Department of Education: Republic of The Philippines

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Republic of the Philippines

Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
LA PAZ NORTH DISTRICT
LA PURISIMA ELEMENTARY SCHOOL
La Purisima La Paz, Tarlac
CLASSROOM DAILY HEALTH MONITORING TOOL FOR COVID-19
Grade Level:TWO Section: SANTOL
Instruction: Write under each column date the code(s) of the symptom(s) observed in the learner during the routine inspection, during the
conduct of the class, or as reported by the learner or their classmates. Refer to the list of symptoms below and their respective codes:

Instruction: Write under each column date the code(s) of the symptom(s) observed in the learner during the routine inspection, during the conduct of the class,
or as reported by the learner or their classmates. Refer to the list of symptoms below and their respective codes:
Fv Fever F/T Fatigue/Tiredness ST Sore throat LoA Loss of appetite D Diarrhea R Rashes

Symptoms Observed/Reported
NAME 2022-03-07 2022-03-08 2022-03-09 2022-03-10 2022-03-11
Monday Tuesday Wednesday Thursday Friday
1. ABELLO,JHON LENARD, J.

2. BAGADIONG,NORIEL, B.

3. BARRANTES,JOROSS,

4. CRUZ, MARK ADRIAN, G.

5. DELA CRUZ,SANDER, P.

6. FAJARDO,LIAM BRYCE, T.

7. FERNANDEZ,JADE ALEXIS, B

8. GAÑA,NATE SOFIAN, N.
Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
LA PAZ NORTH DISTRICT
LA PURISIMA ELEMENTARY SCHOOL
La Purisima La Paz, Tarlac
9. MARCILLA,LIAM ALJEN, F.

10. PAGUIBITAN,DOMINIC YASH, B.

11. PEREZ,JHON REY, T.

12. REMEGIO,JEFFERSON, S.

FEMALE
1. AGUSPIT,CRIS TIN, C.

2. CASTRO,ANGIELA, D.

3. DE GUZMAN,KHEYTH, B.

4. DE LEON,WIEBKELEEN, -

5. DELA CRUZ,ANDREA, T.

6. FLAVIANO,RHO-ANNE, C.

7 JACINTO,NHUR LAILA, I.

8. MANUEL,JAYCE, D.

9 MARQUEZ,DARCYN JOY, C.

10. MARTIN,COLGA ISAAH, TA.

11. NACINO,KHATRIANE CHYRYL, M.

12. RIVERA,NEISHA FATE, B.

13. TAGASA,BERLYN, R.
Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE
LA PAZ NORTH DISTRICT
LA PURISIMA ELEMENTARY SCHOOL
La Purisima La Paz, Tarlac
14. TAGUDIN,ERICA MAE, B

15. TAMANGAN,SHAIRA MAE, B

16 VILLARBA,AIRA, D

Note: As soon as any of the listed symptoms is observed among any of the learners, the teacher is expected to send the learner to the School
Clinic immediately for the proper management by the School Clinic Teacher or health personnel.

Submitted by: Noted by:


JENNIFER B. LUBIANO
Classroom Adviser Clinic Teacher

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