School Nutritional Status: Republic of The Philippines Department of Education
School Nutritional Status: Republic of The Philippines Department of Education
DEPARTMENT OF EDUCATION
School : ____________________________
District :
Year/ Grade :
Date of Weighing : (First Weighing) (Second Weighing)
Name of Student Date of
Age Wt
First Reading
Ht (Ht)2 BMI
Nutri Status
Wt Ht Age Wt
Second Reading
Ht (Ht)2 BMI
Nutri Status
Wt Ht Vision Hearing
Birth
MALE:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
Summary: WEIGHT HEIGHT WEIGHT HEIGHT
FIRST READING SECOND READING
Male Female Male Female Male Female Male Female
No. % No % No % No % No % No % No % No %
Below Normal/ Short
Normal
Above Normal/ Tall
TOTAL