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INDIVIDUAL BMI MONITORING FORM

Rank/Name: Pat Bless Jose’f B Benitez UNIT/OFFICE: RPHAU

Age: 25
Height: 1.65meters
Weight: 69 kgs
Waist: 85cm
Hip: 101cm
Wrist: 17cm
Gender: Male

Date Taken: September 1, 2020

BMI Result: 25.3
Normal Weight: 50.4 Kgs to 67.8 Kgs

Right View Front View Left View Weight to Lose 1.2kgs

BMI CLASSIFICATION Intervention Package: Certified Correct
Signature:
PNP BMI Acceptable WHO Standard PACKAGE “C”
Standard
OVERWEIGHT
OVERWEIGHT
MONTHLY WEIGHT MONITORING
YEAR 2019 2020
MONTH Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

WEIGHT (kg) 63 66 67 69.5 68 68 68 70 69.5 69

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