Barangay Information Form

SURVEY YEAR: ___________ Resident (Residente) Non-Resident (Hindi Residente) Number of family members (Bilang ng Miyembro ng Pamilya):_______ Year first resided in the barangay (Unang Taong nanirahan sa bgy):_______ Place of origin (Lugar ng... More

SURVEY YEAR: ___________ Resident (Residente) Non-Resident (Hindi Residente) Number of family members (Bilang ng Miyembro ng Pamilya):_______ Year first resided in the barangay (Unang Taong nanirahan sa bgy):_______ Place of origin (Lugar ng Pinanggalingan): ________________________ Telephone Company Contact Number Vehicle Ownership (Pag-aari na Sasakyan) Vehicle Number Vehicle Number 3-Wheel AUV Jeepney Bicycle Car Motorcycle Owner Type Jeep Pedicab Tricycle Boat Truck Motorboat Pick-Up Bus Van Coaster Pump Boat Yacht Raft Others HEALTH INFORMATION: Planting herbal plants (Halamang Gamot)? Yes No If yes, what herbal plants (Halamang Gamot)? _____________________ _____________________ _____________________ _____________________ Do you have backyard garden? Yes No Do you use iodized salt? Yes No Do you practice Family Planning? Yes No Not Applicable (Di Naayon) If yes, what method? (Please check) Natural Artificial Rhythm Condom Ligation Temperature Pills Vasectomy Withdrawal IUD Others Less