Department of Education
Region IX
Division of Zamboanga del Sur
SCHOOL NUTRITIONAL STATUS RECORD
District: ________________________
School: _________________________ Date of Weighing: _______________
Grade & Section: _________________
Date of Birth Weight Height Ht in NS
Name of Pupils Age BMI
Month-Day-Yr (Kg) (cm) m2 Weight Height
WEIGHT HEIGHT
SUMMARY ENROLMENT
BN N AN SHORT NORMAL TALL
MALE
FEMALE
TOTAL
Prepared by: