This form to be use by the MSWDO/Focal Person based on the submitted form 2a of the CDW.

(Soft Copy)

Name of Child
Name of Child
No. Province Municipality Barangay Development
Development/ SNP Worker
Center/ SNP

1 BULACAN MALOLOS LIANG LIANG DCC LORIE CONSTANTINO

2 BULACAN MALOLOS LIANG LIANG DCC LORIE CONSTANTINO
3 BULACAN MALOLOS LIANG LIANG DCC LORIE CONSTANTINO
4 BULACAN MALOLOS LIANG LIANG DCC LORIE CONSTANTINO
5 BULACAN MALOLOS LIANG LIANG DCC LORIE CONSTANTINO
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 DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
FIELD OFFICE XII
SUPPLEMENTARY FEEDING PROGRAM SY 2020-2021
MASTERLIST OF BENEFICIARIES

DW. (Soft Copy)

Household ID Middle Date of Birth

Last Name First Name Sex
Number Name (MM/DD/YYYY)

149 ALINCASTRE JOANNE S F May 30, 2018

135 FRANCISCO LEA LOPEZ F May 29, 2018
179 TRINIDAD TRINIE CRUZ F February 20, 2018
347 NUQUI VET CRUZ F December 14, 2018
932 carreon lhen LANSANGAN F July 31, 2019
January 22, 2018
SOCIAL WELFARE AND DEVELOPMENT
FIELD OFFICE XII
RY FEEDING PROGRAM SY 2020-2021
ERLIST OF BENEFICIARIES

NUTRITIONAL STATUS

summary
Date of Weighing Weight Height Age in of
0.5
(MM/DD/YYYY) (kg) (cm) Months weight for weight for height for undernour
age height age
ishedchild
ren

January 13, 2021 12 100 100.0 32 N W T

January 13, 2021 12 80 80.0 32 N N SS
January 13, 2021 15 75 75.0 34 N O SS
January 13, 2021 14 65 65.0 28 N O SS
January 13, 2021 31 70 70.0 17 OW O SS
January 13, 2021 22 90 90.0 12 SUW SW SS
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Pantawid
Member
(pls
specify Child of
RCCT / Solo Name of
4p's or Ethnicity IPS Disability Disable Parent Parent/ Remarks
MCCT ( Yes or Guardian
and No)
indicate
reference
number)
SFP Form 2.b

No. of CDC/ SNP

Name of Child Name of Child Children
# Barangay Development Development / SNP Total 2 yo
Center/ SNP worker Male Female
Male
1 0 0 0 0
2 0 0 0 0
3 0 0 0 0
4 0 0 0 0
5 0 0 0 0
6 0 0 0 0
7 0 0 0 0
8 0 0 0 0
9 0 0 0 0
10 0 0 0 0
11 0 0 0 0
12 0 0 0 0
13 0 0 0 0
14 0 0 0 0
15 0 0 0 0
16 0 0 0 0
17 0 0 0 0
18 0 0 0 0
19 0 0 0 0
20 0 0 0 0
21 0 0 0 0
22 0 0 0 0
23 0 0 0 0
24 0 0 0 0
25 0 0 0 0
26 0 0 0 0
27 0 0 0 0
28 0 0 0 0
29 0 0 0 0
30 0 0 0 0
31 0 0 0 0
32 0 0 0 0
33 0 0 0 0
34 0 0 0 0
35 0 0 0 0
36 0 0 0 0
37 0 0 0 0
38 0 0 0 0
39 0 0 0 0
40 0 0 0 0
41 0 0 0 0
42 0 0 0 0
43 0 0 0 0
44 0 0 0 0
45 0 0 0 0
46 0 0 0 0
47 0 0 0 0
48 0 0 0 0
49 0 0 0 0
50 0 0 0 0
51 0 0 0 0
52 0 0 0 0
53 0 0 0 0
54 0 0 0 0
55 0 0 0 0
56 0 0 0 0
57 0 0 0 0
58 0 0 0 0
59 0 0 0 0
60 0 0 0 0
61 0 0 0 0
62 0 0 0 0
63 0 0 0 0
64 0 0 0 0
65 0 0 0 0
66 0 0 0 0
67 0 0 0 0
68 0 0 0 0
69 0 0 0 0
70 0 0 0 0
71 0 0 0 0
72 0 0 0 0
73 0 0 0 0
74 0 0 0 0
75 0 0 0 0
76 0 0 0 0
77 0 0 0 0
78 0 0 0 0
79 0 0 0 0
80 0 0 0 0
81 0 0 0 0
82 0 0 0 0
83 0 0 0 0
84 0 0 0 0
85 0 0 0 0
86 0 0 0 0
87 0 0 0 0
88 0 0 0 0
89 0 0 0 0
90 0 0 0 0
91 0 0 0 0
92 0 0 0 0
93 0 0 0 0
94 0 0 0 0
95 0 0 0 0
96 0 0 0 0
97 0 0 0 0
98 0 0 0 0
99 0 0 0 0
100 0 0 0 0
101 0 0 0 0
102 0 0 0 0
103 0 0 0 0
104 0 0 0 0
105 0 0 0 0
106 0 0 0 0
107 0 0 0 0
108 0 0 0 0
109 0 0 0 0
110 0 0 0 0
111 0 0 0 0
112 0 0 0 0
113 0 0 0 0
114 0 0 0 0
115 0 0 0 0
116 0 0 0 0
117 0 0 0 0
118 0 0 0 0
119 0 0 0 0
120 0 0 0 0
121 0 0 0 0
122 0 0 0 0
123 0 0 0 0
124 0 0 0 0
125 0 0 0 0
126 0 0 0 0
127 0 0 0 0
128 0 0 0 0
129 0 0 0 0
130 0 0 0 0
131 0 0 0 0
132 0 0 0 0
133 0 0 0 0
134 0 0 0 0
135 0 0 0 0
136 0 0 0 0
137 0 0 0 0
138 0 0 0 0
139 0 0 0 0
140 0 0 0 0
141 0 0 0 0
142 0 0 0 0
143 0 0 0 0
144 0 0 0 0
145 0 0 0 0
146 0 0 0 0
147 0 0 0 0
148 0 0 0 0
149 0 0 0 0
150 0 0 0 0
151 0 0 0 0
152 0 0 0 0
153 0 0 0 0
154 0 0 0 0
155 0 0 0 0
156 0 0 0 0
157 0 0 0 0
158 0 0 0 0
159 0 0 0 0
160 0 0 0 0
161 0 0 0 0
162 0 0 0 0
163 0 0 0 0
164 0 0 0 0
165 0 0 0 0
166 0 0 0 0
167 0 0 0 0
168 0 0 0 0
169 0 0 0 0
170 0 0 0 0
171 0 0 0 0
172 0 0 0 0
173 0 0 0 0
174 0 0 0 0
175 0 0 0 0
176 0 0 0 0
177 0 0 0 0
178 0 0 0 0
179 0 0 0 0
180 0 0 0 0
181 0 0 0 0
182 0 0 0 0
183 0 0 0 0
184 0 0 0 0
185 0 0 0 0
186 0 0 0 0
187 0 0 0 0
188 0 0 0 0
189 0 0 0 0
190 0 0 0 0
191 0 0 0 0
192 0 0 0 0
193 0 0 0 0
194 0 0 0 0
195 0 0 0 0
196 0 0 0 0
197 0 0 0 0
198 0 0 0 0
199 0 0 0 0
200 0 0 0 0
201 0 0 0 0
202 0 0 0 0
203 0 0 0 0
204 0 0 0 0
205 0 0 0 0
206 0 0 0 0
207 0 0 0 0
208 0 0 0 0
209 0 0 0 0
210 0 0 0 0
211 0 0 0 0
212 0 0 0 0
213 0 0 0 0
214 0 0 0 0
215 0 0 0 0
216 0 0 0 0
217 0 0 0 0
218 0 0 0 0
219 0 0 0 0
220 0 0 0 0
221 0 0 0 0
222 0 0 0 0
223 0 0 0 0
224 0 0 0 0
225 0 0 0 0
226 0 0 0 0
227 0 0 0 0
228 0 0 0 0
229 0 0 0 0
230 0 0 0 0
231 0 0 0 0
232 0 0 0 0
233 0 0 0 0
234 0 0 0 0
235 0 0 0 0
236 0 0 0 0
237 0 0 0 0
238 0 0 0 0
239 0 0 0 0
240 0 0 0 0
241 0 0 0 0
242 0 0 0 0
243 0 0 0 0
244 0 0 0 0
245 0 0 0 0
246 0 0 0 0
247 0 0 0 0
248 0 0 0 0
249 0 0 0 0
250 0 0 0 0
TOTAL 0 0 0 0

Additional Data: No. of CDC with vegetable garden: ________________________

No. of CDC with feeding area: ________________________
No. of CDC with potable water: ________________________
No. of CDC with sanitary toilet: ________________________

Prepared by: Noted by:

Name Name
Position/Designation Position/Designation
Date: Date:
 DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
FIELD OFFICE XII
SUPPLEMENTARY FEEDING PROGRAM CY 2020
PROFILE OF BENEFICIARIES
MUNICIPALITY OF ___________________________________

No. of Beneficiaries by Age Pantawid Ben.

2 yo 3yo 4yo 5yo Total
Male Female
Female Male Female Male Female Male Female
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

Approved by:

Name
Position/Designation
Date:
 No. of Children w/ Number of Children w/
No. of IP Children
Disability Solo Parent
Total Total Total Total
Male Female Male Female Male Female

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
SFP Form 3.b
DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
FIELD OFFICE XII
SUPPLEMENTARY FEEDING PROGRAM CY 2020
WEIGHT MONITORING TEMPLATE

Name of Name of
Child Child
Household
No. Province Municipality Barangay Developmen Developmen Last Name First Name
ID Number
t Center/ t/ SNP
SNP Worker

1 BULACAN MALOLOS LIANG LIANG

LORIE
DCC CONSTANTINO
149 ALINCASTRE JOANNE
2 BULACAN MALOLOS LIANG LIANG
LORIE
DCC CONSTANTINO
135 FRANCISCO LEA
3 BULACAN MALOLOS LIANG LIANG
LORIE
DCC CONSTANTINO
179 TRINIDAD TRINIE
4 BULACAN MALOLOS LIANG LIANG
LORIE
DCC CONSTANTINO
347 NUQUI VET
5 BULACAN MALOLOS LIANG LIANG
LORIE
DCC CONSTANTINO
932 carreon lhen
6 0 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0 0
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14 0 0 0 0 0 0 0 0
15 0 0 0 0 0 0 0 0
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25 0 0 0 0 0 0 0 0
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27 0 0 0 0 0 0 0 0
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30 0 0 0 0 0 0 0 0
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32 0 0 0 0 0 0 0 0
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36 0 0 0 0 0 0 0 0
37 0 0 0 0 0 0 0 0
38 0 0 0 0 0 0 0 0
39 0 0 0 0 0 0 0 0
40 0 0 0 0 0 0 0 0
41 0 0 0 0 0 0 0 0
42 0 0 0 0 0 0 0 0
43 0 0 0 0 0 0 0 0
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45 0 0 0 0 0 0 0 0
46 0 0 0 0 0 0 0 0
47 0 0 0 0 0 0 0 0
48 0 0 0 0 0 0 0 0
49 0 0 0 0 0 0 0 0
50 0 0 0 0 0 0 0 0
51 0 0 0 0 0 0 0 0
52 0 0 0 0 0 0 0 0
53 0 0 0 0 0 0 0 0
54 0 0 0 0 0 0 0 0
55 0 0 0 0 0 0 0 0
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57 0 0 0 0 0 0 0 0
58 0 0 0 0 0 0 0 0
59 0 0 0 0 0 0 0 0
60 0 0 0 0 0 0 0 0
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62 0 0 0 0 0 0 0 0
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68 0 0 0 0 0 0 0 0
69 0 0 0 0 0 0 0 0
70 0 0 0 0 0 0 0 0
71 0 0 0 0 0 0 0 0
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73 0 0 0 0 0 0 0 0
74 0 0 0 0 0 0 0 0
75 0 0 0 0 0 0 0 0
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85 0 0 0 0 0 0 0 0
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87 0 0 0 0 0 0 0 0
88 0 0 0 0 0 0 0 0
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90 0 0 0 0 0 0 0 0
91 0 0 0 0 0 0 0 0
92 0 0 0 0 0 0 0 0
93 0 0 0 0 0 0 0 0
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95 0 0 0 0 0 0 0 0
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99 0 0 0 0 0 0 0 0
100 0 0 0 0 0 0 0 0
101 0 0 0 0 0 0 0 0
102 0 0 0 0 0 0 0 0
103 0 0 0 0 0 0 0 0
104 0 0 0 0 0 0 0 0
105 0 0 0 0 0 0 0 0
106 0 0 0 0 0 0 0 0
107 0 0 0 0 0 0 0 0
108 0 0 0 0 0 0 0 0
109 0 0 0 0 0 0 0 0
110 0 0 0 0 0 0 0 0
111 0 0 0 0 0 0 0 0
112 0 0 0 0 0 0 0 0
113 0 0 0 0 0 0 0 0
114 0 0 0 0 0 0 0 0
115 0 0 0 0 0 0 0 0
116 0 0 0 0 0 0 0 0
117 0 0 0 0 0 0 0 0
118 0 0 0 0 0 0 0 0
119 0 0 0 0 0 0 0 0
120 0 0 0 0 0 0 0 0
121 0 0 0 0 0 0 0 0
122 0 0 0 0 0 0 0 0
123 0 0 0 0 0 0 0 0
124 0 0 0 0 0 0 0 0
125 0 0 0 0 0 0 0 0
126 0 0 0 0 0 0 0 0
127 0 0 0 0 0 0 0 0
128 0 0 0 0 0 0 0 0
129 0 0 0 0 0 0 0 0
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131 0 0 0 0 0 0 0 0
132 0 0 0 0 0 0 0 0
133 0 0 0 0 0 0 0 0
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137 0 0 0 0 0 0 0 0
138 0 0 0 0 0 0 0 0
139 0 0 0 0 0 0 0 0
140 0 0 0 0 0 0 0 0
141 0 0 0 0 0 0 0 0
142 0 0 0 0 0 0 0 0
143 0 0 0 0 0 0 0 0
144 0 0 0 0 0 0 0 0
145 0 0 0 0 0 0 0 0
146 0 0 0 0 0 0 0 0
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148 0 0 0 0 0 0 0 0
149 0 0 0 0 0 0 0 0
150 0 0 0 0 0 0 0 0
151 0 0 0 0 0 0 0 0
152 0 0 0 0 0 0 0 0
153 0 0 0 0 0 0 0 0
154 0 0 0 0 0 0 0 0
155 0 0 0 0 0 0 0 0
156 0 0 0 0 0 0 0 0
157 0 0 0 0 0 0 0 0
158 0 0 0 0 0 0 0 0
159 0 0 0 0 0 0 0 0
160 0 0 0 0 0 0 0 0
161 0 0 0 0 0 0 0 0
162 0 0 0 0 0 0 0 0
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164 0 0 0 0 0 0 0 0
165 0 0 0 0 0 0 0 0
166 0 0 0 0 0 0 0 0
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171 0 0 0 0 0 0 0 0
172 0 0 0 0 0 0 0 0
173 0 0 0 0 0 0 0 0
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175 0 0 0 0 0 0 0 0
176 0 0 0 0 0 0 0 0
177 0 0 0 0 0 0 0 0
178 0 0 0 0 0 0 0 0
179 0 0 0 0 0 0 0 0
180 0 0 0 0 0 0 0 0
181 0 0 0 0 0 0 0 0
182 0 0 0 0 0 0 0 0
183 0 0 0 0 0 0 0 0
184 0 0 0 0 0 0 0 0
185 0 0 0 0 0 0 0 0
186 0 0 0 0 0 0 0 0
187 0 0 0 0 0 0 0 0
188 0 0 0 0 0 0 0 0
189 0 0 0 0 0 0 0 0
190 0 0 0 0 0 0 0 0
191 0 0 0 0 0 0 0 0
192 0 0 0 0 0 0 0 0
193 0 0 0 0 0 0 0 0
194 0 0 0 0 0 0 0 0
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196 0 0 0 0 0 0 0 0
197 0 0 0 0 0 0 0 0
198 0 0 0 0 0 0 0 0
199 0 0 0 0 0 0 0 0
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203 0 0 0 0 0 0 0 0
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206 0 0 0 0 0 0 0 0
207 0 0 0 0 0 0 0 0
208 0 0 0 0 0 0 0 0
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MENT

Date of Birth
MiddleName Sex (MM/DD/YYY Date of Age in
Y) Weight (kg) Height (cm) 0.5 weight for
Weighing Months
age

S F 5/30/2018 1/13/2021 31 21.0 70.0 70.0 OW

LOPEZ F 5/29/2018 1/13/2021 31 12.0 80.0 80.0 N
CRUZ F 2/20/2018 1/13/2021 34 15.0 75.0 75.0 N
CRUZ F 12/14/2018 1/13/2021 24 14.0 65.0 65.0 N
LANSANGAN F 7/31/2019 1/13/2021 17 0.0 0.0 0.0
0 0 1/22/2018 1/13/2021 35 0.0 0.0 0.0
0 0 12/30/1899 12/30/1899 0 0.0 0.0 0.0
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0 0 12/30/1899 12/30/1899 0 0.0 0.0 0.0
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 Baseline
NUTRITIONAL STA

weight for
< -3SD -3 SD < -2 SD -2 SD +2 SD > +2 SD <-3SD -3SD <-2SD
height

9 9.1 10 10.1 16.8 16.9 O 6.3 6.4 6.9

9 9.1 10 10.1 16.8 16.9 N 7.8 7.9 8.5
9.4 9.5 10.4 10.5 17.6 17.7 O 7.1 7.2 7.7
8.1 8.2 8.9 9 14.8 14.9 O 5.5 5.6 6
7 7.1 7.8 7.9 12.9 13 #N/A #N/A #N/A
FALSE 0 0 0 0 0 0 0 0
FALSE 0 0 0 0 0 0 0 0
FALSE 0 0 0 0 0 0 0 0
FALSE 0 0 0 0 0 0 0 0
FALSE 0 0 0 0 0 0 0 0
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FALSE 0 0 0 0 0 0 0 0
FALSE 0 0 0 0 0 0 0 0
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 Baseline
NUTRITIONAL STATUS

height for
-2SD +2SD >+2SD +3SD >+3SD < -3SD -3 SD < -2 SD -2 SD
age

7 10 10.1 11.1 11.2 SS 80.6 80.7 84.2 84.3

8.6 12.3 12.4 13.6 13.7 SS 80.6 80.7 84.2 84.3
7.8 11.2 11.3 12.3 12.4 SS 82.4 82.5 86.1 86.2
6.1 8.7 8.8 9.7 9.8 SS 75.9 76 79.2 79.3
#N/A #N/A #N/A #N/A #N/A 71 71.1 73.9 74
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 summary Date of Date
of Deworming Micronutri Date of Age in
Weight (kg)
+2 SD > +2 SD undernouri (1st ent Given Weighing Months
shed Dose) (1st Dose)
children

98.6 98.7 ### ### 0

98.6 98.7 ### ### 0
101.1 101.2 ### ### 0
92.2 92.3 ### ### 0
85.4 85.5 ### ### 0
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FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
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FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
FALSE FALSE ### ### 0
 3 MON

Height (cm) weight for weight for

0.5 < -3SD -3 SD < -2 SD -2 SD +2 SD > +2 SD
age height

0.0 2 2.1 2.3 2.4 4.2 4.3

0.0 2 2.1 2.3 2.4 4.2 4.3
0.0 2 2.1 2.3 2.4 4.2 4.3
0.0 2 2.1 2.3 2.4 4.2 4.3
0.0 2 2.1 2.3 2.4 4.2 4.3
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
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0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
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0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
0.0 0 0 0 0 0 0
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 3 MONTHS AFTER
NUTRITIONAL STATUS

height for
<-3SD -3SD <-2SD -2SD +2SD >+2SD +3SD >+3SD < -3SD
age

#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5

#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
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 summary
of Date of Age in
Weight (kg)
-3 SD < -2 SD -2 SD +2 SD > +2 SD undernouri Remarks Weighing Months
shed
children

43.6 45.3 45.4 52.9 53 0

43.6 45.3 45.4 52.9 53 0
43.6 45.3 45.4 52.9 53 0
43.6 45.3 45.4 52.9 53 0
43.6 45.3 45.4 52.9 53 0
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Height (cm) Weight for Weight for

0.5 < -3SD -3 SD < -2 SD -2 SD +2 SD > +2 SD
age Height

0.0 2 2.1 2.3 2.4 4.2 4.3

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6 MONTHS AFTER
NUTRITIONAL STATUS

Height for
<-3SD -3SD <-2SD -2SD +2SD >+2SD +3SD >+3SD < -3SD
age

#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5

#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A 43.5
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 summary Date of Date
of Deworming Micronutri
-3 SD < -2 SD -2 SD +2 SD > +2 SD undernouri (2nd ent Given
shed Dose) (2nd Dose)
children

43.6 45.3 45.4 52.9 53 ### ###

43.6 45.3 45.4 52.9 53 ### ###
43.6 45.3 45.4 52.9 53 ### ###
43.6 45.3 45.4 52.9 53 ### ###
43.6 45.3 45.4 52.9 53 ### ###
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FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
FALSE 0 0 0 FALSE ### ###
Remarks
 Total No. Children Weighed
Name of Day Care Center UW SUW
Male Female Total TOTAL
M F M F

1 0 0 4 4 0 0 0 0 0
2 0 0 4 4 0 0 0 0 0
3 0 0 4 4 0 0 0 0 0
4 0 0 4 4 0 0 0 0 0
5 0 0 4 4 0 0 0 0 0
6 0 0 4 4 0 0 0 0 0
7 0 0 4 4 0 0 0 0 0
8 0 0 4 4 0 0 0 0 0
9 0 0 4 4 0 0 0 0 0
10 0 0 4 4 0 0 0 0 0
11 0 0 4 4 0 0 0 0 0
12 0 0 4 4 0 0 0 0 0
13 0 0 4 4 0 0 0 0 0
14 0 0 4 4 0 0 0 0 0
15 0 0 4 4 0 0 0 0 0
16 0 0 4 4 0 0 0 0 0
17 0 0 4 4 0 0 0 0 0
18 0 0 4 4 0 0 0 0 0
19 0 0 4 4 0 0 0 0 0
20 0 0 4 4 0 0 0 0 0
21 0 0 4 4 0 0 0 0 0
22 0 0 4 4 0 0 0 0 0
23 0 0 4 4 0 0 0 0 0
24 0 0 4 4 0 0 0 0 0
25 0 0 4 4 0 0 0 0 0
26 0 0 4 4 0 0 0 0 0
27 0 0 4 4 0 0 0 0 0
28 0 0 4 4 0 0 0 0 0
29 0 0 4 4 0 0 0 0 0
30 0 0 4 4 0 0 0 0 0
31 0 0 4 4 0 0 0 0 0
32 0 0 4 4 0 0 0 0 0
33 0 0 4 4 0 0 0 0 0
34 0 0 4 4 0 0 0 0 0
35 0 0 4 4 0 0 0 0 0
36 0 0 4 4 0 0 0 0 0
37 0 0 4 4 0 0 0 0 0
38 0 0 4 4 0 0 0 0 0
39 0 0 4 4 0 0 0 0 0
40 0 0 4 4 0 0 0 0 0
41 0 0 4 4 0 0 0 0 0
42 0 0 4 4 0 0 0 0 0
43 0 0 4 4 0 0 0 0 0
44 0 0 4 4 0 0 0 0 0
45 0 0 4 4 0 0 0 0 0
46 0 0 4 4 0 0 0 0 0
47 0 0 4 4 0 0 0 0 0
48 0 0 4 4 0 0 0 0 0
49 0 0 4 4 0 0 0 0 0
50 0 0 4 4 0 0 0 0 0
51 0 0 4 4 0 0 0 0 0
52 0 0 4 4 0 0 0 0 0
53 0 0 4 4 0 0 0 0 0
54 0 0 4 4 0 0 0 0 0
55 0 0 4 4 0 0 0 0 0
56 0 0 4 4 0 0 0 0 0
57 0 0 4 4 0 0 0 0 0
58 0 0 4 4 0 0 0 0 0
59 0 0 4 4 0 0 0 0 0
60 0 0 4 4 0 0 0 0 0
61 0 0 4 4 0 0 0 0 0
62 0 0 4 4 0 0 0 0 0
63 0 0 4 4 0 0 0 0 0
64 0 0 4 4 0 0 0 0 0
65 0 0 4 4 0 0 0 0 0
66 0 0 4 4 0 0 0 0 0
67 0 0 4 4 0 0 0 0 0
68 0 0 4 4 0 0 0 0 0
69 0 0 4 4 0 0 0 0 0
70 0 0 4 4 0 0 0 0 0
 71 0 0 4 4 0 0 0 0 0
72 0 0 4 4 0 0 0 0 0
73 0 0 4 4 0 0 0 0 0
74 0 0 4 4 0 0 0 0 0
75 0 0 4 4 0 0 0 0 0
76 0 0 4 4 0 0 0 0 0
77 0 0 4 4 0 0 0 0 0
78 0 0 4 4 0 0 0 0 0
79 0 0 4 4 0 0 0 0 0
80 0 0 4 4 0 0 0 0 0
81 0 0 4 4 0 0 0 0 0
82 0 0 4 4 0 0 0 0 0
83 0 0 4 4 0 0 0 0 0
84 0 0 4 4 0 0 0 0 0
85 0 0 4 4 0 0 0 0 0
86 0 0 4 4 0 0 0 0 0
87 0 0 4 4 0 0 0 0 0
88 0 0 4 4 0 0 0 0 0
89 0 0 4 4 0 0 0 0 0
90 0 0 4 4 0 0 0 0 0
91 0 0 4 4 0 0 0 0 0
92 0 0 4 4 0 0 0 0 0
93 0 0 4 4 0 0 0 0 0
94 0 0 4 4 0 0 0 0 0
95 0 0 4 4 0 0 0 0 0
96 0 0 4 4 0 0 0 0 0
97 0 0 4 4 0 0 0 0 0
98 0 0 4 4 0 0 0 0 0
99 0 0 4 4 0 0 0 0 0
100 0 0 4 4 0 0 0 0 0
101 0 0 4 4 0 0 0 0 0
102 0 0 4 4 0 0 0 0 0
103 0 0 4 4 0 0 0 0 0
104 0 0 4 4 0 0 0 0 0
105 0 0 4 4 0 0 0 0 0
106 0 0 4 4 0 0 0 0 0
107 0 0 4 4 0 0 0 0 0
108 0 0 4 4 0 0 0 0 0
109 0 0 4 4 0 0 0 0 0
110 0 0 4 4 0 0 0 0 0
111 0 0 4 4 0 0 0 0 0
112 0 0 4 4 0 0 0 0 0
113 0 0 4 4 0 0 0 0 0
114 0 0 4 4 0 0 0 0 0
115 0 0 4 4 0 0 0 0 0
116 0 0 4 4 0 0 0 0 0
117 0 0 4 4 0 0 0 0 0
118 0 0 4 4 0 0 0 0 0
119 0 0 4 4 0 0 0 0 0
120 0 0 4 4 0 0 0 0 0
121 0 0 4 4 0 0 0 0 0
122 0 0 4 4 0 0 0 0 0
123 0 0 4 4 0 0 0 0 0
124 0 0 4 4 0 0 0 0 0
125 0 0 4 4 0 0 0 0 0
126 0 0 4 4 0 0 0 0 0
127 0 0 4 4 0 0 0 0 0
128 0 0 4 4 0 0 0 0 0
129 0 0 4 4 0 0 0 0 0
130 0 0 4 4 0 0 0 0 0
131 0 0 4 4 0 0 0 0 0
132 0 0 4 4 0 0 0 0 0
133 0 0 4 4 0 0 0 0 0
134 0 0 4 4 0 0 0 0 0
135 0 0 4 4 0 0 0 0 0
136 0 0 4 4 0 0 0 0 0
137 0 0 4 4 0 0 0 0 0
138 0 0 4 4 0 0 0 0 0
139 0 0 4 4 0 0 0 0 0
140 0 0 4 4 0 0 0 0 0
141 0 0 4 4 0 0 0 0 0
142 0 0 4 4 0 0 0 0 0
143 0 0 4 4 0 0 0 0 0
144 0 0 4 4 0 0 0 0 0
145 0 0 4 4 0 0 0 0 0
146 0 0 4 4 0 0 0 0 0
147 0 0 4 4 0 0 0 0 0
148 0 0 4 4 0 0 0 0 0
149 0 0 4 4 0 0 0 0 0
150 0 0 4 4 0 0 0 0 0
151 0 0 4 4 0 0 0 0 0
152 0 0 4 4 0 0 0 0 0
153 0 0 4 4 0 0 0 0 0
154 0 0 4 4 0 0 0 0 0
155 0 0 4 4 0 0 0 0 0
156 0 0 4 4 0 0 0 0 0
157 0 0 4 4 0 0 0 0 0
158 0 0 4 4 0 0 0 0 0
159 0 0 4 4 0 0 0 0 0
160 0 0 4 4 0 0 0 0 0
161 0 0 4 4 0 0 0 0 0
162 0 0 4 4 0 0 0 0 0
163 0 0 4 4 0 0 0 0 0
164 0 0 4 4 0 0 0 0 0
165 0 0 4 4 0 0 0 0 0
166 0 0 4 4 0 0 0 0 0
167 0 0 4 4 0 0 0 0 0
168 0 0 4 4 0 0 0 0 0
169 0 0 4 4 0 0 0 0 0
170 0 0 4 4 0 0 0 0 0
171 0 0 4 4 0 0 0 0 0
172 0 0 4 4 0 0 0 0 0
173 0 0 4 4 0 0 0 0 0
174 0 0 4 4 0 0 0 0 0
175 0 0 4 4 0 0 0 0 0
176 0 0 4 4 0 0 0 0 0
177 0 0 4 4 0 0 0 0 0
178 0 0 4 4 0 0 0 0 0
179 0 0 4 4 0 0 0 0 0
180 0 0 4 4 0 0 0 0 0
181 0 0 4 4 0 0 0 0 0
182 0 0 4 4 0 0 0 0 0
183 0 0 4 4 0 0 0 0 0
184 0 0 4 4 0 0 0 0 0
185 0 0 4 4 0 0 0 0 0
186 0 0 4 4 0 0 0 0 0
187 0 0 4 4 0 0 0 0 0
188 0 0 4 4 0 0 0 0 0
189 0 0 4 4 0 0 0 0 0
190 0 0 4 4 0 0 0 0 0
191 0 0 4 4 0 0 0 0 0
192 0 0 4 4 0 0 0 0 0
193 0 0 4 4 0 0 0 0 0
194 0 0 4 4 0 0 0 0 0
195 0 0 4 4 0 0 0 0 0
196 0 0 4 4 0 0 0 0 0
197 0 0 4 4 0 0 0 0 0
198 0 0 4 4 0 0 0 0 0
199 0 0 4 4 0 0 0 0 0
200 0 0 4 4 0 0 0 0 0
201 0 0 4 4 0 0 0 0 0
202 0 0 4 4 0 0 0 0 0
203 0 0 4 4 0 0 0 0 0
204 0 0 4 4 0 0 0 0 0
205 0 0 4 4 0 0 0 0 0
206 0 0 4 4 0 0 0 0 0
207 0 0 4 4 0 0 0 0 0
208 0 0 4 4 0 0 0 0 0
209 0 0 4 4 0 0 0 0 0
210 0 0 4 4 0 0 0 0 0
211 0 0 4 4 0 0 0 0 0
212 0 0 4 4 0 0 0 0 0
213 0 0 4 4 0 0 0 0 0
214 0 0 4 4 0 0 0 0 0
215 0 0 4 4 0 0 0 0 0
216 0 0 4 4 0 0 0 0 0
217 0 0 4 4 0 0 0 0 0
218 0 0 4 4 0 0 0 0 0
219 0 0 4 4 0 0 0 0 0
220 0 0 4 4 0 0 0 0 0
221 0 0 4 4 0 0 0 0 0
222 0 0 4 4 0 0 0 0 0
223 0 0 4 4 0 0 0 0 0
224 0 0 4 4 0 0 0 0 0
225 0 0 4 4 0 0 0 0 0
226 0 0 4 4 0 0 0 0 0
227 0 0 4 4 0 0 0 0 0
228 0 0 4 4 0 0 0 0 0
229 0 0 4 4 0 0 0 0 0
230 0 0 4 4 0 0 0 0 0
231 0 0 4 4 0 0 0 0 0
232 0 0 4 4 0 0 0 0 0
233 0 0 4 4 0 0 0 0 0
234 0 0 4 4 0 0 0 0 0
235 0 0 4 4 0 0 0 0 0
236 0 0 4 4 0 0 0 0 0
237 0 0 4 4 0 0 0 0 0
238 0 0 4 4 0 0 0 0 0
239 0 0 4 4 0 0 0 0 0
240 0 0 4 4 0 0 0 0 0
241 0 0 4 4 0 0 0 0 0
242 0 0 4 4 0 0 0 0 0
243 0 0 4 4 0 0 0 0 0
244 0 0 4 4 0 0 0 0 0
245 0 0 4 4 0 0 0 0 0
246 0 0 4 4 0 0 0 0 0
247 0 0 4 4 0 0 0 0 0
248 0 0 4 4 0 0 0 0 0
249 0 0 4 4 0 0 0 0 0
250 0 0 4 4 0 0 0 0 0
TOTAL 0 1000 1000 0 0 0 0 0

SFP success indicator for 7th Cycle implementation: a.) 10% of malnourished children in CDCs and SNPs with i

*%
Improvem No. of Children with Improved Weight from SUW to UW
ent of = Total No. of SUW ( Baseline)
SUW to
UW

**% No. of Children with Improved Weight from SUW to N

Improvem
ent of
= Total No. of SUW ( Baseline)
SUW to N

***% No. of Children with Improved Weight from UW to N

Improvem
ent of UW
= Total No. of UW ( Baseline)
to N

Prepared by: Reviewed by:

Name Name
Position/Designation Position/Designation
Date: Date:
 DEPART

N OW W
TOTAL TOTAL TOTAL Total
M F M F M F

0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
 0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 2 2 0 2 2 4 0 0
0 0 500 500 0 500 500 1000 0 0

ren in CDCs and SNPs with improved weight from Severely Underweight to underweight; and

Noted by:
Name
Position/Designation
Date:
 DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT
Field Office: XII
SUPPLEMENTARY FEEDING PROGRAM
Nutritional Impact
10th CYCLE
MUNICIPAL LEVEL

UPON ENTRY/ BASELINE

SW N OW
TOTAL TOTAL TOTAL TOTAL
M F M F M F

0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
 0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 1 1 0 0 0
0 0 0 0 0 250 250 0 0 0

Reviewed by: Noted by:

Name Name
Position/Designation Position/Designation
Date: Date:
 OBESITY S SS
TOTAL Total TOTAL TOTAL
M F M F M F

0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 3 3 4 0 0 0 0 3 3
0 750 750 1000 0 0 0 0 750 750

Noted by:
 Name
Designation Position/Designation
Date:
 No. of
No. of Children
Children Given
N T UW
TOTAL TOTAL Total Dewormed Micronutrie
M F M F ( 1st Dose) nt (1st M
Dose)
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 1 1 4 0 0 0
0 0 0 0 250 250 1000 0 0 0

X 100%

X 100%

X 100%
UW SUW N OW
TOTAL TOTAL TOTAL
F M F M F M F

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
 AFTER 3 Months
W SW N
TOTAL Total TOTAL TOTAL
M F M F M F

0 0 0 0 0 0 0 0 0 0
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Reviewed by:
Name
Position/Designation
Date:
AFTER 3 Months
OW OBESITY S
TOTAL TOTAL TOTAL Total
M F M F M F

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Noted by: Noted by:

Name Name
Position/Designation Position/Designation
Date: Date:
 SS N T
TOTAL TOTAL TOTAL TOTAL
M F M F M F

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0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0
0 0 #DIV/0! 0 #DIV/0! 0 #DIV/0! 0 0 0

Approved by:
Name
Position/Designation
Date:
 Normal
after
feeding -
UW SUW N
normal TOTAL TOTAL TOTAL
before M F M F M F
feeding
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
 -2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-2
-500
 No Data
OW W SW
TOTAL Total TOTAL TOTAL
M F M F M F
Reviewed by:
Name
Position/Designation
Date:
 No Data after 3 Months
N OW OBESITY
TOTAL TOTAL TOTAL Total
M F M F M F
Noted by: Noted by:
Name Name
Position/Designation Position/Designation
Date: Date:
 S SS N T
TOTAL TOTAL TOTAL
M F M F M F M
T Remarks UW SUW
TOTAL Total TOTAL TOTAL
F M F M F

0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 N OW W
TOTAL TOTAL Total TOTAL
M F M F M F

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

Reviewed by:
Name
Position/Designation
Date:
 AFTER 6 Months
SW N OW OBESITY
TOTAL TOTAL TOTAL
M F M F M F M

0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
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Approved by:
Name
Position/Designation
Date:
 No. of Total no. of Normal
Children
children after
Children
with *** % with
Improved
Normal to improved feeding -
UW SUW
Improved Improvemen Overweight to normal - normal TOTAL
weight from t weight
normal to before M F M
UW to N from OW
overweight feeding
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Designation
SUW N OW W
TOTAL TOTAL TOTAL Total
F M F M F M
 No Data after 6 Months
W SW N OW
TOTAL TOTAL TOTAL
F M F M F M F
Reviewed by: Noted by:
Name Name
Position/Designation Position/Designation
Date: Date:
 OBESITY S SS
TOTAL TOTAL Total TOTAL
M F M F M F
Noted by: Noted by:
 Name
Position/Designation Position/Designation
Date:
 No. of
No. of Children
Children Given
N T
TOTAL TOTAL TOTAL Total Dewormed Micronutrie
M F M F ( 1st Dose) nt (1st
Dose)
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
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0 0
0 0
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0 0
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0 0
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0 0
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0 0
0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
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0 0
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0 0
0 0
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0 0
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0 0
0 0
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0 0
0 0
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0 0
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0 0
0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

X 100%

X 100%

X 100%
Remarks