JOY OF GOD ORPHANAGE CHILD DATA COLLECTION FORM

Section A: Personal Information

Full Name: Yohana Kadiri Madiri

Date of Birth: 03/08/2022

Age: 3

Gender: Male

Place of Birth: St.Elizabeth Hospital Arusha

Short Background/Story

Yohana was born at St. Elizabeth Hospital. His mother passed away during childbirth (trial home delivery). She was brought in unconscious due to severe eclampsia. An emergency cesarean section was performed, and by sheer luck, Yohana was born alive.

Section C: Education Information

Current School:

Class/Grade:

School Performance (Last Exam Grade/Remarks):

Section D: Health Information

Known Medical Conditions: His Ok

Allergies: NIL

Disability (if any): NIL

Vaccination Status: I don’t know

Section E: Sponsorship Information

Type of Sponsorship:

   • Education: 0%

   • Health: 0%

   • Food/Nutrition: 0%

   • Clothing: 0%

Other: He Don’t have