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CHECKLIST FOR HEALTH DECLARATION FORM pnhs students

2022, 2021

Form for module retrieval

GRADE: _______________ SECTION: _______________ Republic of the Philippines Department of Education PARACALE NATIONAL HIGH SCHOOL Real St. Bagumbayan, Paracale, Camarines Norte HEALTH DECLARATION FORM NO. NAME HEALTH STATUS (Y-MERON N-WALA) TEMPERATURE MAY UBO MAY SIPON MAY LAGNAT MASAKIT ANG ULO MAY SAKIT ANG ISA SA KAPAMILYA MAY KAPAMILYANG GALING SA BIYAHE LAGDA 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Checked by: Monitored by: Address: Real St., Bagumbayan, Paracale, Camarines Norte, 4605 Contact Number: +63-998-951-2347 E-mail Address: [email protected]