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BNS Form 1B

This form is used to monitor the nutritional statuses of Pre-School Children in the barangay and it aims to identify areas that requires health and nutrition interventions.

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Gen Ramirez
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
208 views

BNS Form 1B

This form is used to monitor the nutritional statuses of Pre-School Children in the barangay and it aims to identify areas that requires health and nutrition interventions.

Uploaded by

Gen Ramirez
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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BNS Form No.

1B
Philippine Plan of Action for Nutrition

NUTRITIONAL STATUS, FEEDING AND MICRONUTRIENT SUPPLEMENTATION RECORD OF PRESCHOOL CHILDREN

Purok/Sitio: ____________________ Municipality: ____________________


Barangay: ________________________ City/Province:____________________
HH Name of Father and Mother Name of Child Date of Birth Age in Weight Height NUTRITIONAL STATUS Practicing SOLID FOOD FEEDING MICRONUTRIENT
No. EBF if
(mm/dd/yyyy) months (kg) (cm) SUPPLEMENTATION
child is
<6 mos.
Date of OPT Weight Length/ Weight
Old (Y/N)
Practicing Age in Current Vitamin Iron Using
for Age¹ Height for CF if child months beneficiary A last drops/ MNP
Plus
for age² length/ is ≥6 mos. started of SF date Syrup
(mm/dd/yyyy) (Y/N)
height³ – 23 mos. CF (Y/N) received received
Old (Y/N) (Y/N)

Y N Y N Y N Y N Y N
(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus

(F) DOB

(M) DOOPlus
Abbreviations
HH – Household EBF – Exclusive Breastfeeding SF – Supplemental Feeding DOB – Date of Birth
CF – Complimentary Feeding MNP – Micronutrient Powder DOOPlus – Date of OPT Plus

¹Weight for age ²²Length/Height for age ³Weight for length/height


SUW Severely Underweight SSt Severely Stunted SUW Severely Underweight
UW Underweight St Stunted UW Underweight
N Normal N Normal N Normal
OW Overweight T Tall OW Overweight
Ob Obese

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