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  • TSFP Treatment & Ration Card

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    Musa Ahmadi
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    This document contains a registration form for a targeted supplementary feeding program (TSFP). The form collects information such as the beneficiary's name, age, sex, admission date and reason for admission. It also tracks the beneficiary's mid-upper arm circumference (MUAC) measurement, weight-for-height Z-score, and whether they received nutrition education, rations, vitamins or deworming medication during their visits. The form is used to monitor the beneficiary's progress until their exit from the program.

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    TSFP Treatment & Ration Card.doc

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    This document contains a registration form for a targeted supplementary feeding program (TSFP). The form collects information such as the beneficiary's name, age, sex, admission date and reason for admission. It also tracks the beneficiary's mid-upper arm circumference (MUAC) measurement, weight-for-height Z-score, and whether they received nutrition education, rations, vitamins or deworming medication during their visits. The form is used to monitor the beneficiary's progress until their exit from the program.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    4 views1 page

    TSFP Treatment & Ration Card

    Uploaded by

    Musa Ahmadi
    This document contains a registration form for a targeted supplementary feeding program (TSFP). The form collects information such as the beneficiary's name, age, sex, admission date and reason for admission. It also tracks the beneficiary's mid-upper arm circumference (MUAC) measurement, weight-for-height Z-score, and whether they received nutrition education, rations, vitamins or deworming medication during their visits. The form is used to monitor the beneficiary's progress until their exit from the program.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Remarks on Treatment Provided

    Registration Number:
    OPD-MAM/OPD-AM PLW (TSFP) CARD
    General Directorate Preventive MedicinePublic Nutrition Department

    Identification of TSFP
    Agency:

    Province:

    Clinic/
    Centre:

    District:

    W/H Score IYCF & Health


    Education (Y/N) Ration received
    (Y/N)
    kgW mcH scoreZ

    Date of next
    visit

    Target
    O Children 6 to 59
    Group
    Village:
    (mark)
    O Pregnant
    O Lactating
    Identification of beneficiary
    Name
    Child immunization card No:
    Fathers or
    Husbands name
    Women MCH-ANC/PNC card No:
    Address/village
    Sex (mark)

    O Female

    O Male
    MUAC (cm)
    W/H Z score
    MUAC (cm)

    Childs age (in months)


    Womans age (in years)
    Admission information
    Reason
    admission

    for
    Mark:

    O New Patient

    O Transferred

    Admission date

    Vitamin A

    Yes / No

    Mebendazole

    Yes / No

    Date

    Ferrous sulphate and folic acid

    Yes / No

    Date

    Mark outcome: Cured

    MUAC (cm)

    12

    10

    1.

    Exit information
    Exit as:

    11

    Date

    Details and Date

    Other medications

    Date

    Yes / No

    MUAC (cm)

    Date

    Measles vaccination

    Visit

    Front

    BACK

    Exit date:
    Default

    Died

    W/H-Z score

    Non-cured

    Transferred

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