chc nrhm-mis

28
NRHM/ DH-SDH-CHC/3/M Printed as on 10/09/2008 Monthly- DH-SDH-CHC 1 of 28 Ministry of Health & Family Welfare (Monitoring & Evaluation Division) Monthly Format for CHC-SDH-DH and Equivalent Institutions State: Due for submission on 5th of following Month District: Month: MMM Block: Year: YYYY Public Private Location Rural Urban Part A. REPRODUCTIVE AND CHILD HEALTH M1 Ante Natal Care Services (ANC) 1 Total number of pregnant women Registered for ANC 1.1 Of which Number registered within first trimester 2 New women registered under Janani Suraksha Yogna 3 Number of pregnant women received 3 ANC check ups 4 Number of pregnant women given 4.1 TT1 4.2 TT2 or Booster 5 Total number of pregnant women given 100 IFA tablets 6 Pregnant women with Hypertension (BP>140/90) 6.1 New cases detected at institution 6.2 Number of Eclampsia cases managed during delivery 7 Pregnant women with Anaemia 7.1 Number having Hb level<11 (tested cases) 7.2 Number having severe anaemia (Hb<7) treated at institution M2 Deliveries 8 Deliveries conducted at the facility 8.1 Of which Number discharged under 48 hours of delivery 8.2 Number of cases where Janani Suraksha Yogna incentive paid to (a) Mothers (b) ASHAs (c) ANM or AWW (only for HPS States) City/ Town/ Village: Facility Name Facility type Numbers reported during the month

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Page 1: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC1 of 14

Ministry of Health & Family Welfare

(Monitoring & Evaluation Division)

Monthly Format for CHC-SDH-DH and Equivalent Institutions

State: Due for submission on 5th of following Month

District: Month: MMM

Block: Year: YYYY

Facility Name

Facility type Public Private

Location Rural Urban

Ref No.

Part A. REPRODUCTIVE AND CHILD HEALTH

M1 Ante Natal Care Services (ANC) M1

1 Total number of pregnant women Registered for ANC 1.1

1.1 Of which Number registered within first trimester 1.1.1

2 New women registered under Janani Suraksha Yogna 1.2

3 Number of pregnant women received 3 ANC check ups 1.3

4 Number of pregnant women given 1.4

4.1 TT1 1.4.1

4.2 TT2 or Booster 1.4.2

5 Total number of pregnant women given 100 IFA tablets 1.5

6 Pregnant women with Hypertension (BP>140/90) 1.6

6.1 New cases detected at institution 1.6.1

6.2 Number of Eclampsia cases managed during delivery 1.6.2

7 Pregnant women with Anaemia 1.7

7.1 Number having Hb level<11 (tested cases) 1.7.1

7.2 Number having severe anaemia (Hb<7) treated at institution 1.7.2

M2 Deliveries M2

8 Deliveries conducted at the facility 2.2

8.1 Of which Number discharged under 48 hours of delivery 2.2.1

8.2 Number of cases where Janani Suraksha Yogna incentive paid to 2.2.2

(a) Mothers 2.2.2 (a)

(b) ASHAs 2.2.2 (b)

(c) ANM or AWW (only for HPS States) 2.2.2 (c)

City/ Town/ Village:

Numbers reported during the month

E14
Anc register CHC 1 to 7.2
E29
LR register
E32
JSY details with accountant
Page 2: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC2 of 14

Ref No.Numbers reported during the month

M3 Number of Caesarean (C-Section) deliveries M3

9 C -Section deliveries performed at facility 3.1.2

M4 Pregnancy outcome & details of new-born M4

10 Pregnancy Outcome (in number) 4.1

10.1 Live Birth 4.1.1

(a) Male 4.1.1(a)

(b) Female 4.1.1(b)

Total ({a} to {b})

10.2 Still Birth 4.1.2

10.3 Abortion (spontaneous/induced) 4.1.3

11 Details of Newborn children weighed 4.2

11.1 Number of newborns weighed at birth 4.2.1

11.2 Number of newborns having weight less than 2.5 kg 4.2.2

12 Number of newborns breast fed within 1 hour 4.3

M5 Complicated pregnancies M5

13 5.1.2

14 Number of Complicated pregnancies treated with 5.3

14.1 IV Antibiotics 5.3.1

14.2 IV Antihypertensive/Magsulph injection 5.3.2

14.3 IV Oxytocin 5.3.3

14.4 Blood Transfusion 5.3.4

M6 Post - Natal Care M6

15 Women receiving post partum checkups within 48 hours after delivery 6.1

16 Women getting a post partum check up between 48 hours and 14 days 6.2

17 PNC maternal complications attended 6.3

M7 Medical Termination of Pregnancy (MTP) M7

18 Number of MTPs conducted at facility 7.1

18.1 Up to 12 weeks of pregnancy 7.1.1

18.2 More than 12 weeks of pregnancy 7.1.2

Total {(18.1) to (18.2)}

M8 Reproductive Tract Infections/Sexually transmitted infections (RTI/STI) Cases M8

19 Number of new RTI/STI for which treatment initiated 8.1

(a) Male 8.1(a)

(b) Female 8.1(b)

Total {(a) to (b)}

20 Number of wet mount tests conducted 8.2

Number of cases of pregnant women with Obstetric Complications and attended at facility

E36
LR register 9 to 14.4
E57
PNC register 15 to 17
E61
MTP regsiteers at authorized facclities
E66
OPD regsiter 19 and 20
Page 3: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC3 of 14

Ref No.Numbers reported during the month

M9 Family Planning M9

21 Number of NSV/Conventional Vasectomy conducted at facility 9.1.1 (b)

22 Number of Laparoscopic sterilizations conducted at facility 9.2.1 (b)

23 Number of Mini-lap sterilizations conducted at facility 9.3.1 (b)

24 Number of Post-Partum sterilizations conducted at facility 9.4.1 (b)

25 Number of new IUD Insertions at facility 9.5.1 (c )

26 Number of IUD removals 9.06

27 Number of Oral Pills cycles distributed 9.07

28 Number of Condom pieces distributed 9.08

29 Number of Centchroman (weekly) pills given 9.09

30 Number of Emergency Contraceptive Pills distributed 9.10

31 Quality in sterilization services 9.11

31.1 9.11.1

(a) Male 9.11.1(a)

(b) Female 9.11.1(b)

Total {(a) to (b)}

31.2 9.11.2

(a) Male 9.11.2 (a)

(b) Female 9.11.2 (b)

Total {(a) to (b)}

31.3 9.11.3

(a) Male 9.11.3 (a)

(b) Female 9.11.3 (b)

Total {(a) to (b)}

32 Does the Institution have NSV trained doctors? YES/NO 9.12

M10 CHILD IMMUNISATION M10

33 Number of Infants 0 to 12 months old who received the following: 10.1

33.01 BCG 10.1.01

33.02 DPT1 10.1.02

33.03 DPT2 10.1.03

33.04 DPT3 10.1.04

33.05 OPV 0 (Birth Dose) 10.1.05

33.06 OPV1 10.1.06

33.07 OPV2 10.1.07

33.08 OPV3 10.1.08

33.09 Hepatitis-B1 10.1.09

33.10 Hepatitis-B2 10.1.10

Number of complications following sterilization

Number of failures following sterilization

Number of deaths following sterilization

E97
RI (0-5 yrs)33 to 34.2
Page 4: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC4 of 14

Ref No.Numbers reported during the month

33.11 Hepatitis-B3 10.1.11

33.12 Measles 10.1.12

33.13 10.1.13

(a) Male 10.1.13(a)

(b) Female 10.1.13(b)

Total {(a) to (b)}

33.14 Number of children more than 16 months who received the following 10.2

33.15 DPT Booster 10.2.1

33.16 OPV Booster 10.2.2

33.17 Measles Rubella Vaccine 10.2.3

34 Immunisation Status 10.3

34.1 10.3.1

(a) Male 10.3.1(a)

(b) Female 10.3.1(b)

Total {(a) to (b}

34.2 Children more than 5 years given DT5 10.3.2

34.3 Children more than 10 years given TT10 10.3.3

34.4 Children more than 16 years given TT16 10.3.4

34.5 Adverse Event Following Immunisation (AEFI) 10.3.5

(a) Abscess 10.3.5.1

(b) Death 10.3.5.2

(c) Others 10.3.5.3

34.6 Number of Immunisation sessions during the month 10.4

(a) Sessions planned 10.4.1

(b) Sessions held 10.4.2

(c) Number of sessions where ASHAs were present 10.4.3

35 Others (Japanese Encephalitis (JE) etc. Please Specify) 10.5

35.1 10.5.1

35.2 10.5.2

35.3 10.5.3

M11 Number of Vitamin A doses M11

36 Administered between 9 months and 5 years 11.1

36.1 Dose-1 11.1.1

36.2 Dose-5 11.1.2

36.3 Dose-9 11.1.3

Total number of children aged between 9 and 11 months who have been fully immunised (BCG+DPT123+OPV123+Measles) during the month

Total number of children aged between 12 and 23 months who have been fully immunised (BCG+DPT123+OPV123+Measles) during the month

E125
Immunizatiion 6-16 yrs
E127
Immunization 0-5 and 6-16 yrs
E131
Compilation sheet of Immunization
E139
RI 0-5 yrs
Page 5: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC5 of 14

Ref No.Numbers reported during the month

M12 Number of cases of Childhood Diseases reported during the month(0-5 years) M12

37 Diphtheria 12.1

38 Pertussis 12.2

39 Tetanus Neonatorum 12.3

40 Tetanus others 12.4

41 Polio 12.5

42 Measles 12.6

43 Diarrhoea and dehydration 12.7

44 Malaria 12.8

45 Number admitted with Respiratory Infections 12.9

Part B. Other Programmes

M13 Blindness Control Programme M13

46 Number of Patients operated for cataract 13.1

47 Number of Intraocular Lens(IOL) implantations 13.2

48 Number of School children detected with Refractive errors 13.3

49 Number of children provided with free glasses 13.4

50 Number of eyes collected 13.5

51 Number of eyes utilised 13.6

Part C. Health Facility Services

M14 Patient Services M14

52 Is the facility functioning as an FRUs? Yes/ No 14.01

53 Does the facility have a Rogi Kalyan Samiti Yes/ No 14.04

53.1 If so, Number of RKS meetings held during the month 14.05

54 Does the facility have Ambulance services (Assured Referral Services) available Yes/ No 14.06

54.1 If so, number of times it was used for transporting patients during the month 14.07

55 Whether Facility has Operational Sick New Born and Child Care Units? Yes/ No 14.08

56 Number of functional Laparoscopes in the Facility 14.09

57 Inpatient 14.10

57.1 Admissions Children (<19 yrs.) Adults 14.10.1

(a) Male 14.10.1(a)

(b) Female 14.10.1(b)

Total {(a) to (b)}

57.2 Deaths 14.10.2

(a) Male 14.10.2(a)

(b) Female 14.10.2(b)

Total {(a) to (b)}

E144
IDSP 37 to 45
E171
Rohini: Indoor register 57.1 a&b
E176
Line lsiting (deth)
Page 6: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC6 of 14

Ref No.Numbers reported during the month

57.3 In-Patient Head Count at midnight 14.11

58 Outpatient 14.12

58.1 OPD attendance (All) 14.12.1

59 Operation Theatre 14.13

59.1 Operation major (General and spinal anaesthesia) 14.13.1

59.2 Operation minor (No or local anaesthesia) 14.13.2

60 Others (Include other services like dental, Ophthalmology, AYUSH etc.) 14.14

(a) AYUSH 14.14.1

(b) Dental Procedures 14.14.2

(c) Adolescent counselling services 14.14.3

(d) 14.14.4

(e) 14.14.5

M15 Laboratory Testing M15

61 Lab Tests Details 15.1

61.1 Total Number of tests for Hb 15.1.1 (a)

61.2 Of which Number having Hb < 7 mg 15.1.1 (b)

62 HIV tests conducted Number Tested Number Positive 15.1.2

(a) Male 15.1.2(a)

(b) Female-Non ANC 15.1.2(b)

(c) Female with ANC 15.1.2(c)

Total {(a) to (c)}

Number Tested

63 Widal tests conducted 15.2

64 VDRL tests conducted 15.3

(a) Male 15.3.1

(b) Female-Non ANC 15.3.2

(c) Female with ANC 15.3.3

Total {(a) to (c)}

65 Malaria tests conducted 15.4

65.1 Blood smears examined 15.4.1

65.2 Plasmodium Vivax test positive 15.4.2

65.3 Plasmodium Falciparum test positive 15.4.3

E181
OPD register
E183
OT register
E192
Lab register 61 to 65.3
Page 7: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC7 of 14

Ref No.Numbers reported during the month

Part D. Mortality Details

M16 Details of deaths reported during the month with probable causes: M17

66 Infant deaths within 24 hrs of birth 17.1

67 Infant Deaths up to 4 weeks by cause Total 17.2

67.1 Sepsis 17.2.1

67.2 Asphyxia 17.2.2

67.3 LBW 17.2.3

67.4 Others 17.2.4

68 Infant/Child Deaths up to 5 years by cause Total 17.3

68.1 Pneumonia 17.3.1

68.2 Diarrhoea 17.3.2

68.3 Fever related 17.3.3

68.4 Measles 17.3.4

68.5 Others 17.3.5

69 Adolescent/Adult deaths by cause 6-14 yrs 15-55 yrs. Above 55 yrs. Total 17.4

69.01 Diarrhoeal diseases 17.4.01

69.02 Tuberculosis 17.4.02

69.03 17.4.03

69.04 Malaria 17.4.04

69.05 Other Fever Related 17.4.05

69.06 HIV/AIDS 17.4.06

69.07 Heart disease/Hypertension related 17.4.07

69.08 Neurological disease including strokes 17.4.08

69.09 Maternal 17.4.09

(a) Abortion 17.4.09(a)

(b) Obstructed/prolonged labour 17.4.09(b)

(c ) Severe hypertesnion/fits 17.4.09(c )

(d) Bleeding 17.4.09(d )

(e) High fever 17.4.09(e )

(f) 17.4.09(f )

69.10 Trauma/Accidents/Burn cases 17.4.10

69.11 Suicide 17.4.11

69.12 Animal bites and stings 17.4.12

69.13 Other Diseases 17.4.13

(a) Known Acute Disease 17.4.13(a)

(b) Known Chronic Disease 17.4.13(b)

(c) Causes not known 17.4.13(c )

Up to 1 Weeks of

BirthBetween 1 week & 4

weeks of birth

Between 1 month and 11

monthsBetween 1 year & 5

years

Respiratory diseases including infections (other than TB)

Other Causes (including causes not known)

E213
line listing death 66 to 69.8
E235
line lisitng maternal death a to f
E242
Rohini: line lisitng death
Page 8: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC8 of 14

LokLF; ,oa ifjokj dY;k.k ea=ky;fujh{k.k ,oa ewY;kadu foHkkx

ekfld izi= leqnkf;d LokLF; dsUnz flfoy vLirky ftyk vLirkyjkT;

ftyk ekg

fodkl[k.M o"kZ

ljdkjh Hkou fdjk;s dk Hkou

{ks= xzkeh.k 'kgjh

jsQjsUl Øekad

iztuu ,oa f'k'kq LokLF;

M1 Ante Natal Care Services (ANC) M1

M1 1.1

1 dqy iathd`r efgykvksa dh la[;k 1.1.1

1.1 izFke frekgh esa iathd`r xHkZorh efgyk,Wa 1.2

2 bl ekg esa tuuh lqj{kk ;kstuk esa iathd`r efgyk,¡ 1.3

3 xHkZorh efgyk,Wa ftudh 3 tkapsa gqbZ gSa 1.4

4 xHkZorh efgykvksa dh la[;k ftUgsa fuEu lqfo/k nh xbZ 1.4.1

4.1 TT1 1.4.2

4.2 1.5

5 1.6

6 1.6.1

6.1 laLFkk esa bl ekg ntZ u, dsl 1.6.2

6.2 ,DyksfE'k;k izca/ku ds dsl dh la[;k 1.7

7 [kwu dh deh okyh xHkZorh efgyk,Wa 1.7.1

7.1 1.7.2

7.2 vfr xaHkhj ,uhfe;k ¼7 th-,e-½ ds dsl ftudk mipkj laLFkk esa gqvk

M2 izlo M2

8 laLFkkxr izlo 2.2

8.1 izloksa dh la[;k tks 48 ?kaVs rd laLFkk esa jgs 2.2.1

8.2 tuuh lqj{kk ;kstuk jkf'k dk Hkqxrku fd;k 2.2.2

(a) izlwrk efgyk dks 2.2.2 (a)

(b) vk'kk dks 2.2.2 (b)

(c) 2.2.2 (c)

tek djus dh fnukad gj ekg dh 25 rkjh[k

'kgj@dLck@xkaolaLFkk dk ukelaLFkk dk izdkj

ekg dh miyC/kh

Hkkx B.

izlo iwoZ lsok;sa ¼ANC½

TT2 ;k cwLVj

dqy xHkZorh efgyk,wa ftUgsa 100 IFA xksyh nh

mPp jDrpki okyh xHkZorh efgyk,W ¼BP>140@90½

ftudk Hb Lrj 11 ls de gS ¼tkap ds ckn½

,-,u-,e@vkaxuokM+h dk;ZdrkZ dks ¼dsoy HPS jkT;ksa esa½

E14
Anc register CHC 1 to 7.2
E16
ANC register PHC level 1 to 7.1
B31
SHC
E31
PHC level Labour room register 8.1.
E33
JSY records with accountant 8.2 a,b&c
Page 9: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC9 of 14

jsQjsUl Øekadekg dh miyC/kh

M3 vkWijs'ku }kjk izlo M3

9 laLFkk esa gq, vkWijs'ku }kjk izlo dh la[;k 3.1.2

M4 xHkkZoLFkk dk ifj.kke o uotkr f'k'kq tkudkjh M4

10 xHkkZoLFkk ifj.kke ¼la[;k½ 4.1

10.1 thfor tUe 4.1.1

(a) ckyd 4.1.1(a)

(b) ckfydk 4.1.1(b)

11 e`r tUe 4.1.2

12 xHkZikr 4.1.3

13 otu fy, x, uotkr f'k'kq dh tkudkjh 4.2

13.1 uotkr f'k'kq dh la[;k ftudk tUe ds le; otu fy;k 4.2.1

13.2 2-5 fdyks ls de otu ds uotkr f'k'kqvksa dh la[;k 4.2.2

14 uotkr f'k'kqvksa dh la[;k ftUgsa 1 ?k.Vs ds vanj Lruiku djk;k x;k 4.3

M5 tfVy izlo M5

15 laLFkk ij tkap dh xbZ xHkZorh efgyk,Wa ftUgsa tfVyrk Fkh 5.1.2

16 tfVy izlo dk izca/ku fd;k 5.3

16.1 vk;-oh- ,UVhck;ksfVDl 5.3.1

16.2 vk;-oh- ,UVhgk;ijVsfUlo@esxlYQ batsD'ku 5.3.2

16.3 vk;-oh- vkWDlhVksflDl 5.3.3

5.3.4

M6 M6

17 izlwrk efgyk ftUgsa 48 ?k.Vs ds vanj izlo Ik'pkr lqfo/kk feyh 6.1

18 izlwrk efgyk ftUgsa 48 ?k.Vs o 14 fnu ds vanj izlo Ik'pkr lqfo/kk feyh 6.2

19 izlo Ik'pkr tfVyrk izca/ku dh la[;k 6.3

M7 xHkZikr

20 laLFkk esa fd, x, xHkZikr dh la[;k M7

20.1 xHkkZoLFkk ds 12 g¶rs rd 7.1

20.2 xHkkZoLFkk ds 12 g¶rs ls vf/kd 7.1.1

7.1.2

21 futh laLFkkvksa esa fd, x, xHkZikr dh la[;kM8 M8

22 u;s dslksa dh la[;k ftudk mipkj 'kq: fd;k 8.1

(a) iq:"k 8.1(a)

(b) efgyk 8.1(b)

23 bl ekg fd;s x;s osV ekmUV tkap dh la[;k 8.2

dqy ({a} + {b})

izlo Ik'pkr ns[kHkky ¼PNC½

dqy {(21.1) to (20.2)}

RTI/STI dsl

dqy {(a) (b)}

B37
LR register 9 to16.3
E58
PNC Regsiter 17 to 19
E62
MTP register 20.1 and 20.2
E68
OPD register 22 a&b
Page 10: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC10 of 14

jsQjsUl Øekadekg dh miyC/kh

M9 Family Planning M9

24 9.1.1 (b)

25 9.2.1 (b)

26 laLFkk esa fd;s x;s feuhysi ulcUnh dh la[;k 9.3.1 (b)

27 laLFkk esa fd;s x,s izlo Ik'pkr ulcUnh dh la[;k 9.4.1 (b)

28 bl ekg laLFkk esa fd, x, ywi fuos'ku dh la[;k 9.5.1 (c )

29 ywi dh la[;k fudkys x, 9.06

30 forfjr vksjy fiy pØ dh la[;k 9.07

31 forfjr fd, x, fujks/k dh la[;k 9.08

32 forfjr lkIrkfgd xksyh ¼lsUVØkseku½ dh la[;k 9.09

33 forfjr vkikrdkyhu xHkZfujks/kd dh la[;k 9.10

34 ulcanh lsokvksa dh xq.koRrk 9.11

34.1 ulcanh ds dkj.k mith tfVyrk 9.11.1

(a) iq:"k 9.11.1(a)

(b) efgyk 9.11.1(b)

34.2 vlQy ulcUnh 9.11.2

(a) iq:"k 9.11.2 (a)

(b) efgyk 9.11.2 (b)

34.3 ulcUnh ds ckn e`R;q 9.11.3

(a) iq:"k 9.11.3 (a)

(b) efgyk 9.11.3 (b)

34.4 YES/NO 9.12

M10 Vhdkdj.k M10

35 0&12 ekg ds cPps ftUgsa fuEu Vhds fn, x, 10.1

35.01 ch-lh-th- 10.1.01

35.02 Mh-ih-Vh- 1 10.1.02

35.03 Mh-ih-Vh- 2 10.1.03

35.04 Mh-ih-Vh- 3 10.1.04

35.05 iksfy;ks 0 ¼tUe ds le;½ 10.1.05

35.06 iksfy;ks 1 10.1.06

35.07 iksfy;ks 2 10.1.07

35.08 iksfy;ks 3 10.1.08

35.09 fgi ch 1 10.1.09

35.10 fgi ch 2 10.1.10

laLFkk esa dh xbZ NSV/iq:"k ulcanh dh la[;k

laLFkk esa dh xbZ LTT dh la[;k

dqy {(a) (b)}

dqy {(a) (b)}

dqy {(a) (b)}

laLFkk esa NSV izf'kf{kr fpfdRld gSa

E99
RI Regsiter (0-5 yrs)35.1 to 37.1 a&b
Page 11: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC11 of 14

jsQjsUl Øekadekg dh miyC/kh

35.11 fgi ch 3 10.1.11

35.12 ehtYl 10.1.12

35.13 10.1.13

(a) ckyd 10.1.13(a)

(b) ckfydk 10.1.13(b)

33.14 10.2

36.1 MhihVh cwLVj 10.2.1

36.2 iksfy;ks cwLVj 10.2.2

36.3 10.2.3

37 Vhdkdj.k Lrj 10.3

37.1 10.3.1

(a) ckyd 10.3.1(a)

(b) ckfydk 10.3.1(b)

37.2 10.3.2

37.3 10.3.3

37.4 Vhdkdj.k Ik'pkr~ izfrdwy izHkko 10.3.4

(a) QksM+k 10.3.5

(b) e`R;q 10.3.5.1

(c) vU; 10.3.5.2

38 ekg esa Vhdkdj.k l= dh la[;k 10.3.5.3

38.1 fu;ksftr l= 10.4

38.2 vk;ksftr l= 10.4.1

38.3 l= tgka vk'kk mifLFkr Fkh 10.4.2

39 vU; ¼tsiuhl budsQsykbfVl½ 10.4.3

39.1 10.5

39.2 10.5.1

39.3 10.5.2

10.5.3

M11 foVkfeu , [kqjkd dh la[;k M11

40 9 ekg ls 5 o"kZ ds chp nh xbZ [kqjkd 11.1

40.1 [kqjkd 1 11.1.1

40.2 [kqjkd 5 11.1.2

40.3 [kqjkd 9 11.1.3

40.4 Dose-9 11.1.4

9&12 ekg ds cPpksa dh la[;k ftudk bl ekg esa iw.kZ Vhdkdj.k gqvk ¼chlhth $ MhihVh 1 2 3 $ iksfy;ks 1 2 3 $ ehtYl½

dqy {(a) (b)}

5 o"kZ rd ds cPps ftUg DTS fn;kA

ehtYl] ;Eil] :csyk ¼MMR½

12&23 ekg ds cPpksa dh la[;k ftudk bl ekg esa iw.kZ Vhdkdj.k gqvk ¼chlhth $ MhihVh 1 2 3 $ iksfy;ks 1 2 3 $ ehtYl½

dqy {(a) (b)}

10 o"kZ ls vf/kd cPps ftUgsa TT10 fn;k16 o"kZ ls vf/kd cPps ftUgsa TT16 fn;k

E118
Village health register (Immunization 0-5 yrs) 23.1,23.2,24.1a&b
E120
Not applicable
E126
Immunization regsiter (6-16 yrs)
E128
Immunization register (0-5 and 6-16 Yrs) 37.4 a,b and c
E132
Rohini: Immunization Compilation sheet 38.1,38.2 &38.3
E141
Immunization register ( 0-5 yrs)40.1 to 40.3
Page 12: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC12 of 14

jsQjsUl Øekadekg dh miyC/kh

M12 0&5 o"kZ ds cPpksa esa chekjh M12

37 fMIFksfj;k 12.1

38 ijV~;wfll 12.2

39 fVVusl ¼uotkr f'k'kq esa½ 12.3

40 fVVusl ¼vU;½ 12.4

41 iksfy;ks 12.5

42 ehtYl 12.6

43 nLr o futZyhdj.k 12.7

44 eysfj;k 12.8

45 Nkrh ds laØe.k ds HkrhZ ejht 12.9

vU; dk;ZØe

M13 vU/kRo fuokj.k dk;ZØe M13

50 eksfr;kfcUn ds vkWijs'ku gq, jksfx;ksa dh la[;k 13.1

51 13.2

52 fjQzsDVjh ,jj dh igpku fd, x, Ldwyh cPpksa dh la[;k 13.3

53 cPPkksa dh la[;k ftUgsa eq¶r p'esa forfjr fd, 13.4

50 us=nku gsrq us= tek gq, 13.5

51 us=nku ls ejhtksa esa us= yxk, x, 13.6

Part C. LokLF; laLFkk lqfo/kk

M14 ejhtksa dks lqfo/kk M14

52 gkWa@ ugha 14.01

53 laqLFkk eas jksxh dY;k.k lfefr xfBr gSA gkWa@ ugha 14.04

53.1 ;fn gka rks bl ekg fdruh cSBds gqbZA 14.05

54 laLFkk esa ,EcwysUl vFkok ifjogu dh lqfo/kk miyC/k gS\ gkWa@ ugha 14.06

54.1 ;fn gka rks bl ekg fdruh ckj ejhtksa ds fy, bldk mi;ksx gqvk\ 14.07

55 gkWa@ ugha 14.08

56 laLFkk esa fdrus ysijksLdksi pkyw gkyr esa gS\ 14.09

58.1 HkrhZ 19 o"kZ rd cPps c;Ld 14.10

(a) ckyd 14.10.1

(b) ckfydk 14.10.1(a)

14.10.1(b)

58.2 e`R;q 14.10.2

(a) iq:"k e`R;q 14.10.2(a)

(b) efgyk 14.10.2(b)

Hkkx B.

jksxh ftuesa IOL yxk,

D;k laLFkk FRU ds :Ik esa dk;Z dj jgh gSA

D;k laLFkk esa SNW dk;Z'khy gS\

dqy {(a) (b)}

dqy {(a) (b)}

E147
IDSP 37 to 45
E175
Indoor register 58.1 a&b
E178
Line listing (death)
Page 13: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC13 of 14

jsQjsUl Øekadekg dh miyC/kh

59 jkr esa fdrus ejht laLFkk esa HkrhZ Fks 14.11

60 ckg~; jksxh 14.12

60.1 dqy ckg~; jksxh 14.12.1

61 vkWijs'ku fFk;sVj 14.13

61.1 cM+h 'kY; fØ;k ¼tujy@LikbZuy ,usLFksfl;k fn;k½ 14.13.1

61.2 NksVh 'kY; fØ;k ¼yksdy ,usLFksfl;k fn;k½ 14.13.2

62 vU; ¼nar fpfdRlk us= jksx] vk;q"k vkfn½ 14.14

(a) vk;q"k 14.14.1

(b) nar fpfdRlk 14.14.2

(c) fd'kksjksa dks ijke'kZ lqfo/kk 14.14.3

(d) 14.14.4

(e) 14.14.5

M15 iz;ksx'kkyk esa tkap Total M15

63 foLr`r tkudkjh 15.1

63.1 15.1.1 (a)

63.2 15.1.1 (b)

64 Number Tested Number Positive 15.1.2

(a) iq:"k 15.1.2(a)

(b) efgyk ¼xHkZorh ugha½ 15.1.2(b)

(c) xHkZorh efgyk 15.1.2(c)

Number Tested

65 foMky VsLV dh la[;k 15.2

66 15.3

(a) iq:"k 15.3.1

(b) efgyk ¼xHkZorh ugha½ 15.3.2

(c) xHkZorh efgyk 15.3.3

67 eysfj;k VsLV 15.4

67.1 jDr iV~Vh dh tkap 15.4.1

67.2 15.4.2

67.3 15.4.3

fd, x, Hb VsLV dh la[;k

VsLV fd, x, esa ls 7 gm ls de Hb

HIV VsLV

dqy {(a) ls (c)}

VDRL VsLV dh la[;k

dqy {(a) ls (c)}

Plasmodium Vivax ik, x,

Plasmodium Falciparum ik, x,

E183
OPD registr
E185
OT register 61.1&61.2
E194
Lab register 63 to 67.3
Page 14: CHC NRHM-MIS

NRHM/ DH-SDH-CHC/3/M

Printed as on 10/09/2008 Monthly- DH-SDH-CHC14 of 14

jsQjsUl Øekadekg dh miyC/kh

e`R;q dh foLr`r tkudkjh

M16 ekg esa gqbz e~R;q ds dkj.k M17

68 tUe ds 24 ?kaVs ds vUnj gqbZ uotkr f'k'kq dh e`R;q 17.1

69 dqy 17.2

69.1 laØe.k 17.2.1

69.2 lkal ysus esa rdyhQ 17.2.2

69.3 de out 17.2.3

69.4 vU; 17.2.4

70 5 lky rd ds cPpksa dh e`R;q ds dkj.k dqy 17.3

70.1 fueksfu;ks 17.3.1

70.2 nLr 17.3.2

70.3 cq[kkj 17.3.3

70.4 ehtYl 17.3.4

70.5 vU; 17.3.5

71 fd'kksj@o;Ld e`R;q ds dkj.k 6&14 o"kZ15&55 o"kZ dqy 17.4

71.01 nLr 17.4.01

71.02 {k;jksx 17.4.02

71.03 lkal dh chekjh `¼{k;jksx ds vykok½ 17.4.03

71.04 eysfj;k 17.4.04

71.05 vU; cq[kkj lacaf/kr 17.4.05

71.06 ,p-vk;-oh@,M~l 17.4.06

71.07 fny@mPp jDrpki dh chekjh 17.4.07

71.08 rkaf=dh@nkSjk 17.4.08

71.09 ekr` e`R;q 17.4.09

(a) xHkZikr 17.4.09(a)

(b) vo:)@foyafcr izlo 17.4.09(b)

(c ) mPp jDrpki@>Vds 17.4.09(c )

(d) jDrL=ko 17.4.09(d )

(e) rst cq[kkj 17.4.09(e )

(f) vU; dkj.k 17.4.09(f )

71.10 pksV@nq?kZVuk@ty tkus ds dkj.k 17.4.10

71.11 vkRegR;k 17.4.11

71.12 Ik'kq@dhM+s ds dkVus ls 17.4.12

71.13 vU; chekjh 17.4.13

(a) xaHkhj chekjh 17.4.13(a)

(b) yach chekjh 17.4.13(b)

(c) dkj.k irk ugha 17.4.13(c )

Hkkx E.

4 g¶rs ds vUnj gqbZ uotkr f'k'kq e`R;q ds dkj.k

tUe ds 1 g¶rs rd

tUe ds 1&4 g¶rs rd

1 ekg ls 11 ekg dh mez

1&5 o"kZ dh mez

> 55 o"kZ

E215
line listing death 68 to71.08
E237
Line lsiting maternal deaths