Student Profiling Template
Student Profiling Template
Sor D. Rubio Street Corner San Vicente Sts, Bogo City, Cebu
DepEd School I.D. 404317, Division City of Bogo
Region VII, Central Visayas
PAFTE: Member School
School Dictum: SCIENTIA CORONAT OP! PEAC: ESC Participating School
Guidance Office
Student Information Profile: Junior High School Department
Elementary
Secondary
(for transferees
only)
C. Medical History
Allergies: Yes____ No ____
If Yes, what kind of allergy? ________________________________
Maintaining Medicine: Yes ____ No ____
If Yes, for what? _________________________________________
Any history of hospital confinement: Yes ____ No ____
Physician’s Diagnose: Yes ____ No ____
If Yes, what is it? ________________________________________
I hereby declare that the information is written above true and correct according to the best of my knowledge and any
mental reservation.
________________________________
Signature over Printed Name
NORTHERN CEBU COLLEGES, INC.
Sor D. Rubio Street Corner San Vicente Sts, Bogo City, Cebu
DepEd School I.D. 404317, Division City of Bogo
Region VII, Central Visayas
PAFTE: Member School
School Dictum: SCIENTIA CORONAT OP! PEAC: ESC Participating School
Guidance Office
Elementary
Secondary
(for transferees
only)
C. Medical History
Allergies
Yes____ No____ If Yes, what kind of allergy? ________________________________
Maintaining Medicine:
Yes ____ No ____ If Yes, for what? _________________________________________
Any history of hospital confinement?
Yes ____ No ____
Physician’s Diagnose?
Yes ____ No ____
I hereby declare that the information is written above true and correct according to the best of my knowledge and any
mental reservation.
________________________________
Guidance Office
NORTHERN CEBU COLLEGES, INC.
Sor D. Rubio Street Corner San Vicente Sts, Bogo City, Cebu
DepEd School I.D. 404317, Division City of Bogo
Region VII, Central Visayas
PAFTE: Member School
School Dictum: SCIENTIA CORONAT OP! PEAC: ESC Participating School
Elementary
Secondary
(for transferees
only)
C. Medical History
Allergies
Yes____ No ____ If Yes, what kind of allergy? ________________________________
Maintaining Medicine:
Yes ____ No ____ If Yes, for what? _________________________________________
Any history of hospital confinement?
Yes ____ No ____
Physician’s Diagnose?
Yes ____ No ____ If Yes, what is it? ________________________________________
I hereby declare that the information written above is true and correct according to the best of my knowledge and any
mental reservation.
________________________________
Signature over Printed Name