Deworming Blank

Republic of the Philippines
Department of Education
Region III Central Luzon
SCHOOLS DIVISION OF TARLAC PROVINCE
Makabulos Drive, San Roque, Tarlac City
Telephone: 982-2463/ Telefax: 982-0374
Website: http://www.depedtarlacprovince.net
HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

FOR SELECTED NEGLECTED TROPICAL DISEASES
Legend
E = Enrolment
DA = Deworming Accomplishment
MDA = Mass Drug Administration
% =#SE/Numbered Treated x 100%
TB = Total No. of Beneficiaries
SCH = Schistosomiasis
PZQ = Praziquantel
LF = Lymphatic Filariasis
DEC = Diethyicarbamazine citrate
SY: 2015 2016

SCHOOL: CARAEL
DISTRICT: CAMILING EAST
DA(IHCP)
GRADE
ALB
1 Dose
MDA(SCH)
%
ST
K
1
2
3
4
17/1
9
30/2
9
28
34/3
5
25/2
6
PZQ
DA(IHCP)
%
ALB
2 Dose
ND
17
100
%
19
29
96.66
%
29
28
34
25
21
21
24
24
TOTAL
182
178
100
%
100
%
100
%
100
%
100
%
100
%
MDA(LF)
%
28
35
26
21
24
182
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
DEC
+ALB
TOTAL NO. OF BENEFICIARIES

%
REMARKS
TB
ALB
1ST
2 transferred
in
1 dropped out
100
%
100
%
1
0
10
100
%
10
1 transferred
in
100
%
1 transferred
in
100
%
100
%
100
%
4
5
45
100
%
45
ALB
2ND
100%
100%
100%
100%
100%
100%
100%
100
%
PZQ
DEC
REMARKS
Noted:
Prepared by:
MARCEMELIA A. ROMBAOA
School Health Leader
MARVINA M.
Princip


Legend
IS = In school
PP = Private Physician
AH = At Home
O = Others
PZQ = Praziquantel
DEC = Diethyicarbamazine
citrate
IMPORTANT REMINDER:
*Deworming = Albendazole
*Treatment of Schistosomiasis = Praziquantel
*Treatment of Filariasis = DEC + Albendazole
DO NOT give double dose of ALB for integrated treatment of
helminthiasis and filariasis
ALB = Albendazole
GRADE:
SCHOOL:
NAME
4Ps
BENEFICIARY
YES
NO
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
D
REMARKS
ALB
NAME
4Ps
BENEFICIARY
YES
TOTAL
NO
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
D
REMARKS
ALB
Noted:
Prepared by:
________________________
Adviser
Principal I

Legend
IS = In school
AH = At Home
O = Others
PZQ = Praziquantel
citrate
IMPORTANT REMINDER:
ALB = Albendazole
GRADE:
SCHOOL:
NAME
4Ps
BENEFICIARY
YES
NO
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
D
REMARKS
ALB
NAME
4Ps
BENEFICIARY
YES
NO
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
TOTAL
Prepared by:
Noted:
D
REMARKS
ALB
________________________
Adviser
Principal I

Legend
IS = In school
AH = At Home
O = Others
PZQ = Praziquantel
citrate
IMPORTANT REMINDER:
ALB = Albendazole
GRADE:
SCHOOL:
NAME
4Ps
BENEFICIARY
YES
NO
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
D
REMARKS
ALB
NAME
4Ps
BENEFICIARY
YES
NO
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
REMARKS
ALB
TOTAL
Prepared by:
________________________
Adviser
Noted:
Principal I


Legend
IS = In school
AH = At Home
O = Others
PZQ = Praziquantel
citrate
IMPORTANT REMINDER:
ALB = Albendazole
GRADE:
SCHOOL:
NAME
4Ps
BENEFICIARY
YES
NAME
NO
4Ps
BENEFICIARY
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
D
ALB
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
D
REMARKS
ALB
REMARKS
YES
NO
1ST
DOSE
DATE
REMARKS
IS PP AH O
ALB
2ND
DOSE
DATE
REMARKS
IS PP AH O
ALB
TOTAL
Noted:
Prepared by:
________________________
Adviser
Principal I


Legend
IS = In school
AH = At Home
O = Others
PZQ = Praziquantel
citrate
IMPORTANT REMINDER:
ALB = Albendazole
GRADE:
SCHOOL:
NAME
4Ps
BENEFICIARY
YES
NAME
NO
DEWORMING (ALB)
1ST
DOSE
4Ps
BENEFICIARY
YES
NO
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
D
ALB
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
D
REMARKS
ALB
D
REMARKS
ALB
TOTAL
Noted:
Prepared by:
________________________
Adviser
Principal I


Legend
IS = In school
AH = At Home
O = Others
PZQ = Praziquantel
citrate
IMPORTANT REMINDER:
ALB = Albendazole
GRADE:
SCHOOL:
NAME
4Ps
BENEFICIARY
YES
NAME
NO
DEWORMING (ALB)
1ST
DOSE
4Ps
BENEFICIARY
YES
NO
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
ST
1
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
D
ALB
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
ND
2
DOSE
DATE
REMARKS
IS PP AH O
D
REMARKS
ALB
D
REMARKS
ALB
TOTAL
Noted:
Prepared by:
________________________
Adviser
Principal I

Legend
IS = In school
AH = At Home
O = Others
PZQ = Praziquantel
citrate
IMPORTANT REMINDER:
ALB = Albendazole
GRADE:
SCHOOL:
NAME
4Ps
BENEFICIARY
YES
NAME
NO
DEWORMING (ALB)
1ST
DOSE
4Ps
BENEFICIARY
YES
NO
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
1ST
DOSE
DATE
REMARKS
IS PP AH O
D
ALB
DEWORMING (ALB)
2ND
DOSE
D
ALB
DATE
REMARKS
IS PP AH O
DEWORMING (ALB)
2ND
DOSE
DATE
REMARKS
IS PP AH O
D
REMARKS
ALB
D
REMARKS
ALB
TOTAL
Prepared by:
________________________
Adviser
Noted:
Principal I

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Republic of the Philippines

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

SY: 2015 2016

TOTAL NO. OF BENEFICIARIES

Republic of the Philippines

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

Republic of the Philippines

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

Region III Central Luzon

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

Makabulos Drive, San Roque, Tarlac City

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

HARMONIZED SCHEDULE OF MASS DRUG ADMINISTRATION

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