Solo Parent
Illness/
(SC) Sickness/
Senior Injury Bank Account,
PHILSYS?
Name Relationship Birthdate Registered? (PCN) HGC/Current Citizen (SC) Work and Place Hours and Salary Operation Gcash,
Pregnant (P) Timbang Palawan,ASA, etc.
Disability/P Mortality/De
WD
ath
Water:
Disaster: Internet?
CR: Refrigerator/Freezer
Typhoon Aircon
Power outage Garbage/Basura:
Washing machine
Drought Public Safety? Stove/Gas range
Rain Housing Characteristics Radio
Landslide Social Protection and Assistance
Type of Building: TV
Earthquake Programs:
# of Floors: Audio component/Karaoke
Volcanic eruption SSS Landline/Wireless Telephone
Fire GSIS Roof: Phone (Keypad)
Pests- harvest - poultry - crops PHILHEALTH Walls: Smart phone
Crops failed MEDICARD, etc.
Flooring (finishing): Tablet
Livestock/poultry died 4Ps
Flooring (construction): Laptop/Desktop
Pollution SENIOR CITIZEN Car
Building collapsed AICS Square meters: Van
Increase in prices FOOD STAMP Bedrooms: Jeep
Political conflict Educational Assistance:
Own house?______________ Truck
Death UAQTE,TES,SHS VP,GASTPE
Year Built: _______________ Motorcycle
Illness TUPAD, Cash for Work E-bike
No water supply Assistance from LGU Tricycle
n n Fuel/Energy for lighting: _____________________ Bicycle
Evacuation Center? Other Pedicab
Number/Hotline? Motorized boat/Banca
b Fuel/Energy for cooking: _____________________
Non-motorized boat/Banca