Professional Documents
Culture Documents
Age in months
Weight in kilograms (1 dec.)
Height in centimeters (1 dec.)
Ht/A Percentile
Ht/A Standard deviations
Ht/A Percent of ref. median
Wt/A Percentile
Wt/A Standard deviations
Wt/A Percent of ref. median
Wt/Ht Percentile
Wt/Ht Standard deviations
Wt/Ht Percent of ref. median
Reason not measured
Height: lying or standing
Day of birth of child
Date measured (day)
Date measured (month)
Date measured (year)
Sex
Month of birth of child
Year of birth of child
Date of birth (cmc)
Completeness of information
Line no. of parent/caretaker
Read consent statement
Age in months
Weight in kilograms (1 dec.)
Height in centimeters (1 dec.)
Ht/A Percentile
Ht/A Standard deviations
Ht/A Percent of ref. median
Wt/A Percentile
Wt/A Standard deviations
Wt/A Percent of ref. median
Wt/Ht Percentile
Wt/Ht Standard deviations
Wt/Ht Percent of ref. median
Reason not measured
Height: lying or standing
Day of birth of child
Date measured (day)
Date measured (month)
Date measured (year)
Line no. of parent/caretaker
Read consent statement
Hemoglobin level (g/dl - 1 decimal)
Result of measuring (Hemoglobin)
Hemoglobin level adjusted by altitude (g/dl - 1 decimal)
Anemia level
Agrees to referral
Ht/A Standard deviations (according to WHO)
Wt/A Standard deviations (according to WHO)