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Primary'Health'Center
sub$center
Household
MO
ANM
ASHA
Women&&&Children
2
3
4
1
Auxiliary Nurse Midwives (sub-‐centers)Professional Staff with 6 months+ training
ASHAVoluntary Community Health Care Workers
Medical Officer Primary Health Care Center (PHC)
NaAonal Rural Health Mission (NRHM)
Eligible CouplesAll women of reproducDve age registered as an
Eligible Couple
Thursday, July 5, 12
#ili~ (~~~~~)~)'~O.~i~ ~ ~o:D ~~ ~ro;)~~d~ ~~f""\l 2( (.:l~ n~F~~CM Net!t.3e~) '-- ----'
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20~~958
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Thayi CardThursday, July 5, 12
#ili~ (~~~~~)~)'~O.~i~ ~ ~o:D ~~ ~ro;)~~d~ ~~f""\l 2( (.:l~ n~F~~CM Net!t.3e~) '-- ----'
~~~~ ~~~rn ~M~7l~~~om~~~ ;;:l~11~~ ~~~~ ~~~~
20~~958
I M~o~ nz;lF"r-$(50~ ~~cm~./ o:m~)
<iifil~D "'I~D
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~eh~ ~~ 1 ~eh~ ~onc! 1 "'I~O 1~=~w~v~v:!l : ~~to~ 1 1 ~td~ 1 1 o:mt;lvW.:l51:=====:
~~ht~ 1 1 ~t:5w 1 1 "'I~O LI _-----'
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~c:3 ;;:lo&3v: t:)~~: ~;;:l ~~t:5 rod.:l~: .
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Thayi Card
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Thursday, July 5, 12
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Thayi CardThursday, July 5, 12
Pregnancy RegistraAon / ANC1
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
Thursday, July 5, 12
Pregnancy RegistraAon / ANC1
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
THO/ PHC
Manual Data Entry from Thayi Card Mother/Pregnancy Registra5onDelivery / Child Registra5on
ANM
MCTS
Thursday, July 5, 12
Pregnancy RegistraAon / ANC1
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
THO/ PHC
Manual Data Entry from Thayi Card Mother/Pregnancy Registra5onDelivery / Child Registra5on
Annex 1 & 2 from Thayi cardcollected 1-‐2 / week
ANM
MCTS
Thursday, July 5, 12
Pregnancy RegistraAon / ANC1
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
THO/ PHC
Manual Data Entry from Thayi Card Mother/Pregnancy Registra5onDelivery / Child Registra5on
Annex 1 & 2 from Thayi cardcollected 1-‐2 / week
ANM
MCTS WEB
Thursday, July 5, 12
Pregnancy RegistraAon / ANC1
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
THO/ PHC
Manual Data Entry from Thayi Card Mother/Pregnancy Registra5onDelivery / Child Registra5on
Annex 1 & 2 from Thayi cardcollected 1-‐2 / week
ANM
MCTS WEB
Thursday, July 5, 12
Pregnancy RegistraAon / ANC1
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
THO/ PHC
Manual Data Entry from Thayi Card Mother/Pregnancy Registra5onDelivery / Child Registra5on
Annex 1 & 2 from Thayi cardcollected 1-‐2 / week
ANM
MCTS WEB
SMS ReportsANC Visits, Delivery, Child Immuniza5on,
S5ll Births
SMS
ANM
Thursday, July 5, 12
Pregnancy RegistraAon / ANC1
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
THO/ PHC
Manual Data Entry from Thayi Card Mother/Pregnancy Registra5onDelivery / Child Registra5on
Annex 1 & 2 from Thayi cardcollected 1-‐2 / week
ANM
MCTS WEB
SMS ReportsANC Visits, Delivery, Child Immuniza5on,
S5ll Births
SMS
ANM
SMS
SMS Reminders /Monthly AcAon PlanANC Visits, Delivery, Child Immuniza5on,
S5ll Births
WorkPlan
Generated Reports
ANM
Thursday, July 5, 12
Delivery/Child RegistraAon
DistricVZ;'l~: Talukl...,~tl Year/c::i~F Mother Card Nol 2055958...,~ ~t!"F ~o~,;·
Primary Health Centrel .1 Sub Center/W~5eog 1 Village/a5~~qic:J:l5 eMe~ 5eog
Namel Ii~F~ Ne® ~reF 05;!jct: Husband Name I lio~c:j 05~ro• :::!:;
--Address lli~FIT! ~e® ~fClF ,:)Qt);!j: Date of Birth of pregnant womenl Age Ic::i®~
Ii2:FIT! Ne® iIDWd t:Jc::E05/• :£ c....
JSY Beneficiary Caste: I~w;::;<c:3elcpt,<)ot~c:loi:e I Yes I ~ SC 1 1
ST 11 Others 1ze<)o
Phone No of Whom loSJ'<;oMOWil~ fJO~6 Phone No I ~o;;m~ ;!jO~6 Linked facility for delivery10~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 .v ...
1 sc IlpHCI ICHCII TH 11 OH 1 IpVTIName of ANM /wwi1woo;jo il5fJo:: PhoneNoofANM;)wi1cJOO:::lCi11'iio:::lO~ ::;o.ti"Name of Facility/ ~~ ffiMoi""i:Tle;~~;j ::l~
Name of ASHAj::1m5<~Fo:!F~ il5::;dJ PhoneNoofASHAlt:~~~F53Fx')MO;;r::r.::;o~; LMP Date / ar.~~ ~~~ O;:E05c
----------~-------------------------------------------------~------------------------------------
District/ee; Talukl...,~tl Mother Card Nol 205595~M ...,~ ~t!"r ~o~1i
Primary Health Centrel Sub Center/ero~5fo~ Village/a5~~qic:J:l5 eMe~ 5wg
City/Mohalla/c:!~re ~a5I!_:], Year/c::i~F OUTCOME NOS [QJmwDJW[]J0= Still Birth
DATE OF DELlVERY/ffiM()jj;)d t:JMlO5 DELIVERY TYPE()jj;)c::i5~';0.i:l ffiMo:mM 1 Normal 1 1 CS 11 Instrumental/ Forcees 1
XPLACE OF DELIVERY / il5M~d ~Q DATEOF DISCHARGE SEX (Male/Female)/ mro;);J ~oK~~1£!3'F ::10ClNolO5I Home I I Public I I Private I llio~ 1 1 05~ 1
Date of JSY Payment / COMPLICATIONS1 Yes 1 []£J WEIGHT AT BIRTH (kg)
23w;:fc::1~o:-.c:i';,I.,OONolOo M~M ffiMo.te (~N,I.,otln c;l)roc:l~M5)
BREAST FEEDING WITHIN I HOUR I Yes I [EQJ Blood Group/O~d roo~ffiMoiJ<)d I ~,I.,c:ir.JQ71 ~~o:t wi:lalclrn~;:;i~Mo.te
BCG/~AI~ (t:JMlO5) OPV O/L,;.;c:l-O(t:J~05) HEP-BI-a3C:::~elW;::;<-~1 (t:JMlC5)
Abortion Type / T1QF~3d 5e'; I MTP<12I I MTP>12I I Spontaneous I
Thursday, July 5, 12
Home delivery Rs. 500 (~ $10 USD)
For InsAtuAonal Delivery (Rural Areas)
Rs. 600-‐700 ($12 USD)
Registered private hospital for caesarean-‐secAon
Rs. 1500 ($26 USD)
Mothers and ASHA’s IncenAvised---------------------------------~----------------------------------------------------------------------~--------
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Thursday, July 5, 12
Current DrishA System
MCTS CommCare
ANM
DrishA (MoTECH)
Thayi FormsSchedules / Work Plans
DrishA Android
PaDent Data
ASHA Women&&&Children
SMS Reminders
Thayi Forms(XML)
Thayi Form Data(SMS)
IVR Reminders
Thursday, July 5, 12