Aedes Larval Survey report for the week from ___________ to ______________

District : CHNC: PHC: Name of the MPHEO/SUO:

Positive for Aedes larva

No. checked Indices

S.No. Habitation Date of survey Houses Containers Houses Containers House index Container index Breatua index
1
2
3
4
5
6
Total:

Singanature SPHO
Caluclation of Indices
1. House Index = No. of Houses positive for aedes larva
X 100
Total No. of Houses checked

2. Container index= No. of containers positive for aedes larva

X 100
Total No. of Houses checked

3. Breatua index = No. of containers positive for aedes larva

X 100
Total No. of Houses checked