Ministry of Health – National Malaria Elimination Centre

Form B: Health Centre Aggregation Form

Province……………………………………………………………………………District………………………………………………..
Health Centre ………………………………………………………………………………………………………………………………..
Compiled by: ……………………………………………………………..Date of Compilation: …………………………………
No. Name of No. of Total No of Total No. People No. of LLINs No. of LLINs First Date of No. of LLINs Issued Comment
NHC/Zones (A) community Households in households required Received (F) Issue
(I)
/ villages
(C) (D) (E) (G)
(H)
(B)

1.

2.

3.

4.

5.

6.

7.

8.
Total