cas study panti ashan

CO-0008 Komang Tri budawati Current Number: IO-736-0156Page 1

CASE STUDY(please print)

1 Case Worker:2 Date Prepared: 11/2008

(month/year)

3 Update4 Child Number: IO-736-01565 Child Name: Komang Tri budawati

Abbreviated Name: Komang Tri budawatiCommonly Used Name: Komang

6 Birthdate: 11/8/2000 Age: 10 Sex: Male Female(day/month/year)

CHRISTIAN ACTIVITIES7 Sunday School/Church Youth Group Bible Class Camp

8 Vacation Bible School Choir Other: Hindu

FAMILY DUTIES9 Washing Clothes Gardening/Farming Running Errands Making Beds

10 Cleaning Animal Care Carries Water Child Care

11 Sewing Gathers Firewood Teaching Others Teaching Others Buying/Selling in Market

12 Kitchen Help Other:

HOBBIES AND SPORTS13 Dolls Group Games Soccer/Football Bicycling

14 Play House Rolling a Hoop Baseball Walking

15 Jacks Marbles Basketball Swimming

16 Hide and Seek Cars Volleyball Running

17 Reading Art/Drawing Ping Pong Jump Rope

18 Singing Listening to Music Other Ball Games Story Telling

19 Musical Instrument: Other: Dancing


HEALTHPhysical Handicaps/Chronic Illnesses:

20 None Epilepsy Asthma Polio Mentally Retarded Other:

21 Crippled: Spine due to . . . . . . Injury Disease Birth defect22 Left Foot due to . . . Injury Disease Birth defect23 Right Foot due to . . Injury Disease Birth defect24 Left Hand due to . . Injury Disease Birth defect25 Right Hand due to . . Injury Disease Birth defect26 Left Leg due to . . . . Injury Disease Birth defect27 Right Leg due to . . Injury Disease Birth defect28 Left Arm due to . . . Injury Disease Birth defect29 Right Arm due to . . Injury Disease Birth defect30 Speech: . . . . . . . . . . . . . . . . . . . . . . . . Defective Mute31 Hearing: Left Ear . . . . . . . . . Defective Deaf32 Right Ear . . . . . . . . Defective Deaf33 Sight: Left Eye . . . . . . . . . Defective Blind34 Right Eye . . . . . . . . Defective Blind

35 Is this child receiving regular medical treatment? Yes No36 Is this child receiving regular medication? Yes No

SCHOOLING37 Is the child attending school? Yes No38 If not attending, give reason:

COUNTRY LEVEL U.S. EQUIVALENT

39 Preschool 40 Kindergarten 41 Primary School 3 342 Middle School 43 High School 44 Vocational School Level: Give course of study:45 Apprenticeship Level: Give course of study:46 College/University Level: Give course of study:47 Other School Level: Give course of study:

School Performance:48 Below Average Average Above Average49 What is the child's best subject? Indonesian

Future Plans: Date child expects to enter (day/month/year): Course of study:50 High School: 9/7/2017 College Prep.51 College/University: 9/8/2020 Unsure52 Bible School: //53 Vocational Training: //54 Other: //


GUARDIANS55 Father Brother Stepfather Friends56 Mother Sister Stepmother Institutional Workers57 Uncle Grandfather Godfather Foster Parents58 Aunt Grandmother Godmother Other Relatives

NATURAL PARENTS59 Are the natural parents together now? Yes No Unknown

60 Marital status of natural parents: Now married.61 Were married, now separated by death.62 Were married, now divorced or permanently separated.63 Were never married.64 Unknown.

NATURAL FATHER NATURAL MOTHERYes No Unknown Yes No Unknown

65 Alive ? Yes Alive ? Yes66 Living with this child?Yes Living with this child?Yes67 Contributing financially to this child?Yes Contributing financially to this child? Yes

68 Handicapped? No Handicapped? No(How? ) (How? )

69 Chronically ill? No Chronically ill? No(How? ) (How? )

70 Mentally ill? No Mentally ill? No71 In prison? No In prison? No

FATHER or MALE GUARDIAN MOTHER or FEMALE GUARDIAN72 The father or male guardian is The mother or female guardian is

regularly employed regularly employed

73 The father or male guardian is The mother or female guardian issometimes employed sometimes imployed

74 The father or male guardian is not employed The mother or female guardian is not employed75 There is no father or male guardian There is no mother or female guardian

The Father or male guardian: The mother or female guardian:

76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: laborer:82 other: Buruh tani other:


FAMILY SIZENumber of family members in home under 18 years of age: (including this child)

83 Boys: 2 Girls: 3

Brothers and sisters registered with Compassion:

84 Kadek Nofairi / IO-736-0066

85 Date of planned child sponsorship completion: 8/ 2022 Month Year

GENERAL COMMENTS (include any additional information - details of medical, school, family, etc.)

86 Child's religion is Hindu.- by jpalumian on 11/06/2008

CO-0008 Putu Yuni Krismayani Current Number: IO-736-0157Page 1



(month/year)

3 Update4 Child Number: IO-736-01575 Child Name: Putu Yuni Krismayani

Abbreviated Name: Putu Yuni KrismayaniCommonly Used Name: Putu Yuni



8 Vacation Bible School Choir Other:











19 Musical Instrument: Other:









School Performance:48 Below Average Average Above Average49 What is the child's best subject? history

Future Plans: Date child expects to enter (day/month/year): Course of study:50 High School: 10/7/2013 college prep51 College/University: 10/8/2016 Unsure52 Bible School: //53 Vocational Training: //54 Other: //






65 Alive Alive66 Living with this child? Living with this child?67 Contributing financially to this child? Contributing financially to this child?

68 Handicapped? Handicapped?(How? ) (How? )

69 Chronically ill? Chronically ill?(How? ) (How? )

70 Mentally ill? Mentally ill?71 In prison? In prison?






76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: laborer:82 other: Farmhand other: Farmhand



83 Boys: 1 Girls: 1


84

85 Date of planned child sponsorship completion: / Month Year



CO-0008 KM Febri Wahana Current Number: IO-736-0158Page 1



(month/year)

3 Update4 Child Number: IO-736-01585 Child Name: KM Febri Wahana

Abbreviated Name: KM Febri WahanaCommonly Used Name: Febri























School Performance:48 Below Average Average Above Average49 What is the child's best subject? Bahasa Indonesia

Future Plans: Date child expects to enter (day/month/year): Course of study:50 High School: 7/7/2020 College prep51 College/University: 8/8/202452 Bible School: //53 Vocational Training: //54 Other: //






65 Alive? Yes Alive? Yes66 Living with this child? Yes Living with this child? Yes67 Contributing financially to this child?Yes Contributing financially to this child? Yes









76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: laborer:82 other: Hindu other:



83 Boys: 1 Girls: 1


84 Luh KD Sri Dewi (IO-736-0093)



86 child has medical check up once in 6 months- by errmanurung on 03/08/2007 Chil 87 d's condition remains the same with the previous.- by jpalumian on 04/14/200988 Anak masih tinggal dikelas 1, anak sangat sulit untuk mengikuti pelajaran hal itu disebabkan saat anak sering mengalami step.

CO-0008 Intan Yuliana Sari David Current Number: IO-736-0159Page 1



(month/year)

3 Update4 Child Number: IO-736-01595 Child Name: Intan Yuliana Sari David

Abbreviated Name: Intan Yuliana Sari DavidCommonly Used Name: Intan






























65 Alive? Yes Alive Yes66 Living with this child? Yes Living with this child? Yes67 Contributing financially to this child? Yes Contributing financially to this child? Yes









76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: Construction worker laborer:82 other: other:



83 Boys: 2 Girls: 1


84



86

CO-0008 KM Riska Yani Current Number: IO-736-0160Page 1



(month/year)

3 Update4 Child Number: IO-736-01605 Child Name: KM Riska Yani

Abbreviated Name: KM Riska YaniCommonly Used Name: KM Riska



8 Vacation Bible School Choir Other: Kristen



























65 Alive? Yes Alive? Yes66 Living with this child? Yes Living with this child? Yes67 Contributing financially to this child? Yes Contributing financially to this child? Yes









76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: laborer:82 other: Kerajinan alat music tradisional other:



83 Boys: 1 Girls: 2


84

85 Date of planned child sponsorship completion: 8 / 2021 Month Year



CO-0008 Rosita Pertiwi Current Number: IO-736-0161Page 1



(month/year)

3 Update4 Child Number: IO-736-01615 Child Name: Rosita Pertiwi

Abbreviated Name: Rosita PertiwiCommonly Used Name: Rosita














19 Musical Instrument: Other: Dancing









School Performance:48 Below Average Average Above Average49 What is the child's best subject? Drawing, Membaca







65 Alive? Yes Alive? Yes66 Living with this child? Yes Living with this child? No67 Contributing financially to this child? Yes Contributing financially to this child? No









76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: Farmhand laborer:82 other: other:



83 Boys: 2 Girls: 3


84 Cristin Ulandari



86 This child is Hindu.- by jpalumian on 11/18/200887 Ke-2 orang anak sudah bercerai dan ibu anak sudah menikah lagi, saat ini anak tinggal dengan nyahnya.

CO-0008 KD Agus Widianto Current Number: IO-736-0162Page 1



(month/year)

3 Update4 Child Number: IO-736-01625 Child Name: KD Agus Widianto

Abbreviated Name: KD Agus WidiantoCommonly Used Name: Agus






















39 Preschool 40 Kindergarten 41 Primary School 842 Middle School 243 High School 44 Vocational School Level: Give course of study:45 Apprenticeship Level: Give course of study:46 College/University Level: Give course of study:47 Other School Level: Give course of study:

School Performance:48 Below Average Average Above Average49 What is the child's best subject? Sport and health, Bahasa Indonesia

Future Plans: Date child expects to enter (day/month/year): Course of study:50 High School: 10/7/2012 college prep51 College/University: 10/8/2016 Unsure52 Bible School: //53 Vocational Training: //54 Other: //






65 Alive? Yes Alive? No66 Living with this child? No Living with this child? No67 Contributing financially to this child? Yes Contributing financially to this child? No

68 Handicapped?No Handicapped? No(How? ) (How? )


70 Mentally ill? No Mentally ill? No71 In prison?No In prison? No






76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: laborer:82 other: Ojek other:



83 Boys: 1 Girls: 3


84 Komang Triana Wati (IO-736-0097) Primawati (IO-736-0098)



86 previous data of mother was incorrect, mother still alive but now permanently se 87 parated- by errmanurung on 03/08/2007 Child's religion is Hindu.- by jpalumi 88 an on 11/04/2008

CO-0008 Kadek Dwi Saputra Current Number: IO-736-0163Page 1



(month/year)

3 Update4 Child Number: IO-736-01635 Child Name: Kadek Dwi Saputra

Abbreviated Name: Kadek Dwi SaputraCommonly Used Name: Kadek Dwi



8 Vacation Bible School Choir Other: Hin du



























65 Alive Alive66 Living with this child? Living with this child?67 Contributing financially to this child? Contributing financially to this child?

68 Handicapped? Handicapped?(How? ) (How? )

69 Chronically ill? Chronically ill?(How? ) (How? )

70 Mentally ill? Mentally ill?71 In prison? In prison?






76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: laborer:82 other: other:



83 Boys: 1 Girls: 1


84 Luh Pupayanti (IO-736-0116)




CO-0008 GD Agus Heryanto Current Number: IO-736-0164Page 1



(month/year)

3 Update4 Child Number: IO-736-01645 Child Name: GD Agus Heryanto

Abbreviated Name: GD Agus HeryantoCommonly Used Name: Agus























School Performance:48 Below Average Average Above Average49 What is the child's best subject?Matematika







65 Alive? Yes Alive? Yes66 Living with this child? Yes Living with this child? Yes67 Contributing financially to this child? Yes Contributing financially to this child? Yes









76 farmer farmer77 sells in market sells in market78 church worker church worker79 project worker project worker80 teacher teacher81 laborer: laborer:82 other: Farmhand other:



83 Boys: 2 Girls: 1


84



86

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cas study panti ashan