Mother Child Tracking System (MCTS) Karnataka, India Thursday, July 5, 12 Thursday, July 5, 12 NaAonal Rural Health Mission (NRHM) 2 Primary'Health'Center MO Medical Officer Primary Health Care Center (PHC) 1 sub$center ANM Auxiliary Nurse Midwives (sub-‐centers) Professional Staff with 6 months+ training 3 ASHA Voluntary Community Health Care Workers ASHA 4 Household Women&&&Children Thursday, July 5, 12 Eligible Couples All women of reproducDve age registered as an Eligible Couple #ili~ (~~~~~) ~i~ 2( ~~~~ ~ro;)~ ~d~ ~o:D ~~ ~ \l (.:l~ n~F~~CM 20~~958 ~)'~O. ~~f"" Net!t.3e~) '-- ----' ~M~7l~~~om~~~ ;;:l~11~~ ~~~~ ~~~~ ~~~rn I ANC :!lorov: M~o~ nz;lF"r-$ (50~ ~~cm~./ o:m~) '---------' ~<5F"t:5o~~n~ :!lorov ;IjO)o:m~v wo::::on~.) ,. rn <iifil~D 'I-------,1 O<J~F":!lorov: t:).~.~~. 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" " ~tt.~t1~~ lJv G 'R ~ it v '}:l -e 1» 1: 1: 6;» n ~ o~ m ~':l~ ~ v gn1-'3 1PE 0 'l6) I ']6) ']6)< o Ob cl -g'O:J llE dJ'l8 ~~ a::: 'RI __ 3'0 B nO- u~ 1P11l,--QC 1» 1: -G o 1: 66) cu \0 'll ~~'1 1::U 6J>" -e~ 'l:1t) 13 o 'li) re ~-:l 10 ~ ~ I I Thayi Card 10 11 1 yr. 9 8 7 6 5 4 3 2 1 C:!~~~"~~.O n~ 13 -9-:1 -9 ~ ~ ~ ;;> t: 00 Age (completed weeks, months and years) x: ~ t1mo Ma;,~C:~ N~~t3~CI t3~Q~CI~omno~" t1~~ ~,,~ ~~ ~ W~tTo>i.lC: . al~;;:$ooml\ c;;;:$t1mo N~CI !"t1c"Q:)Jl" mM ~oll" om~n\,l~ 10 11 3y rs. 9 8 7 9 •...~ 3:9 g 16ldl' _'1 I 'lB . ~ g ~ M ~ ~ ;;> op _ ~ -M' = fl 'lS ~ ~ o v1a -.:: ,." v _r:l~ 'lI)'l n )( lZV ~ Cl 'Qj e"d.r.l~.o . . N~CI iOS.d"d ~~II!~o31 1-.' '0, 6 5 4 3 l~~WMTo> Q:)z:Sme.>.)iIlz:S~iIlz:S~ MO uef;) I 13 >- I ~ 10 11 2 yrs. 9 8 7 6 5 4 3 2 1 r."' I I r2 I ! f I .. r-- t- 3 ...s~ort~Ol;l~ ~~,~ __ ~ a.~.~.~Mot)1I 1:: Thursday, July 5, 12 10 Ci - I-- .-...~- - _. r- 2 1 I - I ,~' I 1- ' 1I!~!:i.o:Jtt." I.L - r L ~d t- 4 .I 5 6 ... ~ . ..- 6 ... ./ 8 14 < :j~~ ~e,)\I!O!!cI@PI 13 ~ C:!l:jp:j~:jo!!~e... '\\ 14 15 ~:5u0:5I!Qoi:!:MI! ~:jo58;)e 0 (Below-3SD)L ~,~ 15 16 (Below - 2SD to - 3SD) ~ 0 16 ~~5Qoi:!:M5 eJ\)~~ 17 ~o:m~u o~~rlt;i~ zjt;i~~n~ 17 10 11 3 yrs. 9 8 7 6 5 4 3 2 10 11 2 yrs. 1 9 8 7 6 5 4 3 2 10 11 1 yr. 1 9 8 7 6 5 4 3 2 1 (WHO ~~dotZdO:3) 3 ~~~d~cli ~~Nod ~! ~~~d ~~ ~ro - ~~~n Pregnancy RegistraAon / ANC1 Talukl...,~tl DistricVZ;'l~: Primary Health Centrel ~qic:J:l5 eMe~ 5eog Namel Ii~F~ • Ne® :::!:; Address lli~FIT! ~e® -- Year/c::i~F 1 Village/a5~ .1 Sub Center/W~5eog ~reF Husband 05;!jct: ~fClF ,:)Qt);!j: Phone No of Whom loSJ'<;oMOWil~ j;:loe;OQ50!c:3affiJ"a~~o/~~a 10~ fJO~6 Name I lio~c:j 05~ro Date of Birth of pregnant womenl Ii2:FIT! Ne® iIDWd t:Jc::E05/ • :£ c.... Age Ic::i®~ JSY Beneficiary ~w;::;<c:3elcpt,<)ot~c:loi:e Yes Caste: ze<)o I Phone No I ~o;;m~ 2055958 Mother Card Nol ...,~ ~t!"F ~o~,;· I~ I SC 1 1 11 Others 1 Linked facility for delivery ;!jO~6 ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj 1 sc IlpHCI v PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ - c ... . ICHCII TH 11 OH 1 IpVTI Name of ANM /wwi1woo;jo il5fJo:: il5::;dJ ST ffiMoi""i:Tle;~~;j ::l~ O;:E05 ---------~-------------------------------------------------~-----------------------------------Thursday, July 5, 12 Pregnancy RegistraAon / ANC1 MCTS THO/ PHC Talukl...,~tl DistricVZ;'l~: Year/c::i~F Primary Health Centrel ~qic:J:l5 eMe~ 5eog Namel Ii~F~ • Address lli~FIT! ~e® Ne® :::!:; -- ~reF Husband 05;!jct: ~fClF ,:)Qt);!j: 1 Village/a5~ I fJO~6 10~ Name I lio~c:j Phone No I ~o;;m~ 05~ro Age Ic::i®~ Date of Birth of pregnant womenl Ii2:FIT! Ne® iIDWd t:Jc::E05/ • :£ c.... JSY Beneficiary ~w;::;<c:3elcpt,<)ot~c:loi:e Yes Phone No of Whom loSJ'<;oMOWil~ j;:loe;OQ50!c:3affiJ"a~~o/~~a 2055958 Mother Card Nol ...,~ ~t!"F ~o~,;· .1 Sub Center/W~5eog I~ I Caste: ze<)o SC 1 1 ST Others 11 1 Linked facility for delivery ;!jO~6 ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj 1 ICHCII TH 11 OH 1 IpVTI Name of ANM /wwi1woo;jo il5fJo:: PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ - . ... v sc IlpHCI ffiMoi""i:Tle;~~;j c ::l~ O;:E05 ---------~-------------------------------------------------~------------------------------------ Talukl...,~tl District/ee; M Mother Card Nol ...,~ ~t!"r ~o~1i 205595~ Manual Data Entry from Thayi Card Mother/Pregnancy Registra5on X I I I I Delivery / Child Registra5on Primary Health Centrel ~qic:J:l5 eMe~ 5wg City/Mohalla/c:!~re Sub Center/ero~5fo~ Year/c::i~F ~a5I!_:], DATE OF DELlVERY/ffiM()jj;)d PLACE OF DELIVERY Home ~Q Private ANM Thursday, July 5, 12 wi:lalclrn~;:;i~Mo.te (t:JMlO5) Abortion Type / T1QF~3d 5e'; Normal 1 1 CS I Yes llio~ 1 I Yes 1 []£J [EQJ OPV O/L,;.;c:l-O(t:J~05) I MTP<12I [QJmwDJW[]J Instrumental/ 11 Forcees SEX (Male/Female)/ mro;);J ~oK I BREAST FEEDING WITHIN I HOUR BCG/~AI~ 1 DATE OF DISCHARGE ~~1£!3'F ::10ClNolO5 COMPLICATIONS M~M ffiMo.te Date of JSY Payment / 23w;:fc::1~ o:-.c:i';,I.,O ONolOo ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t OUTCOME NOS 0= Still Birth t:JMlO5 DELIVERY TYPE ()jj;)c::i5~';0.i:l ffiMo:mM / il5M~d Public I Village/a5~ 1 1 05~ 1 WEIGHT AT BIRTH (kg) c;l)roc:l~M5) (~N,I.,otln Blood Group/O~d roo~ HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5) I MTP>12I I Spontaneous I 1 Pregnancy RegistraAon / ANC1 MCTS THO/ PHC Annex 1 & 2 from Thayi card collected 1-‐2 / week Talukl...,~tl DistricVZ;'l~: Year/c::i~F Primary Health Centrel ~qic:J:l5 eMe~ 5eog Namel Ii~F~ • Address lli~FIT! ~e® Ne® :::!:; -- ~reF Husband 05;!jct: ~fClF ,:)Qt);!j: 1 Village/a5~ I fJO~6 10~ Name I lio~c:j Phone No I ~o;;m~ 05~ro Age Ic::i®~ Date of Birth of pregnant womenl Ii2:FIT! Ne® iIDWd t:Jc::E05/ • :£ c.... JSY Beneficiary ~w;::;<c:3elcpt,<)ot~c:loi:e Yes Phone No of Whom loSJ'<;oMOWil~ j;:loe;OQ50!c:3affiJ"a~~o/~~a 2055958 Mother Card Nol ...,~ ~t!"F ~o~,;· .1 Sub Center/W~5eog I~ I Caste: ze<)o SC 1 1 ST Others 11 1 Linked facility for delivery ;!jO~6 ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj 1 ICHCII TH 11 OH 1 IpVTI Name of ANM /wwi1woo;jo il5fJo:: PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ - . ... v sc IlpHCI ffiMoi""i:Tle;~~;j c ::l~ O;:E05 ---------~-------------------------------------------------~------------------------------------ Talukl...,~tl District/ee; M Mother Card Nol ...,~ ~t!"r ~o~1i 205595~ Manual Data Entry from Thayi Card Mother/Pregnancy Registra5on X I I I I Delivery / Child Registra5on Primary Health Centrel ~qic:J:l5 eMe~ 5wg City/Mohalla/c:!~re Sub Center/ero~5fo~ Year/c::i~F ~a5I!_:], DATE OF DELlVERY/ffiM()jj;)d PLACE OF DELIVERY Home ~Q Private ANM Thursday, July 5, 12 wi:lalclrn~;:;i~Mo.te (t:JMlO5) Abortion Type / T1QF~3d 5e'; Normal 1 1 CS I Yes llio~ 1 I Yes 1 []£J [EQJ OPV O/L,;.;c:l-O(t:J~05) I MTP<12I [QJmwDJW[]J Instrumental/ 11 Forcees SEX (Male/Female)/ mro;);J ~oK I BREAST FEEDING WITHIN I HOUR BCG/~AI~ 1 DATE OF DISCHARGE ~~1£!3'F ::10ClNolO5 COMPLICATIONS M~M ffiMo.te Date of JSY Payment / 23w;:fc::1~ o:-.c:i';,I.,O ONolOo ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t OUTCOME NOS 0= Still Birth t:JMlO5 DELIVERY TYPE ()jj;)c::i5~';0.i:l ffiMo:mM / il5M~d Public I Village/a5~ 1 1 05~ 1 WEIGHT AT BIRTH (kg) c;l)roc:l~M5) (~N,I.,otln Blood Group/O~d roo~ HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5) I MTP>12I I Spontaneous I 1 Pregnancy RegistraAon / ANC1 WEB THO/ PHC Annex 1 & 2 from Thayi card collected 1-‐2 / week Talukl...,~tl DistricVZ;'l~: Year/c::i~F Primary Health Centrel ~qic:J:l5 eMe~ 5eog Namel Ii~F~ • Address lli~FIT! ~e® Ne® :::!:; -- ~reF Husband 05;!jct: ~fClF ,:)Qt);!j: 1 Village/a5~ I fJO~6 10~ Name I lio~c:j Phone No I ~o;;m~ 05~ro Age Ic::i®~ Date of Birth of pregnant womenl Ii2:FIT! Ne® iIDWd t:Jc::E05/ • :£ c.... JSY Beneficiary ~w;::;<c:3elcpt,<)ot~c:loi:e Yes Phone No of Whom loSJ'<;oMOWil~ j;:loe;OQ50!c:3affiJ"a~~o/~~a 2055958 Mother Card Nol ...,~ ~t!"F ~o~,;· .1 Sub Center/W~5eog I~ I Caste: ze<)o SC 1 1 ST Others 11 1 Linked facility for delivery ;!jO~6 ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj 1 ICHCII TH 11 OH 1 IpVTI Name of ANM /wwi1woo;jo il5fJo:: PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ - . ... v sc IlpHCI ffiMoi""i:Tle;~~;j c ::l~ O;:E05 ---------~-------------------------------------------------~------------------------------------ Talukl...,~tl District/ee; M Mother Card Nol ...,~ ~t!"r ~o~1i 205595~ Manual Data Entry from Thayi Card Mother/Pregnancy Registra5on X I I I I Delivery / Child Registra5on Primary Health Centrel ~qic:J:l5 eMe~ 5wg City/Mohalla/c:!~re Sub Center/ero~5fo~ Year/c::i~F ~a5I!_:], DATE OF DELlVERY/ffiM()jj;)d PLACE OF DELIVERY Home ~Q Private ANM Thursday, July 5, 12 wi:lalclrn~;:;i~Mo.te (t:JMlO5) Abortion Type / T1QF~3d 5e'; Normal 1 1 CS I Yes llio~ 1 I Yes 1 []£J [EQJ OPV O/L,;.;c:l-O(t:J~05) I MTP<12I [QJmwDJW[]J Instrumental/ 11 Forcees SEX (Male/Female)/ mro;);J ~oK I BREAST FEEDING WITHIN I HOUR BCG/~AI~ 1 DATE OF DISCHARGE ~~1£!3'F ::10ClNolO5 COMPLICATIONS M~M ffiMo.te Date of JSY Payment / 23w;:fc::1~ o:-.c:i';,I.,O ONolOo ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t OUTCOME NOS 0= Still Birth t:JMlO5 DELIVERY TYPE ()jj;)c::i5~';0.i:l ffiMo:mM / il5M~d Public I Village/a5~ 1 1 05~ 1 WEIGHT AT BIRTH (kg) c;l)roc:l~M5) (~N,I.,otln Blood Group/O~d roo~ HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5) I MTP>12I I Spontaneous I 1 MCTS Pregnancy RegistraAon / ANC1 WEB THO/ PHC Thursday, July 5, 12 MCTS Pregnancy RegistraAon / ANC1 WEB THO/ PHC Annex 1 & 2 from Thayi card collected 1-‐2 / week Talukl...,~tl DistricVZ;'l~: Year/c::i~F Primary Health Centrel ~qic:J:l5 eMe~ 5eog Namel Ii~F~ • Address lli~FIT! ~e® Ne® :::!:; -- ~reF Husband 05;!jct: ~fClF ,:)Qt);!j: 1 Village/a5~ I fJO~6 10~ Name I lio~c:j Phone No I ~o;;m~ 05~ro Age Ic::i®~ Date of Birth of pregnant womenl Ii2:FIT! Ne® iIDWd t:Jc::E05/ • :£ c.... JSY Beneficiary ~w;::;<c:3elcpt,<)ot~c:loi:e Yes Phone No of Whom loSJ'<;oMOWil~ j;:loe;OQ50!c:3affiJ"a~~o/~~a 2055958 Mother Card Nol ...,~ ~t!"F ~o~,;· .1 Sub Center/W~5eog I~ I Caste: ze<)o SC 1 1 ST Others 11 1 Linked facility for delivery ;!jO~6 ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj 1 ICHCII TH 11 OH 1 IpVTI Name of ANM /wwi1woo;jo il5fJo:: PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ - . ... v sc IlpHCI ffiMoi""i:Tle;~~;j c ::l~ O;:E05 ---------~-------------------------------------------------~------------------------------------ Talukl...,~tl District/ee; M Mother Card Nol ...,~ ~t!"r ~o~1i 205595~ Manual Data Entry from Thayi Card Mother/Pregnancy Registra5on X I I I I Delivery / Child Registra5on Primary Health Centrel ~qic:J:l5 eMe~ 5wg City/Mohalla/c:!~re Sub Center/ero~5fo~ Year/c::i~F ~a5I!_:], DATE OF DELlVERY/ffiM()jj;)d PLACE OF DELIVERY Home ~Q Private ANM Thursday, July 5, 12 wi:lalclrn~;:;i~Mo.te (t:JMlO5) Abortion Type / T1QF~3d 5e'; Normal 1 1 CS I Yes llio~ 1 I Yes 1 []£J [EQJ OPV O/L,;.;c:l-O(t:J~05) I MTP<12I [QJmwDJW[]J Instrumental/ 11 Forcees SEX (Male/Female)/ mro;);J ~oK I BREAST FEEDING WITHIN I HOUR BCG/~AI~ 1 DATE OF DISCHARGE ~~1£!3'F ::10ClNolO5 COMPLICATIONS M~M ffiMo.te Date of JSY Payment / 23w;:fc::1~ o:-.c:i';,I.,O ONolOo ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t OUTCOME NOS 0= Still Birth t:JMlO5 DELIVERY TYPE ()jj;)c::i5~';0.i:l ffiMo:mM / il5M~d Public I Village/a5~ 1 1 05~ 1 WEIGHT AT BIRTH (kg) c;l)roc:l~M5) (~N,I.,otln Blood Group/O~d roo~ HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5) I MTP>12I I Spontaneous I 1 MCTS Pregnancy RegistraAon / ANC1 WEB THO/ PHC Annex 1 & 2 from Thayi card collected 1-‐2 / week SMS Talukl...,~tl DistricVZ;'l~: Year/c::i~F Primary Health Centrel ~qic:J:l5 eMe~ 5eog Namel Ii~F~ • Address lli~FIT! ~e® Ne® :::!:; -- Husband 05;!jct: ~fClF ,:)Qt);!j: 1 Village/a5~ I fJO~6 10~ Name I lio~c:j Phone No I ~o;;m~ 05~ro Age Ic::i®~ Date of Birth of pregnant womenl Ii2:FIT! Ne® iIDWd t:Jc::E05/ • :£ c.... JSY Beneficiary ~w;::;<c:3elcpt,<)ot~c:loi:e Yes Phone No of Whom loSJ'<;oMOWil~ j;:loe;OQ50!c:3affiJ"a~~o/~~a 2055958 Mother Card Nol ...,~ ~t!"F ~o~,;· .1 Sub Center/W~5eog ~reF MCTS I~ I Caste: ze<)o SC 1 1 ST Others 11 1 Linked facility for delivery ;!jO~6 ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj 1 ICHCII TH 11 OH 1 IpVTI Name of ANM /wwi1woo;jo il5fJo:: PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ - . ... v sc IlpHCI ffiMoi""i:Tle;~~;j c ::l~ O;:E05 ---------~-------------------------------------------------~------------------------------------ Talukl...,~tl District/ee; M Mother Card Nol ...,~ ~t!"r ~o~1i 205595~ Manual Data Entry from Thayi Card Mother/Pregnancy Registra5on X I I I I Delivery / Child Registra5on Primary Health Centrel ~qic:J:l5 eMe~ 5wg City/Mohalla/c:!~re Sub Center/ero~5fo~ Year/c::i~F ~a5I!_:], DATE OF DELlVERY/ffiM()jj;)d PLACE OF DELIVERY Home ~Q Private ANM Thursday, July 5, 12 wi:lalclrn~;:;i~Mo.te (t:JMlO5) Abortion Type / T1QF~3d 5e'; Normal 1 1 CS I Yes llio~ 1 I Yes 1 []£J [EQJ OPV O/L,;.;c:l-O(t:J~05) I MTP<12I [QJmwDJW[]J Instrumental/ 11 Forcees 1 SEX (Male/Female)/ mro;);J ~oK I BREAST FEEDING WITHIN I HOUR BCG/~AI~ 1 DATE OF DISCHARGE ~~1£!3'F ::10ClNolO5 COMPLICATIONS M~M ffiMo.te Date of JSY Payment / 23w;:fc::1~ o:-.c:i';,I.,O ONolOo ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t OUTCOME NOS 0= Still Birth t:JMlO5 DELIVERY TYPE ()jj;)c::i5~';0.i:l ffiMo:mM / il5M~d Public I Village/a5~ 1 1 05~ 1 WEIGHT AT BIRTH (kg) c;l)roc:l~M5) (~N,I.,otln Blood Group/O~d roo~ HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5) I MTP>12I I Spontaneous I ANM SMS Reports ANC Visits, Delivery, Child Immuniza5on, S5ll Births Pregnancy RegistraAon / ANC1 WEB THO/ PHC Annex 1 & 2 from Thayi card collected 1-‐2 / week Year/c::i~F Primary Health Centrel ~qic:J:l5 eMe~ 5eog Namel Ii~F~ • Ne® :::!:; Address lli~FIT! ~e® -- Husband 05;!jct: ~fClF ,:)Qt);!j: I fJO~6 10~ Name I lio~c:j Phone No I ~o;;m~ 05~ro Age Ic::i®~ I~ I Caste: ze<)o SC 1 1 ST Others 11 1 Linked facility for delivery ;!jO~6 ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj 1 ICHCII TH 11 OH 1 IpVTI PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ - . ... v sc IlpHCI Name of ANM /wwi1woo;jo il5fJo:: ffiMoi""i:Tle;~~;j c ::l~ O;:E05 ---------~-------------------------------------------------~------------------------------------ Talukl...,~tl District/ee; M Mother Card Nol ...,~ ~t!"r ~o~1i 205595~ Manual Data Entry from Thayi Card Mother/Pregnancy Registra5on X I I I I Delivery / Child Registra5on Primary Health Centrel ~qic:J:l5 eMe~ 5wg Sub Center/ero~5fo~ City/Mohalla/c:!~re Year/c::i~F ~a5I!_:], DATE OF DELlVERY/ffiM()jj;)d PLACE OF DELIVERY Home / il5M~d Public I ~Q Private ANM Thursday, July 5, 12 Abortion Type / T1QF~3d 5e'; Normal 1 1 CS I Yes llio~ 1 I Yes 1 []£J [EQJ OPV O/L,;.;c:l-O(t:J~05) I MTP<12I [QJmwDJW[]J Instrumental/ 11 Forcees 1 SEX (Male/Female)/ mro;);J ~oK I wi:lalclrn~;:;i~Mo.te (t:JMlO5) 1 DATE OF DISCHARGE ~~1£!3'F ::10ClNolO5 BREAST FEEDING WITHIN I HOUR BCG/~AI~ OUTCOME NOS 0= Still Birth COMPLICATIONS M~M ffiMo.te Date of JSY Payment / 23w;:fc::1~ o:-.c:i';,I.,O ONolOo ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t Village/a5~ t:JMlO5 DELIVERY TYPE ()jj;)c::i5~';0.i:l ffiMo:mM Generated Reports Work Plan 1 Village/a5~ Date of Birth of pregnant womenl Ii2:FIT! Ne® iIDWd t:Jc::E05/ • :£ c.... JSY Beneficiary ~w;::;<c:3elcpt,<)ot~c:loi:e Yes Phone No of Whom loSJ'<;oMOWil~ j;:loe;OQ50!c:3affiJ"a~~o/~~a 2055958 Mother Card Nol ...,~ ~t!"F ~o~,;· .1 Sub Center/W~5eog ~reF SMS SMS Talukl...,~tl DistricVZ;'l~: MCTS 1 1 05~ 1 WEIGHT AT BIRTH (kg) c;l)roc:l~M5) (~N,I.,otln Blood Group/O~d roo~ HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5) I MTP>12I I Spontaneous I ANM SMS Reports ANC Visits, Delivery, Child Immuniza5on, S5ll Births ANM SMS Reminders / Monthly AcAon Plan ANC Visits, Delivery, Child Immuniza5on, S5ll Births 4252 789456123 OPV1 101210 ANM ID Thursday, July 5, 12 THAYI CARD # SERVICE CODE DATE 10~j;:loe;OQ50!c:3affiJ"a~~o/~~a ~~F~ ~oofjo;i).) oilu~ eMeTh ;!jo~oj.)e2 alM c:iT:lt31.iMr.;! ex: ~ oj.)m;;ufj sc IlpHCI . ... v ICHCII TH 11 OH 1 IpVTI Delivery/Child RegistraAon 1 Name of ANM /wwi1woo;jo il5fJo:: PhoneNo of ANM ;)wi1cJOO:::lCi 11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ Name of ASHAj::1m5<~Fo:!F~ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ il5::;dJ - ffiMoi""i:Tle;~~;j c ::l~ O;:E05 ---------~-------------------------------------------------~------------------------------------ District/ee; Talukl...,~tl Mother Card Nol ...,~ ~t!"r ~o~1i Primary Health Centrel ~qic:J:l5 eMe~ 5wg Sub Center/ero~5fo~ Village/a5~ City/Mohalla/c:!~re Year/c::i~F OUTCOME NOS 0= Still Birth M ~a5I!_:], DATE OF DELlVERY/ffiM()jj;)d PLACE OF DELIVERY I Home I I Public t:JMlO5 DELIVERY TYPE ()jj;)c::i5~';0.i:l ffiMo:mM / il5M~d I I ~Q Private BCG/~AI~ wi:lalclrn~;:;i~Mo.te (t:JMlO5) Abortion Type / T1QF~3d 5e'; Thursday, July 5, 12 1 1 CS I Yes llio~ 1 I Yes 1 []£J [EQJ OPV O/L,;.;c:l-O(t:J~05) I MTP<12I [QJmwDJW[]J Instrumental/ 11 Forcees 1 1 05~ 1 WEIGHT AT BIRTH (kg) c;l)roc:l~M5) (~N,I.,otln Blood Group/O~d roo~ HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5) I MTP>12I I Spontaneous 1 X SEX (Male/Female)/ mro;);J ~oK I BREAST FEEDING WITHIN I HOUR ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t Normal DATE OF DISCHARGE ~~1£!3'F ::10ClNolO5 COMPLICATIONS M~M ffiMo.te Date of JSY Payment / 23w;:fc::1~ o:-.c:i';,I.,O ONolOo 1 205595~ I Mothers and ASHA’s IncenAvised ft -suo 11\)""\ ••• ~ U ° !3-~ 3";J:J 0 -a~ ~ B cO I <l:: -aM _ 'Jll: {&'1 ~ "D -a Cl 12 l3 ~ 1:: 6- (J £ ;J 18 () ~ R) a, ~ g fj QC 13:: ~ :.3 13 onv -gn "R.g o l"" ~C'lJ 13 13a 13' l'" o't> '3 V"R_ e~ _f.! {j '16)' "R-:J'll :D fj ~ ;J 13 :.3 -B ~ "hl' 0 66) 'Ji Q 'b 0 fJ ..J ~ .•.. 11\) 'lJ l'" 0 ° liJ 1ii 1ii 0 " -B 'Ji 66) Q e -B kj') :D 'lD 0 .•.. 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II fl -2' D 2 'ID :D ~ 13""\ ° ~liJ ~ ~ I .. 10 0 ~II :~ 13""\ I : ··c fl 13 I I I 'lZ "R"l I I 1'1 @'l> a I ~ C »~.., 13""\ ~ 'rZ Dt ~ ° ~ 13""\ ° D! 'lP ° ~ o 'Ji 16)") e {1"hl") :3 ~ -? .Q fJ .i (j _ lPG tJ ;3 "R 13 13 «: 1: -§ -§ 0 or:: 18 lP ~ 1» 'Ji 'Ji ~ 6 B ~ 'l: ~. 0 (J 'lfJ 'RG ~ liJ 66) 1: ---------------------------------~----------------------------------------------------------------------~-------- ~II l0 L~ C.) .N 0 "R I I 13- ~ lA, 13 ~ 6 3 e -~ r& 1P~ %/'I'<'<!l) i.~-::t~iiJ'J a e ~ . L ~.:.. __ .a "R n "R Q 11\) 'lP n n "R .g -.. I . . M 13 13a ~ ill 'tl •..• 00'1 .tJ 'la ~ •..• :" 13 I : I I I iI 'lJ'" ~ : 8 -i t] fl I I I ;0 18 ~ q:g cO '3 _ _' Thursday, July 5, 12 ._~ Registered private hospital for caesarean-‐secAon Rs. 1500 ($26 USD) --------------------------------~--------------------- ~ For InsAtuAonal Delivery (Rural Areas) Rs. 600-‐700 ($12 USD) ~-------.::2'_'-~ Home delivery Rs. 500 (~ $10 USD) Madilu Kits Given to BPL Mothers at Birth Thursday, July 5, 12 Thursday, July 5, 12 Current DrishA System CommCare Thayi Forms Thayi Forms (XML) PaDent Data Schedules / Work Plans DrishA Android ANM Thursday, July 5, 12 DrishA (MoTECH) Thayi Form Data (SMS) MCTS IVR Reminders SMS Reminders ASHA Women&&&Children Mother/Child Client Registry Thursday, July 5, 12 Client Registries Maternal Thursday, July 5, 12 Child Family Planning Birth Expected Date of Delivery Immunization ANC Services Growth Monitoring Pregnancy Status Vital Events Last Seen Last Seen
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