Republic of the Philippines

Department of Education
Region III
Division of Bulacan
District of San Rafael
NUTRITIONAL STATUS REPORT
School: Tambubong Elementary School
Grade: Grade VI - A
Boys #
Names
1
Bautista, Raniel S.
2
Concepcion, Aerials March S.
3
De Jesus, Joshua V.
4
De Vera, John Adrian B.
5
Dela Cruz, Carlos Miguel S.
6
Dela Cruz, Edmond Ambross V.
7
Espiritu, John Reynolds M.
8
Feliciano, Fores Jam S.
9
Francisco, Mark Anthony R.
10
Gabinete, Warren F.
11
Mamugay, Adrian H.
12
Mercado, Justin Carl A.
13
Ortiz, Luis Arc Reilly M.
14
Plamenco, Robert B.
15
Ramos, Red Dominic M.
16
Torres, Dominic S.
17
Vasallo, Klarence D.
Vizconde, John Kenneth M.
18

Teacher:
Date:
Date Taken
Birthday
6/16/2014
8/1/2002
6/16/2014
8/21/2002
6/16/2014
8/20/2002
6/16/2014
8/29/2002
6/16/2014 10/31/2002
6/16/2014
3/22/2003
6/16/2014 12/28/2001
6/16/2014
7/29/2002
6/16/2014
6/5/2003
6/16/2014
9/2/2002
6/16/2014
12/6/2001
6/16/2014
4/25/2003
6/16/2014 12/12/2002
6/16/2014
5/24/2003
6/16/2014
8/8/2002
6/16/2014
9/2/2003
6/16/2014
9/14/2002
6/16/2014 12/25/2002

Age
11.10
11.09
11.09
11.09
11.07
11.02
12.05
11.10
11.00
11.09
12.06
11.01
11.06
11.00
11.10
10.09
11.09
11.05
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

Weight(kg)
31
27
37
28.5
67
43
39
45
24
31
30.5
29.5
27
39
36.5
26.5
53.5
23

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

of the Philippines
ment of Education
Region III
ion of Bulacan
ct of San Rafael
NAL STATUS REPORT
Remedios V. Castaeda
6/16/2014
Height(cm)
141
134
150
137
154
148
151
151
136
143
144
137.5
132
148
136
137
161
126

BMI
15.59
15.04
16.44
15.18
28.25
19.63
17.10
19.74
12.98
15.16
14.71
15.60
15.50
17.80
19.73
14.12
20.64
14.49
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REMARKS
Normal
Normal
Normal
Normal
Obese
Normal
Normal
Normal
Severely Wasted
Normal
Wasted
Normal
Normal
Normal
Normal
Wasted
Normal
Wasted

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Republic of the Philippines

Department of Education
Region III
Division of Bulacan
District of San Rafael
NUTRITIONAL STATUS REPORT
School: Tambubong Elementary School
Grade: Grade VI - A
Girls #
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22

Names
Alcantara, Loren Rabelle S.
Caliso, Maiceljen P.
Cruz, Mary Nicole T.
Dalmacio, Jhanise Angela S.
Dela Cruz, Edlene M.
Don Diego, Hershey A.
Galvez, Rachel Leigh
Ignacio, Cindy Aira C.
Ileto, Elizah Marie C.
Malabanan, Monica E.
Mauricio, Arbie Mae B.
Mitra, Avelyn S.
Morata, Maurene A.
Palubon, Sarah Mae V.
Pantaleon, Ashlie A.
Poblete, Lyna Kristine O.
Quiambao, Raiza M.
Ronda, Kathleen S.
Sta. Ana, Lean Valerie F.
Ugay, Angel V.
Viquiera, Cazandra N.
Vizconde, Angeline S.

Teacher:
Date:
Date Taken
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014
6/16/2014

Birthday
3/26/2003
11/1/2002
11/28/2002
12/15/2003
1/25/2003
9/25/2002
4/18/2002
6/22/2003
10/26/2003
9/3/2003
1/2/2002
8/20/2002
6/15/2003
4/2/2002
8/17/2003
6/11/2003
10/25/2002
8/19/2002
4/14/2003
9/29/2002
1/7/2003
11/15/2002

Age
11.02
11.07
11.06
10.06
11.04
11.08
12.01
10.11
10.07
10.09
12.05
11.09
11.00
12.02
10.09
11.00
11.07
11.09
11.02
11.08
11.05
11.07
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

Weight(kg)
43
30.5
50
29
39
28
40
62.5
24
32.5
46
31
27
39
30.5
29
34
39
35
31.5
25
30.5

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

of the Philippines
ment of Education
Region III
ion of Bulacan
ct of San Rafael
NAL STATUS REPORT
Remedios V. Castaeda
6/16/2014
Height(cm)
149
144
150
143
140
143
152
160
131
144
155
139
135
152
134
137
143
139
150
137
135
136

BMI
19.37
14.71
22.22
14.18
19.90
13.69
17.31
24.41
13.99
15.67
19.15
16.04
14.81
16.88
16.99
15.45
16.63
20.19
15.56
16.78
13.72
16.49
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REMARKS
Normal
Normal
Normal
Normal
Normal
Wasted
Normal
Overweight
Wasted
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Wasted
Normal

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Republic of the Philippines

Department of Education
Region III
Division of Bulacan
District of San Rafael
NUTRITIONAL STATUS SUMMARY REPORT
School:
Teacher:
Grade:
Date:

Tambubong Elementary School

Remedios V. Castaeda
Grade VI - A
6/16/2014
Table A. Tabulated Data Presentation
Boys
Nutrition Result
Total
Severely Wasted:
1
Wasted:
3
Normal: 13
Overweight:
0
Obese:
1
Grand Total
18

Percent
5.56
16.67
72.22
0.00
5.56
100

Girls
Total Percent
0
0.00
3
13.64
18
81.82
1
4.55
0
0.00
22
100

Table B. Graphical Data Presentation

Nutrition Status
Severely Wasted:
Wasted:
Normal:
Overweight:
Obese:
CREATED BY: DOMINICK L. DERILO

Percentage
2.50
15.00
77.50
2.50
2.50

Total
Total
Percent
1
2.50
6
15.00
31
77.50
1
2.50
1
2.50
40
100