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PASCHIM BANGA VIGYAN MANCHA

Malda Zilla Committee


Survery for Cancer incident in your Locality
Sl No.

Name

Sex

Age

Type of
Cancer

How it was
detected

Name of the Student :

School :

Address of the School :

Area of survey :

District :

State :

Treatment
followed

Place of
treatment

Surgery

Name of the villag

GA VIGYAN MANCHA

illa Committee

r incident in your Locality


Any unconventional
treatment method
followed

chool :

rea of survey :

ate :

Name of the village :

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