ALAMINOS CITY, PANGASINAN FORM 1: CHT MOBILIZATION REPORT AS OF JANUARY 2013 CHD: ILOCOS REGION

BARANGAY (A) NUMBER OF HOUSEHOLDS (B) NHTS CCT CHT TARGETS (C) TARGET NO. OF CH TEAMS TARGET NO. OF CHT MEMBERS NO. OF CH TEAMS TRAINED ACTUAL NUMBER OF CHT MOBILIZED (D) NO. OF CHT MEMBERS TRAINED NO. OF RNHeals TRAINED O CHT (E) NO. OF NHTS HHs ASSIGNED TO CHT NO. OF NHTS HH VISITED BY CHT EXPLANATION VARIANCE: COLUM F COMPARED TO COLUMN G (H)

NO. OF CHT MEMBERS DEPLOYED

(F)

(G)

1.ALOS 2.AMANDIEGO 3.AMANGBANGAN 4.BALANGOBONG 5.BALAYANG 6.BALEYADAAN 7.BISOCOL 8.BOLANEY 9.BUED 10.CABATUAN 11.CAYUCAY 12.DULACAC 13.INERANGAN 14.LANDOC 15.LINMANSANGAN 16.LUCAP 17.MAAWI 18.MACATIW 19.MAGSAYSAY 20.MONA 21.PALAMIS 22.PANDAN

23.PANGAPISAN 24.POBLACION 25.POCAL-POCAL 26.POGO 27.POLO 28.QUIBUAR 29.SABANGAN 30.SAN ANTONIO 31.SAN JOSE 32.SAN ROQUE 33.SAN VICENTE 34.STA.MARIA 35.TANAYTAY 36.TANGCARANG 37.TAWIN-TAWIN 38.TELBANG 39.VICTORIA TOTAL

Prepared by: Alaminos Cty RNHeals

Noted by: Cynthia R. Razote, PHN III Cesar A. Briboneria III, PHN II

Approved by: Dr. Ma. Victoria O. Carambas, CHO

ALAMINOS CITY, PANGASINAN FORM 2A: CHT HOME VISITS REPORT AS OF JANUARY 2013
BARANGAYS NO. OF NHTS HH WITH HEALTH USE PLAN NO. OF NHTS FAMILY WITH PHIL HEALTH ID NUMBER OF HOUSEHOLDS NUMBER OF SEEN AND REFFERED CURRENT MODERN FAMILY PLANNING USERS NEWBORN UNDER 5 SENIOR PWDs MEN WOMEN CHILDREN CITIZENS NO. OF MATERNAL DEATHS NO. OF NEONATAL DEATHS

PREGNANT WOMEN

WITH ACCESS TO SAFE WATER

WITH SANITARY TOILET FACILITIES TB

WITH RISK FACTOR/S FOR MALARIA NCD

1.ALOS 2.AMANDIEGO 3.AMANGBANGAN 4.BALANGOBONG 5.BALAYANG 6.BALEYADAAN 7.BISOCOL 8.BOLANEY 9.BUED 10.CABATUAN 11.CAYUCAY 12.DULACAC 13.INERANGAN 14.LANDOC 15.LINMANSANGAN 16.LUCAP 17.MAAWI 18.MACATIW 19.MAGSAYSAY 20.MONA 21.PALAMIS 22.PANDAN

23.PANGAPISAN 24.POBLACION 25.POCAL-POCAL 26.POGO 27.POLO 28.QUIBUAR 29.SABANGAN 30.SAN ANTONIO 31.SAN JOSE 32.SAN ROQUE 33.SAN VICENTE 34.STA.MARIA 35.TANAYTAY 36.TANGCARANG 37.TAWIN-TAWIN 38.TELBANG 39.VICTORIA

Prepared by: Alaminos Cty RNHeals

Noted by: Cynthia R. Razote, PHN III Cesar A. Briboneria III, PHN II

Approved by: Dr. Ma. Victoria O. Carambas, CHO

ALAMINOS CITY, PANGASINAN FORM 2B: NUMBER OF FAMILY PLANNING USERS BY METHOD AS OF JANUARY 2013

BARANGAYS

TRADITIONAL METHODS MEN WITHDRAWAL WOMEN CALENDAR MEN CONDOM VASECTOMY CERVICAL MUCUS SYMPTOTHERMAL

MODERN METHODS BASAL BODY TEMPERATURE WOMEN LAM SDM/ CYCLE/ BEADS PILLS INJECTABLE/ DMPA IUD BILATERAL TUBAL LIGATION

1.ALOS 2.AMANDIEGO 3.AMANGBANGAN 4.BALANGOBONG 5.BALAYANG 6.BALEYADAAN 7.BISOCOL 8.BOLANEY 9.BUED 10.CABATUAN 11.CAYUCAY 12.DULACAC 13.INERANGAN 14.LANDOC 15.LINMANSANGAN 16.LUCAP 17.MAAWI 18.MACATIW 19.MAGSAYSAY 20.MONA 21.PALAMIS 22.PANDAN

23.PANGAPISAN 24.POBLACION 25.POCAL-POCAL 26.POGO 27.POLO 28.QUIBUAR 29.SABANGAN 30.SAN ANTONIO 31.SAN JOSE 32.SAN ROQUE 33.SAN VICENTE 34.STA.MARIA 35.TANAYTAY 36.TANGCARANG 37.TAWIN-TAWIN 38.TELBANG 39.VICTORIA

Prepared by: Alaminos Cty RNHeals

Noted by: Cynthia R. Razote, PHN III Cesar A. Briboneria III, PHN II

Approved by: Dr. Ma. Victoria O. Carambas, CHO

ALAMINOS CITY, PANGASINAN FORM 2C: NUMBER OF HEALTH USE PLANS DEVELOPED BY FORM AS OF JANUARY 2013 BARANGAYS 1.ALOS 2.AMANDIEGO 3.AMANGBANGAN 4.BALANGOBONG 5.BALAYANG 6.BALEYADAAN 7.BISOCOL 8.BOLANEY 9.BUED 10.CABATUAN 11.CAYUCAY 12.DULACAC 13.INERANGAN 14.LANDOC 15.LINMANSANGAN 16.LUCAP 17.MAAWI 18.MACATIW 19.MAGSAYSAY 20.MONA 21.PALAMIS 22.PANDAN 23.PANGAPISAN 24.POBLACION 25.POCAL-POCAL 26.POGO 27.POLO 28.QUIBUAR FORM 2A FORM 2B FORM 2C FORM 2D FORM 2E FORM 2F FORM 2G

29.SABANGAN 30.SAN ANTONIO 31.SAN JOSE 32.SAN ROQUE 33.SAN VICENTE 34.STA.MARIA 35.TANAYTAY 36.TANGCARANG 37.TAWIN-TAWIN 38.TELBANG 39.VICTORIA

Prepared by: Alaminos Cty RNHeals

Noted by: Cynthia R. Razote, PHN III Cesar A. Briboneria III, PHN II

Approved by: Dr. Ma. Victoria O. Carambas, CHO