To,

Medical Officer
City Family Welfare Bureau
Pune Municipal Corporation

Submitting herewith the report of MTP done in the month of January - 2022 in the revised format

MEDICAL TERMINATION OF PREGNANCY ACT

Name of the Hospital:

Address:
MTP Certificate No :- Liscence No: -

Sr. No Details During Month Progressive

1 Total no. M.T.P. cases done
Duration of Pregnancy - -
2 Before 12 weeks
Between 12 to 20 weeks
Age Group - -
Below 15 years
15 to 19 years
20 to 24 years
3 25 to 29 years
30 to 34 years
35 to 39 years
40 to 44 years
45 years
Total:- 0 0
Religion - -
Hindu
Muslims
4 Christian
Shikh
Others
Total:- 0 0
Reason for M.T.P - -
a. Danger to life of pregnant women
b. Grave injury to Physical health of pregnant women
Grave injury to Mental health of pregnant women
5
Pregnancy caused by rape
Substantial risk that if child was born would suffer from such physical
or mental abnormalities as to be seriously handicapped
Failure of any contraceptive deivce or method
Termination with - -
a. Sterilisation
6
b. IUD insertion
c. Oral pills prescribed/distributed
MTP by Medical Methods
1. M.V.A.
7
2. M.A. (R.U.486)
3. Others (D&E)
8 No. of Deaths reported

Signature of the Officer With Date

Seal