Anecdotal Record

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Republic of the Philippines

Department of Education
Region XIII – CARAGA
Name of school and Address
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ANECDOTAL RECORD

Name of Learner Observed____________________________________________________


Grade / Year Level: __________________________ Section: __________________
Name of School: ___________________________________________________________
Date/ Time Place Observer Behavior Observed How Handled

Summary:
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Prepared by:

__________________________________
Name over printed signature / School Guidance Designate

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