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OPT Plus Form 1

This document is a form from the Philippine Department of Health and National Nutrition Council to record weight and height measurements of preschoolers in a barangay to identify nutritional status. The form includes fields to record purok, household number, names of household head/caregiver and preschooler, sex, birthdate, age in months, weight, length/height, and nutritional status based on weight-for-age, length/height-for-age, and weight-for-length/height. Nutritional status codes are provided to indicate normal, underweight, severely underweight, overweight, stunted, severely stunted, wasted, severely wasted, or obese. The form is

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2K views1 page

OPT Plus Form 1

This document is a form from the Philippine Department of Health and National Nutrition Council to record weight and height measurements of preschoolers in a barangay to identify nutritional status. The form includes fields to record purok, household number, names of household head/caregiver and preschooler, sex, birthdate, age in months, weight, length/height, and nutritional status based on weight-for-age, length/height-for-age, and weight-for-length/height. Nutritional status codes are provided to indicate normal, underweight, severely underweight, overweight, stunted, severely stunted, wasted, severely wasted, or obese. The form is

Uploaded by

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

Department of Health
NATIONAL NUTRITION COUNCIL
OPT Plus Form 1. List of preschoolers with weight and height measurement and identified Nutritional Status
Revised February 2012
Barangay: ____________ City/Municipality: _________ Province: _________+ Year: ______ Date of OPT Plus: ____________

Purok Household Name of Name of Sex Date of (Yr-Mo-Day) Age in Weight Length/ Nutritional Status*
Number Household Head/ Preschooler Birthday Measurement Months (kg) Height Weight Length/ Weight for
Mother/ (cm) for Age Ht for Age Length/
Weight Length/
Caregiver Height
Height
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14)

*Codes: for nutritional status: Weight-for-age: N-Normal UW-Underweight SUW- Severely Underweight OW-Overweight *Note: Use WEIGHT-FOR-LENGTH for 0-23months old preschool children and
Length/Height-for-Age: N-Normal St-Stunting SSt-Severely Stunting T-Tall WEIGHT- FOR-HEIGHT for 24-60 months old preschool children
Weight-for-Length/Height: N-Normal W-Wasted SW-Severely Wasted OW-Overweight Ob-Obese Use WEIGHT-FOR-LENGTH or WEIGHT-FOR-HEIGHT to correctly
determine overweight and obesity.
'1/"Age-in-months" refers to completed number of months. For instance, 34 months and 30 days is considered 34 months only.

Prepared By: _______________________________________________ Checked : ________________________________________________


Name and Signature of Barangay Nutrition Scholar Name and Signature of Municipal Nutrition Action Officer

Date: ___________________________ Date: ___________________________

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