Professional Documents
Culture Documents
RDLC
RDLC
Dated: 06-12-2020
Time : 15:36:53
Module MIS
Periodicity M
Proforma / Format SC
State Maharashtra
District Amravati
Period August
1.1 Total number of pregnant women registered for ANC Number reported during
the month
1.1.1 Out of the total ANC registered, number registered within 1st Number reported during
trimester (within 12 weeks) the month
1.2.4 Number of PW given 180 Iron Folic Acid (IFA) tablets Number reported during
the month
1.2.6 Number of PW given one Albendazole tablet after 1st trimester Number reported during
the month
1.2.7 Number of PW received 4 or more ANC check ups Number reported during
the month
1.2.8 Number of PW given ANC Corticosteroids in Pre Term Labour Number reported during
the month
1.3.1.a Out of the new cases of PW with hypertension detected, cases Number reported during
managed at institution the month
1.4.1 Number of PW tested for Haemoglobin (Hb ) 4 or more than 4 Number reported during
times for respective ANCs the month
1.4.2 Number of PW having Hb level<11 (tested cases)(7.1 to 10.9) Number reported during
the month
1.5.1.a Number of PW tested using POC test for Syphilis Number reported during
the month
1.5.1.b Out of above, number of PW found sero positive for syphilis Number reported during
the month
2.1.1.a Number of Home Deliveries attended by Skill Birth Attendant(SBA) Number reported during
(Doctor/Nurse/ANM) the month
2.1.1.b Number of Home Deliveries attended by Non SBA (Trained Birth Number reported during
Attendant(TBA) /Relatives/etc.) the month
2.1.2 Number of PW given Tablet Misoprostol during home delivery Number reported during
the month
2.1.3 Number of newborns received 7 Home Based Newborn Care Number reported during
(HBNC) visits in case of Home delivery the month
2.2.1 Out of total institutional deliveries number of women discharged Number reported during
within 48 hours of delivery the month
2.2.2 Number of newborns received 6 HBNC visits after Institutional Number reported during
Delivery the month
3.1.2 Number of Pre term newborns ( < 37 weeks of pregnancy) Number reported during
the month
3.3.2 Number of newborns having weight less than 2.5 kg Number reported during
the month
3.3.3 Number of Newborns breast fed within 1 hour of birth Number reported during
the month
4.1 Women receiving 1st post partum checkup within 48 hours of home Number reported during
delivery the month
4.2 Women receiving 1st post partum checkup between 48 hours and Number reported during
14 days the month
4.3 Number of mothers provided full course of 180 IFA tablets after Number reported during
delivery the month
4.4 Number of mothers provided 360 Calcium tablets after delivery Number reported during
the month
5.1 Number of Interval IUCD Insertions (excluding PPIUCD and Number reported during
PAIUCD) the month
5.2 Number of Post Partum (within 48 hours of delivery) IUCD Number reported during
insertions the month
5.8 Injectable Contraceptive-Antara Program- Fourth or more than Number reported during
fourth the month
5.9 Number of Combined Oral Pill cycles distributed Number reported during
the month
5.11 Number of Centchroman (weekly) pill strips distributed Number reported during
the month
5.12 Number of Emergency Contraceptive Pills (ECP) given Number reported during
the month
5.13 Number of Pregnancy Test Kits (PTK) used Number reported during
the month
6.9 Number of children (6-59 months) provided 8-10 doses (1ml) of IFA Number reported during
syrup (Bi weekly) the month
6.10 Number of children (12-59 months) provided Albendazole Number reported during
the month
6.11 Number of severely underweight children provided Health Checkup Number reported during
(0-5 yrs) the month
6.1.17 Child immunisation - Inactivated Polio Vaccine 1 (IPV 1) Number reported during
the month
6.1.18 Child immunisation - Inactivated Polio Vaccine 2 (IPV 2) Number reported during
the month
6.2.1 Child immunisation (9-11months) - Measles & Rubella (MR)- 1st Number reported during
Dose the month
6.2.2 Child immunisation (9-11months) - Measles 1st dose Number reported during
the month
6.3.1 Child immunisation - Measles & Rubella (MR)- 1st Dose Number reported during
the month
6.2.4.a Children aged between 9 and 11 months fully immunized- Male Number reported during
the month
6.2.4.b Children aged between 9 and 11 months fully immunized - Female Number reported during
the month
6.4.1 Child immunisation - Measles & Rubella (MR)- 2nd Dose (16-24 Number reported during
months) the month
6.4.2 Child immunisation - Measles 2nd dose (More than 16 months) Number reported during
the month
6.4.5 Child immunisation - Measles, Mumps, Rubella (MMR) Vaccine Number reported during
the month
6.4.6 Number of children more than 16 months of age who received Number reported during
Japanese Encephalitis (JE) vaccine the month
6.5.4 Children more than 16 years received TT16 Number reported during
the month
6.5.2 Children more than 5 years received DPT5 (2nd Booster) Number reported during
the month
6.5.3 Children more than 10 years received TT10 Number reported during
the month
6.7.3 Number of Immunisation sessions where ASHAs were present Number reported during
the month
8.1.1.b Malaria (RDT) - Plasmodium Vivax test positive Number reported during
the month
8.1.1.c Malaria (RDT) - Plamodium Falciparum test positive Number reported during
the month
9.3 Number of Anganwadi centres/ UPHCs reported to have conducted Number reported during
Village Health & Nutrition Day (VHNDs)/ Urban Health & Nutrition the month
Day (UHNDs)/ Outreach / Special Outreach
10.1.1 Number of Hb tests conducted Number reported during
the month
10.1.2 Out of the total number of Hb tests done, Number having Hb < 7 Number reported during
mg the month
10.2.1.a Number of pregnant women screened for HIV Number reported during
the month
10.2.1.b Out of the above, number screened positive Number reported during
the month
11.1.1 Last Date of Supply of essential drugs (DD/MM/YYYY) Number reported during
the month
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
11.1.2.c Vit A syrup
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
11.1.1.i Antibiotics
Dropdown - Adequate
Dropdown - Inadequate
11.1.1.j Availability of drugs for common ailments e.g PCM, anti- allergic
drugs etc.
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
11.2.1 Last Date of Supply of essential contraceptives (DD/MM/YYYY) Number reported during
the month
11.2.2.a IUCD
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
Dropdown - Adequate
Dropdown - Inadequate
12.6.14 Number of Adolscent / Adult deaths due to Causes Not known Number reported during
the month
12.6.1 Number of Adolscent / Adult deaths due to Diarrhoeal diseases Number reported during
the month
12.4.1 Number of Child Deaths (1 -5 years) due to Pneumonia Number reported during
the month
12.4.2 Number of Child Deaths (1 -5 years) due to Diarrhoea Number reported during
the month
12.1 Infant deaths within 24 hrs(1 to 23 Hrs) of birth Number reported during
the month
12.4.3 Number of Child Deaths (1 -5 years) due to Fever related Number reported during
the month
12.4.4 Number of Child Deaths (1 -5 years) due to Measles Number reported during
the month
12.2.3 Infant Deaths up to 4 weeks due to Other causes Number reported during
the month
12.4.5 Number of Child Deaths (1 -5 years) due to Others Number reported during
the month
12.6.2 Number of Adolscent / Adult deaths due to Tuberculosis Number reported during
the month
12.6.3 Number of Adolscent / Adult deaths due to Respiratory diseases Number reported during
including infections (other than TB) the month
12.6.4 Number of Adolscent / Adult deaths due to Other Fever Related Number reported during
the month
12.6.5 Number of Adolscent / Adult deaths due to HIV/AIDS Number reported during
the month
12.6.6 Number of Adolscent / Adult deaths due to Heart Number reported during
disease/Hypertension related the month
12.6.7 Number of Adolscent / Adult deaths due to Cancer Number reported during
the month
12.5.2 Number of Maternal Deaths due to High fever Number reported during
the month
12.3.1 Number of Infant Deaths (1 -12 months) due to Pneumonia Number reported during
the month
12.3.2 Number of Infant Deaths (1 -12 months) due to Diarrhoea Number reported during
the month
12.3.3 Number of Infant Deaths (1 -12 months) due to Fever related Number reported during
the month
12.3.4 Number of Infant Deaths (1 -12 months) due to Measles Number reported during
the month
12.3.5 Number of Infant Deaths (1 -12 months) due to Others Number reported during
the month
12.5.4 Number of Maternal Deaths due to Obstructed/prolonged labour Number reported during
the month
12.5.5 Number of Maternal Deaths due to Severe hypertesnion/fits Number reported during
the month
12.5.6 Number of Maternal Deaths due to Other Causes (including causes Number reported during
Not known) the month
12.6.8 Number of Adolscent / Adult deaths due to Neurological disease Number reported during
including strokes the month
12.6.9 Number of Adolscent / Adult deaths due to Accidents/Burn cases Number reported during
the month
12.6.10 Number of Adolscent / Adult deaths due to Suicide Number reported during
the month
12.6.11 Number of Adolscent / Adult deaths due to Animal bites and stings Number reported during
the month
12.6.12 Number of Adolscent / Adult deaths due to known Acute Disease Number reported during
the month
12.6.13 Number of Adolscent / Adult deaths due to known Chronic Disease Number reported during
the month
12.7.1 Number of Deaths due to Malaria- Plasmodium Vivax Number reported during
the month
12.7.2 Number of Deaths due to Malaria- Plasmodium Falciparum Number reported during
the month
Maharashtra
Maharashtra ->
Amravati
Dhamangaon Railway
Asegaon Talagaon
Dashasar
0
0
0
0
9
0
0
2
11
12
15
0
0
23
27082018
1
1
1
1
27082018
0
0
0
0