015
9,7
21
1.28
12.8
Wasted
Pangasinense
116 Vidal, Rica Mae C.
###
6/16/2015
11,5
24
1.31
13.9
Wasted
Pangasinense
35304157
117 Doloque, Eugene N.
2/10/2004 6/16/2015
11,4
24
1.34
13.3
Wasted
Pangasinense
35085314
118 Serafica, Jude Landell C.
8/19/2005 6/16/2015
9,9
21
1.27
13
Wasted
Pangasinense
119 Oraya, Daisy Jane D.
9/30/2005 6/16/2015
9,8
20
1.3
11.8
Severely Wasted
Pangasinense
Donna Oraya
No
120 Rayos, Prences Dianne E.
10/6/2003 6/16/2015
11,8
24
1.34
13.3
Wasted
Pangasinense
Nenita Rayos
No
121 Sevidal, Rose Jane F.
2/3/2005
6/16/2015
10,4
19
1.21
12.9
Wasted
Pangasinense
Jimly Sevidal
No
122 Sison, Camille Ann M.
###
6/16/2015
10,7
21
1.31
12.2
Severely Wasted
Pangasinense
Lourdes Sison
No
123 Valdez, Ron Stephen F.
8/7/2003
6/16/2015
11,10
29
1.47
13.4
Wasted
Pangasinense
Rolando Valdez
No
124 Castres, Joshua A.
###
6/16/2015
10,7
23
1.3
13.6
Wasted
Pangasinense
Alma Castres
No
125 Javier, Jopher Doodz E.
9/21/1999 6/16/2015
15,8
48
1.86
13.8
Severely Wasted
Pangasinense
Sandra Javier
No
126 Caballero, Daisy A.
7/15/1999 6/16/2015
15,11
31
1.45
14.7
Wasted
Pangasinense
Marilou Caballero
No
127 Ceralde, Princess M.
3/10/2000 6/16/2015
15,3
32
1.5
14.2
Severely Wasted
Pangasinense
Francisco Ceralde
No
128 Mina, Ofelia P.
1/26/2003 6/16/2015
12,4
25
1.33
14.1
Wasted
Pangasinense
Joel Mina
No
129 Casilang, Joven Alveno Chadnizar
3/1/2003
6/17/2015
12,3
26
1.36
14
Wasted
Pangasinense
130 Lazo, Ruwie J.
1/4/2003
6/17/2015
12,5
23
1.29
13.8
Wasted
Pangasinense
131 Cervera, Lyka C.
3/5/2003
6/17/2015
12,3
33
1.53
14
Wasted
132 Paras, Ma. Ivonie Lyka C.
###
6/17/2015
11,7
20
1.23
13.2
133 Paras, Myrdianne A.
3/12/2002 6/17/2015
13,3
25
1.34
13.9
134 Bautista, Marc Bryan F.
5/11/2002 6/16/2015
13,1
32
1.47
135 Tamayo, Marcelo D.
1/23/2002 6/16/2015
13,4
27
11,5
22
136 Garcia, Paula V.

Prepared by:
###
6/16/2015
35301307
Name of Parents
35610766
Marlene Paras
Beneficia
ry of
SBFP in
Previous
Years
(yes or
no)
No
Joanne Trinidad
No
Mirasol Vidal
No
Vilma Doloque
No
Emilyn Serafica
No
35187421
Joven Mejia
No
Rito Lazo
Yes
Pangasinense
Gilbert Cervera
No
Wasted
Pangasinense
Rogelio Paras
No
Wasted
Pangasinense
Cesar Paras
No
14.8
Wasted
Pangasinense
Edward Bautista
No
1.41
13.5
Severely Wasted
Pangasinense
Marcelino Tamayo
No
1.27
13.6
Wasted
Melchor Garcia
Yes
Pangasinense
35295630
35267308
Noted :
LORENA G. CALMA
Feeding Focal Person
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
MARGOTH B. CALULUT, Ph.D.

School Principal / Officer-in-Charge
SBFP Form 2
Region I
SCHOOL-BASED FEEDING PROGRAM (SBFP)

Division/Province: Dagupan City / Pangasinan
City/ Municipality/Barangay : Dagupan City / Bonuan Gueset
Name of School / School District : General Gregorio Del Pilar Elementary School / District III
ofBeneficiaries
Pupils
Ethnicity No.
4 Ps
Nutritional Status at Start of Feeding
Number of Undernourished
No. of
School Children by Grade
Severely
Level
who are
Total
beneficiaries
BeneficiariNo. of Ethnic Ben.
No. of 4 Ps Ben. in previous
es
years
Wasted
No. of
Wasted
1. Kinder
13
26
39
2. Grade I
17
22
3. Grade II
16
18
4. Grade III
5. Grade IV
12
14
6. Grade V
19
22
7. Grade VI
11
14
32
104
136
24
Total
Prepared by:
LORENA G. CALMA
SBFP DepEd Focal
Remarks
Noted by:
MARGOTH B. CALULUT, Ph.D.

Unit Chief
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEdHNC
SBFP Form 3
Region ___
SCHOOL-BASED FEEDING PROGRAM (SBFP)

Division/Province: ______________________________________
School District/City/ Municipality : ____________________________
Name of Schools
BEIS ID No.
School Address
Prepared by:
Name of District
Total
Supervisors/
Name of Barangay
Contact Number Beneficiari
School Principal
es
or OICs
Noted by:
SBFP DepED Focal
Unit Chief
Note: This form shall be prepared by the DO, for final consolidation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC
SBFP Form 4
SCHOOL-BASED FEEDING PROGRAM
FOR THE MONTH OF SEPTEMBER/OCTOBER , S.Y. 2014

Region: I
Division: Dagupan City
District: III
NAME OF PUPIL
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
26
27
28
29
30
31
32
33
34
35
36
Arenas, Jeayea P.
Sembrana, Honey Khae
Paras, Noah
Reyes, Dexter
Bernardez Jr. Eduardo M.
De Guzman, Melvin P.
Doloque, John Patrick
Calleja, San Joe E.
Panganiban, Alexander James S.
De Guzman, Mark V.
Vidal, Anthonette Gel DC.
Veloso, Gizl P.
Calupit, Ashley
Abule, Rhencel L.
Capinpin, Princess Mae P.
Narag, Jasmin
Munar, Shanelle Irish C.
Maragana, Angelo E.
Dela Cruz, Jessalyn Joy L.
Yao, Jerome V.
Mercado, Edra Jane
Samson, Juvelyn S.
Aquino, Marcilo S.
Vidal, Elizabeth F.
Arguelles, John Wayne C.
Reyes, Kassandra Kyle
Ampalayan, Aldrin M.
Toralba, Jesus Gabrielle C.
Paras, Clarissa S.
Carrera, Cindy
Corbillon, Christian F.
Lazo, Ruwei J.
Veloso, Remedios P.
Gutierrez, Wilfred S.
Garcia, Paula V.
Labrador, Normie Lea P.
School: GENERAL GREGORIO DEL PILAR ELEMENTARY SCHOOL

Grade: __________ Section _____________________
4Ps
Benefi Beneficia
ciary
ry of
(y or Previous
n)
SBFP
(y or n)
ACTUAL FEEDING
PRE FEEDING
Age
Ht
Nutritional Status
Wt
Date
cm
kg
Taken
0.95
11
6/11/2014
SU
Sex
Birth Date
53 mos.
10/3/2009
NS
61 mos.
5/6/2009
1.02
11
6/11/2014
SU
65 mos.
12/12/2008
1.03
12
6/11/2014
SU
64 mos.
1/28/2009
1.05
12
6/11/2014
SU
66 mos.
11/16/2008
13
6/11/2014
SU
61 mos.
4/21/2009
1.08
12
6/11/2014
SU
63 mos.
2/13/2009
1.06
11
6/11/2014
SU
61 mos.
5/2/2009
1.04
14
6/11/2014
62 mos.
3/26/2009
0.99
12
6/11/2014
SU
60 mos.
5/18/2009
0.96
13
6/11/2014
66 mos.
11/25/2008
1.1
14
6/11/2014
68 mos.
9/20/2008
0.96
13
6/6/2014
SW
6,6
11/11/2007
10.7
17
6/6/2014
SW
69 mos.
8/28/2008
1.06
13
6/6/2014
SW
71 mos.
6/12/2008
0.98
11
6/6/2014
SW
71 mos.
6/9/2008
1.03
13
6/6/2014
SW
7,4
1/23/2007
1.15
17
6/9/2014
SW
9,7
10/16/2004
1.28
19
6/9/2014
SW
11,10
8/6/2002
1.98
40
6/9/2014
SW
8,4
1/17/2006
1.14
17
6/9/2014
8,7
10/27/2005
1.16
17
6/9/2014
7,11
6/12/2006
1.32
20
6/9/2014
SW
10,6
11/28/2003
1.18
17
6/9/2014
SW
8,0
5/15/2006
1.2
18
6/9/2014
7,8
9/20/2006
1.21
19
6/9/2014
9,9
9/8/2004
1.36
22
6/10/2014
SW
9,6
12/7/2004
1.3
19
6/10/2014
SW
9,2
3/24/2005
1.35
22
6/10/2014
SW
9,10
7/26/2004
1.32
21
6/10/2014
SW
12,6
11/21/2001
1.45
25
6/10/2014
SW
12,3
2/26/2002
1.37
25
6/6/2014
SW
11,5
1/6/2003
1.26
20
6/6/2014
SW
11,0
6/6/2003
1.45
25
6/6/2014
SW
11,2
3/29/2003
1.21
19
6/6/2014
SW
10,5
12/28/2003
1.24
19
6/6/2014
SW
10,6
11/22/2003
1.18
17
6/6/2014
SW
Y
Y
Deworming
( ) or Date 23
(X) Taken 1
Page 8
24
25
26
29
30
10
13
14
15
16
17
20
21
10
11
12
13
14
15
16
17
18
19
20
SBFP Form 4
FOR THE MONTH OF SEPTEMBER/OCTOBER , S.Y. 2014

Region: I
Division: Dagupan City
District: III
NAME OF PUPIL
37
38
39
40

Grade: __________ Section _____________________
4Ps
Benefi Beneficia
ciary
ry of
(y or Previous
n)
SBFP
(y or n)
Vidal, Angelica
Cabalar, Carlos Jonel V.
Tamayo, Marlon D.
Aquino, Benjie V.
Age
Sex
Birth Date
11,7
Y
ACTUAL FEEDING
PRE FEEDING
Ht
Nutritional Status
Wt
Date
cm
kg
Taken
NS
10/22/2002
1.36
24
6/10/2014
SW
12,0
6/2/2002
1.42
24
6/9/2014
SW
14,5
12/22/1999
1.5
31
6/9/2014
SW
14,6
11/14/1999
1.42
30
6/9/2014
Deworming
( ) or Date 23
(X) Taken 1
24
25
26
29
30
10
13
14
15
16
17
20
21
10
11
12
13
14
15
16
17
18
19
20
TOTAL:
Prepared by:
LEGEND
LORENA G. CALMA
Feeding Teacher / School Nurse
A. Nutritional Status
For 6-19 y.o
B. Deworming
For below 6 y.o
D. Actual Feeding
SW - Severely wasted
SU - Severely underweight
( x ) - not dewormed
( ) - Present, served
W - Wasted
U - Underweight
( ) - dewormed
( A ) - Absent, not served
N - Normal
N - Normal
Ow - Overwieght
Ow - Overwieght
( ) - Present, served twice
O - Obese
Note: This form shall be prepared by the school to be consolidated using SBFP Form 5
Page 9
SBFP Form 4
FOR THE MONTH OF OCTOBER / NOVEMBER / DECEMBER , SY 2014-2015

Region
I
Division Dagupan City
District III

Grade: __________ Section _____________________
ACTUAL FEEDING
NAME OF PUPIL
22 23 27 28 29 30 31 3 4 5 6 7 10 11 12 14 17 18 19 20 21 24 25 26 27 28 1 2 3 4 5 8 9 10 11 12 15
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57
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
26
27
28
29
30
31
32
33
34
35
36
Arenas, Jeayea P.
Paras, Noah
Reyes, Dexter
Calleja, San Joe E.
De Guzman, Mark V.
Veloso, Gizl P.
Calupit, Ashley
Abule, Rhencel L.
Narag, Jasmin
Maragana, Angelo E.
Yao, Jerome V.
Mercado, Edra Jane
Samson, Juvelyn S.
Aquino, Marcilo S.
Vidal, Elizabeth F.
Paras, Clarissa S.
Carrera, Cindy
Lazo, Ruwei J.
Veloso, Remedios P.
Garcia, Paula V.
page 2
SBFP Form 4
FOR THE MONTH OF OCTOBER / NOVEMBER / DECEMBER , SY 2014-2015

Region
I
District III

Grade: __________ Section _____________________
ACTUAL FEEDING
NAME OF PUPIL
22 23 27 28 29 30 31 3 4 5 6 7 10 11 12 14 17 18 19 20 21 24 25 26 27 28 1 2 3 4 5 8 9 10 11 12 15
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57
37
38
39
40
Vidal, Angelica
Tamayo, Marlon D.
Aquino, Benjie V.
TOTAL
D. Actual Feeding
page 2
SBFP Form 4
FOR THE MONTH OF ______________________ , SY 2014-2015

Region I
District III

Grade: __________ Section _____________________
ACTUAL FEEDING
NAME OF PUPIL
58
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
26
27
28
29
30
31
32
33
34
35
36
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
Arenas, Jeayea P.
Paras, Noah
Reyes, Dexter
Calleja, San Joe E.
De Guzman, Mark V.
Veloso, Gizl P.
Calupit, Ashley
Abule, Rhencel L.
Narag, Jasmin
Maragana, Angelo E.
Yao, Jerome V.
Mercado, Edra Jane
Samson, Juvelyn S.
Aquino, Marcilo S.
Vidal, Elizabeth F.
Paras, Clarissa S.
Carrera, Cindy
Lazo, Ruwei J.
Veloso, Remedios P.
Garcia, Paula V.
page 3
SBFP Form 4
FOR THE MONTH OF ______________________ , SY 2014-2015

Region I
District III

Grade: __________ Section _____________________
ACTUAL FEEDING
NAME OF PUPIL
58
37
38
39
40
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
Vidal, Angelica
Tamayo, Marlon D.
Aquino, Benjie V.
TOTAL:
D. Actual Feeding
page 3
SBFP Form 4
FOR THE MONTH OF ______________________ , SY _____________

Region ____________________________
Division ___________________________
District ___________________________
School: _____________________________________
Grade: __________ Section _____________________
ACTUAL FEEDING
POST FEEDING
NAME OF PUPIL
98
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
26
27
28
29
30
31
32
33
34
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
Ht
cm
Nutritional Status
Wt
Date
kg
Taken
ATTENDANCE
NS
Days
Present
Feeding
Days
(A)
(B)
Arenas, Jeayea P.
Paras, Noah
Reyes, Dexter
Calleja, San Joe E.
De Guzman, Mark V.
Veloso, Gizl P.
Calupit, Ashley
Abule, Rhencel L.
Narag, Jasmin
Maragana, Angelo E.
Yao, Jerome V.
Mercado, Edra Jane
Samson, Juvelyn S.
Aquino, Marcilo S.
Vidal, Elizabeth F.
Paras, Clarissa S.
Carrera, Cindy
Lazo, Ruwei J.
Veloso, Remedios P.
page 4
SBFP Form 4
FOR THE MONTH OF ______________________ , SY _____________

Region ____________________________
Division ___________________________
District ___________________________
School: _____________________________________
Grade: __________ Section _____________________
ACTUAL FEEDING
POST FEEDING
NAME OF PUPIL
98
35
36
37
38
39
40
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
Ht
cm
Nutritional Status
Wt
Date
kg
Taken
ATTENDANCE
NS
Days
Present
Feeding
Days
(A)
(B)
Garcia, Paula V.
Vidal, Angelica
Tamayo, Marlon D.
Aquino, Benjie V.
TOTAL:
AVERAGE:
D. Actual Feeding
page 4
NDANCE
Percentage
(A/B)*100
page 4
NDANCE
Percentage
(A/B)*100
page 4
SBFP Form 5
CONSOLIDATED NUTRITIONAL STATUS AND ATTENDANCE REPORT

Region: _______
Division/District: ________________________
School: ________________________________
BEIS ID No.: ___________________________
GRADES AND SECTIONS
No. of Pupils
Dewormed
NUTRITIONAL STATUS
SW/SU
W/U
BEFORE
N
Ow
Ob
Total
SW/SU
W/U
AFTER
N
Ow
Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TOTAL
AVERAGE:
Legend:
For 6-19 y.o
SW - Severely Wasted
W - Wasted
N - Normal
Ow - Overweight
O - Obese
For below 6 y.o

SU - Severely Underweight
U - Underweight
N - Normal
Ow - Overweight
Prepared by:
_____________________________
Classroom Adviser / School Nurse
Noted by:
Note: This form shall be prepared by the school using the data from SBFP Form 4.
___________________________
School Head
PERCENTAGE
ATTENDANCE

SBFP Form 1: Master List Beneficiaries For School-Based Feeding Program (SBFP)

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

SBFP Form 1: Master List Beneficiaries For School-Based Feeding Program (SBFP)

Uploaded by

Copyright:

Available Formats

SBFP Form 1

Master List Beneficiaries for School-Based Feeding Program (SBFP)

Name of Principal : Margoth B. Calulut

City/ Municipality/Barangay : Dagupan City / Bonuan Gueset

Name of Feeding Focal Person : Lorena G. Calma

Nutritional Status (NS)

3 Manaois III, Valeriano C.

4 Milo, Aaron Macky DG.

6 Foronda, Jamecha Jasmin

8 Paras, Andrea Lorreine E.

10 Torio, Kylie Janine N.

13 Zamora, Chezka Marniel J.

15 Javier, John Joseph M.

18 Clores, Janilla Mae V.

Mary Joy L. Clores

19 Abejuela, Randale Josh M.

20 Landingin, Louie Jake S.

21 Pastor, John Paul G.

25 Diaz, Denryl Joeci B.

27 Landingin, Diana Rose C.

Joana Rose Bordios

29 Parayaoan, Jean Ysabel D.

31 Lopez, Alejhandro Jet D.

33 Zabala, Alexander Romel

Nutritional Status (NS)

37 Mama, Princess Carla B.

38 Narag, Ma. Jennica R.

39 Zabala, Marian Irish

40 Collado, Jayden Harvey O.

41 Gallardo, Dexhian Matthew

Mark Anthony Gallardo

42 Mores, Jhasper Lamod

43 Alon, Jilian Bombilla

44 Dioquino, Jasmine Andrea M.

45 Bernardez Jr., Eduardo

Eduardo Bernardez Sr.

46 Caballero, Frank Gian M.

47 Doloque, Jhan Patrick D.

53 Del Monte, Marvic James P.

Susana P. Del Monte

Sheryl Ann Zulieta

58 Prasmo, Mark Aiken

59 Serrano, Ken Louise L.

Rocky Mar Ferrer

64 Macatiag, Dustine John

66 Ceralde, Jhon Mark J.

67 Clores, Jun Mark

71 Pastor, Carl Marphy

73 Delima, Frencess, Jay

Wilma Dela Cruz

Nutritional Status (NS)

76 Forca, Alexander Melvin

81 Sembrana, Samantha Nicole A.

82 Lumban, Kurt Anthony S.

83 Veloso, Rhea Rhose P.

84 Pedrones, Lance Sidrix C.

86 Mercado, Edra Jane D.

87 Casaa, John Joshua M.

88 Nicolas, Mark Angel M.

89 Viray, Zimri Louis F.

90 Dacer, Codee Jan M.

91 Abulencia, John Rovic P.

92 Cayoyong, Mark Jolo V.

FOR THE MONTH OF __________ , SY _

FOR THE MONTH OF __________ , SY _