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Dle Name) Subject Area & Title Date Issued TOTAL FOR MALE TOTAL COPIES Section Grade Level Returned Subject Area & Title Date Issued Returned Subject Area & Title Date Issued Returned Subject Area & Title Date Issued Returned Subject Area & Title Date Issued Returned Subject Area & Title Date Issued Returned Subject Area & Title Date Issued Returned Date Issued Returned REMARKS/ACTION TAKEN (Please refer to the legend on last page) Subject Area & Title NO. LEARNER.

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