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MCH - Tracking Formats
MCH - Tracking Formats
Notes 1) Use State, District, SubDist and Village ID as per Census 2011 proposed codes PREGNANT WOMAN TRACKING
2) For RURAL entry State, District,SubDist,HealthBlock ID, PHC ID, SubCentre ID and Village ID are compulsory Location Details State District
Vishakapatn
3) For URBAN entry State, District, SubDist, (PPU ID or UHC ID) are compulsory Andhra Pradesh am
Rural area compulsory fields Urban area compulsary fields
These are the location code fields required for e-Mamta 1 5 6 7
28 13 40 29 1 RAJAYAPETA RAJAYAPETA
28 13 40 29
2 PEDDA TEENARLA PEDDA TEENARLA
28 13 40 29 3 NAMAVARAM AYYANAPALEM
28 13 40 29
4 RAJAYAPETA BOYAPADU
28 13 40 29
5 RAJAYAPETA BOYAPADU
28 13 40 29
6 RAJAYAPETA RAJAYANAGARAM
28 13 40 29
7 RAJAYAPETA POLAVARAM
28 13 40 29
8 RAJAYAPETA RAJAYAPETA
28 13 40 29
9 RAJAYAPETA BOYAPADU
10 RAJAYAPETA RAJAYAPETA
11 RAJAYAPETA RAJAYAPETA
12 UPAMAKA PENIGOLLU
13
14
15
16
17
18
19
20
PREGNANT WOMAN TRACKING
Identification Details
8 9 10.1 10.2 11 12 13
Phone
Husband's Phone Date of Birth JSY Caste
Name Number (SC/ST/
name Number Beneficiary
Others)
of Whom
Author:
PREGNANT WOMAN TRACKING (Booster is required
only for those women
who have been
previously immunised
and hence require only
Health Provider Details single
ANC Checkup Details Date to be specified dose)
(dd/mm/yyyy)
14 15 16 17 18 19.1 19.2 20 21 22 23 24 25 26
r:
er is required
PREGNANT WOMAN TRACKING
r those women
ave been
usly immunised
nce require only
dose) ANC Details Date to be specified (dd/mm/yyyy) Pregnency Outcome Pregnency Outcome
27 28 29 30 31.1 31.2 32 33.1 33.2 33.3 34 35 36 37 38
Abortion
(MTP<12/
Complication Delivery Type MTP>12
IFA tablets Anemia (Hypertensive / Date of Place of delivery (Home-Type/ (Normal Date of Discharge /Spontaneou
TT Booster Whether HIV s /None)
given (Date (Moderate Diabetics / RTI/STI Delivery Institutional-Type) /CS Complications from Institution (if JSY Benefits
on which <11/Severe APH test Done (Y/N) (dd/mm/yyy (Y/N) applicable) paid(Date) (If
100 IFA Tabs <7/Normal) /Malaria / (Y?N) y) /Instrumenta (dd/mm/yyyy) None,
completed) None) l) then other
details
Home Type Public Private to
Date Date be filled)
7/28/2010 (Moderate<1 None Yes No 11/23/2010 Non SBA Sub Centre Normal No None
1
(Moderate<1
1 None Yes No 8/23/2010 Non SBA PHC Normal No 8/24/2010 None
8/21/2010 Severe<7 None Yes No 10/28/2010 Non SBA Sub Centre Normal No None
PNC
PNC Home Complicati Post Partum Outcome
Visit ons (PPH/ Contraception PNC Numbers
( Within Sepsis/ Method Checkup (0/1/2/3/4/5)
48 hours Death/ (Sterilisation/IU (Y/N) 0=Still Birth
/7 days) Others/ D/Injectibles)
None)
Infant Details
44.1 44.2 44.3 44.4 45.1 45.2 45.3 45.4
2) For RURAL entry State, District,SubDist,HealthBlock ID, PHC ID, SubCentre ID and Village ID are compulsory Location Details State District
3) For URBAN entry State, District, SubDist, (PPU ID or UHC ID) are compulsory Andhra Pradesh
Rural area compulsory fields Urban area compulsary fields
These are the location code fields required for e-Mamta 1 4 6 7
PPU ID UHC ID (For
Disctrict SubDist Health SubCentre Anganwadi Rural (For urban urban area
State Code PHC ID Village ID ID (If not Urban area this is S.No City/ Mohalla Gram Panchayat/Village Address
Code Code Block ID ID then 0) (R/U) must if this is must if
UHC ID=0) PPU ID=0)
11
12
13
14
15
16
17
18
19
20
21
22
Child Immunization tracking (for each child)
Sub-District
Identification Details
8 9 10.1 10.2
ID No of
ID No. of Child (Unique 16 Name of the Mother's Mother(It
digits as per NRHM /Father's should be
format) Child Name match with
mother sheet)
Father's
Father's
Father's
Father's
Father's
Father's
Father's
Father's
Father's
Father's
Father's
Father's
Identification Details Health Provider Details
11 12 13 14 15 16 17 18
Place of
delivery Blood Group Caste
Phone Number of Whom Number Date of Birth (Home, (SC/ST/Other Name of Sub- Name of ANM
(DD/MM/YY) Public/Private (if available) s) Centre
Institution)