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Arh Individual Reporting Form

Adolescent report

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miapalma0217
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20 views3 pages

Arh Individual Reporting Form

Adolescent report

Uploaded by

miapalma0217
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education
REGION VIII
SCHOOLS DIVISION OF NORTHERN SAMAR

SCHOOL HEALTH SECTION


ADOLESCENT REPRODUCTIVE HEALTH PROGRAM
REPORT
__________________________________________
Quarter __________

TEENAGE PREGNANCY DATA IN PUBLIC SCHOOLS


(_____________________________)
School Grade No. of No. of No. of Learners: Impregnator:
Level Pregnan Learners: Quarter of CY Numbe
t Trimester of Reported for first r
Learners Pregnancy at clinic
First Clinic consultation/refer
Consultation/ ral
Referral
1st 2nd 3rd 1st 2nd 3rd 4th minor adult undeter
mined

Grade
7
Grade
8
Grade
9
Grade
10
Grade
11
Grade
12
Total

STATUS OF PREGNANT LEARNERS (__________________________________)


Grade ACCESS TO EDUCATION-No. of Learners ACCESS TO HEALTH SERVICES-No. of Learners
Level
No. in No. on No. No. to No. with No. Lost to
School ADM Dropped RHU/MHSO Private OB Follow-up
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11

Mabini St., Brgy. Acacia, Catarman, 6400, Northern Samar


Telefax: (055) 500 9801 Website: northernsamar.deped.gov.ph
Email: nsamardivision@deped.gov.ph
Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF NORTHERN SAMAR

Grade 12
Total

ADOLESCENT REPRODUCTIVE HEALTH ACTIVITIES


ACTIVITIES Elementary/ NO. OF PARTICIPANTS
High School TEACHERS/NTP LEARNERS PARENTS

Prepared by: Approved:

______________________________ NOE M. HERMOSILLA

Mabini St., Brgy. Acacia, Catarman, 6400, Northern Samar


Telefax: (055) 500 9801 Website: northernsamar.deped.gov.ph
Email: nsamardivision@deped.gov.ph
Republic of the Philippines
Department of Education
REGION VIII
SCHOOLS DIVISION OF NORTHERN SAMAR

District Nurse SGOD Chief

District: _________________________

Mabini St., Brgy. Acacia, Catarman, 6400, Northern Samar


Telefax: (055) 500 9801 Website: northernsamar.deped.gov.ph
Email: nsamardivision@deped.gov.ph

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