SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade Levels)

School Name District Division

School ID Grade Section Track/Strand (SHS)

Learner's Name Nutritiona

Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name) (kg/m²)
MALE
 Learner's Name Nutritiona
Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name) (kg/m²)

FEMALE
 Learner's Name Nutritiona
Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name) (kg/m²)

SUMMARY TABLE
Nutritional Status He
Summary Table
SEX Severely Severely
Wasted Normal Overweight Obese TOTAL Stunted Normal
Wasted Stunted
MALE
FEMALE
TOTAL

Date of Assessment: Conducted/Assessed By: Certified Correct By:

 Region

School Year

ional Status
Height for
BMI Remarks
Age (HFA)
Category
ional Status
Height for
BMI Remarks
Age (HFA)
Category
ional Status
Height for
BMI Remarks
Age (HFA)
Category

Height for Age (HFA)

Summary Table
Tall Total

Reviewed By:

SFRT 2017