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  • RI Tally Sheet & Due List Format

    Загружено:

    nirvana.7
    1K просмотров1 страница
    This document is a tally sheet tracking vaccination and vitamin A distribution for a health session. It lists beneficiaries by name, age, caste, vaccines received, and supplies utilized. Key information recorded includes the total number of beneficiaries, vaccines distributed, and unused supplies to be returned. The sheet is signed by the attending ANM and community health workers.

    Исходное описание:

    & Due List Format

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    © © All Rights Reserved

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    This document is a tally sheet tracking vaccination and vitamin A distribution for a health session. It lists beneficiaries by name, age, caste, vaccines received, and supplies utilized. Key information recorded includes the total number of beneficiaries, vaccines distributed, and unused supplies to be returned. The sheet is signed by the attending ANM and community health workers.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    1K просмотров1 страница

    RI Tally Sheet & Due List Format

    Загружено:

    nirvana.7
    This document is a tally sheet tracking vaccination and vitamin A distribution for a health session. It lists beneficiaries by name, age, caste, vaccines received, and supplies utilized. Key information recorded includes the total number of beneficiaries, vaccines distributed, and unused supplies to be returned. The sheet is signed by the attending ANM and community health workers.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 1

    DUE BENEFICIARY CUM TALLY SHEET

    SC:

    PHC(N):

    TOTAL
    MORE THAN 1 YEAR
    ITEM
    0.5 ml ADS
    Received
    Utilized
    Return opened
    Return unopened
    Name of ANM:
    Name of ASHA/ AWW/ Mobilizers:

    0.1 ml ADS

    District:

    Vit A

    TT

    Measles
    2

    16 Yr

    10 Yr

    DPT 5 Yr

    DPT

    OPV

    TT (PW)

    Hepatitis
    B

    Vaccination and Vitamin A given

    LESS THAN 1 YEAR

    Block:

    Caste

    BCG

    Age in Name of Father/ Mother


    months

    Others

    Name of Beneficiary - list Sex


    to be updated as due list M/F

    ST

    Session Site:

    SC

    Date:

    MALE
    FEMALE
    MALE
    FEMALE

    5 ml Syringe

    BCG vials

    DPT vials

    Signature of ANM:
    Signature of ASHA/ AWW/ Mobilizers:

    OPV vials

    Measles vials

    TT vials

    HepB vials

    Beneficiaries
    who did not
    come for the
    session - to be
    included in due
    list for next
    session

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