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TOTAL NUMBER OF PATIENTS SEEN AT THE ABC FOR THE MONTH OF ______ Male – Female – TOTAL = AGE CATEGORY: 18 years old and below Above 18 years old – TYPE OF ANIMALS: Dog Cat Others – TYPE OF CATEGORY OF BITE SEEN: Category 1 Category 2 Category 3 – NUMBER OF PATIENTS WHO RECEIVED ACTIVE IMMUNIZATION: Purified vero cell Purified chick embryo – NUMBER OF PATIENTS WHO RECEIVED PASSIVE IMMUNIZATION: Human Rabies Immunoglobulin – Equine Rabies immunoglobulin – NUMBER OF FREE VACCINES RECEIVED/DONATED BY GOVERNMENT & NON-GOVERNMENT AGENCIES Rabipur ERIG NUMBER OF PATIENTS WHO COMPLETED DOSAGE OF ACTIVE IMMUNIZATIONS: 3rd dosage 4th dosage –
NUMBER OF PATIENTS WITH ADVERSE REACTION/EVENT TO: a. ERIG – b. Others – ACTIVITIES OF THE ANIMAL BITE CENTER PROGRAM: a. Lectures / Advocacy b. Distribution of IEC materials c. Seminars / lectures attended or conducted –