Facility Assessment Health and Wellness Center

Record ID

Actions: Download PDF of instrument(s)

• This data entry form (blank)

Video: Basic data entry

Form 1

You may view an existing record/response by selecting it from one of the drop-down lists below. The records are separated into each drop-down list according to their status for this particular data collection instrument. To create a new record/response, click the button below.

Data Search
Choose a field to search (excludes multiple choice fields)	All fieldsrecord_id (Record ID)name_of_filed_officer (Name of field officer)date_asses (1.1 Date of assessment:)name_invest ( 1.2 Name of the investigator:)name_facili (1.3 Name of the facility:)oth_type ( 1.4.1 Specify Other)gps_crdnts (1.6 GPS coordinates)other_distict_name (Specify Other)other_taluk (Specify others)name_vlg ( 1.8 Name of the village:)dstnc_vlg (1.9 Distance of the facility from village bus stand? in km)total (Total :)slum (Slum :)name_stff (Name of the staff currently available)oth_gendr (Any other, Specify)age (Age (years))oth_desgn ( Other, Specify)edu_oth ( other)name_stff_1 (Name of the staff currently available)oth_gendr_1 (Any other, Specify)age_1 ( Age (years))oth_desgn_1 (Other, Specify)edu_oth_1 (other)name_stff_2 (Name of the staff currently available)oth_gendr_2 (Any other, Specify)age_2 ( Age (years))oth_desgn_2 (Other, Specify)edu_oth_2 (other)name_stff_3 (Name of the staff currently available)oth_gendr_3 (Any other, Specify)age_3 ( Age (years))oth_desgn_3 (Other, Specify)edu_oth_3 (other)name_stff_4 (Name of the staff currently available)oth_gendr_4 (Any other, Specify)age_4 ( Age (years))oth_desgn_4 (Other, Specify)edu_oth_4 (other)name_stff_5 (Name of the staff currently available)oth_gendr_5 (Any other, Specify)age_5 ( Age (years))oth_desgn_5 (Other, Specify)edu_oth_5 (other)name_stff_6 (Name of the staff currently available)oth_gendr_6 (Any other, Specify)age_6 ( Age (years))oth_desgn_6 (Other, Specify)edu_oth_6 (other)name_stff_7 (Name of the staff currently available)oth_gendr_7 (Any other, Specify)age_7 ( Age (years))oth_desgn_7 (Other, Specify)edu_oth_7 (other)name_stff_8 (Name of the staff currently available)oth_gendr_8 (Any other, Specify)age_8 ( Age (years))oth_desgn_8 (Other, Specify)edu_oth_8 (other)name_stff_9 (Name of the staff currently available)oth_gendr_9 (Any other, Specify)age_9 ( Age (years))oth_desgn_9 (Other, Specify)edu_oth_9 (other)name_stff_10 (Name of the staff currently available)oth_gendr_10 (Any other, Specify)age_10 ( Age (years))oth_desgn_10 (Other, Specify)edu_oth_10 (other)name_stff_11 (Name of the staff currently available)oth_gendr_11 (Any other, Specify)age_11 ( Age (years))oth_desgn_11 (Other, Specify)edu_oth_11 (other)name_stff_12 (Name of the staff currently available)oth_gendr_12 (Any other, Specify)age_12 ( Age (years))oth_desgn_12 (Other, Specify)edu_oth_12 (other)name_stff_13 (Name of the staff currently available)oth_gendr_13 (Any other, Specify)age_13 ( Age (years))oth_desgn_13 (Other, Specify)edu_oth_13 (other)name_stff_14 (Name of the staff currently available)oth_gendr_14 (Any other, Specify)age_14 ( Age (years))oth_desgn_14 (Other, Specify)edu_oth_14 (other)name_stff_15 (Name of the staff currently available)oth_gendr_15 (Any other, Specify)age_15 ( Age (years))oth_desgn_15 (Other, Specify)edu_oth_15 (other)name_stff_16 (Name of the staff currently available)oth_gendr_16 (Any other, Specify)age_16 ( Age (years))oth_desgn_16 (Other, Specify)edu_oth_16 (other)name_stff_17 (Name of the staff currently available)oth_gendr_17 (Any other, Specify)age_17 ( Age (years))oth_desgn_17 (Other, Specify)edu_oth_17 (other)name_stff_18 (Name of the staff currently available)oth_gendr_18 (Any other, Specify)age_18 ( Age (years))oth_desgn_18 (Other, Specify)edu_oth_18 (other)name_stff_19 (Name of the staff currently available)oth_gendr_19 (Any other, Specify)age_19 ( Age (years))oth_desgn_19 (Other, Specify)edu_oth_19 (other)name_of_month_1 (Name of month 1)name_of_month_3 (Name of month 2)name_of_month_2 (Name of month 3)num_anc_regs_mnt_1 (Number of ANC registration Month 1 )num_anc_regs_mnt_2 (Number of ANC registration Month 2)num_anc_regs_mnt_3 (Number of ANC registration Month 3)no_follow_up_mnth_1 (Number of Follow-up of high-risk pregnancies (H...)no_follow_up_mnth_2 (Number of Follow-up of high-risk pregnancies (H...)no_follow_up_mnth_3 (Number of Follow-up of high-risk pregnancies (H...)no_hrp_rfrd_facili_mnth_1 (Number of HRP referred to higher facilit...)no_hrp_rfrd_facili_mnth_2 (Number of HRP referred to higher facilit...)no_hrp_rfrd_facili_mnth_3 (Number of HRP referred to higher facilit...)no_tt_immuni_mnth_1 (Number of TT Immunization for pregnant women in...)no_tt_immuni_mnth_2 (Number of TT Immunization for pregnant women in...)no_tt_immuni_mnth_3 (Number of TT Immunization for pregnant women in...)no_ifa_provid_mnth_1 (Number of IFA provided in month 1)no_ifa_provid_mnth_2 (Number of IFA provided in month 2)no_ifa_provid_mnth_3 (Number of IFA provided in month 3)no_dspns_tab_mnth_1 (Number of Dispenses Tab Calcium in month 1)no_dspns_tab_mnth_2 (Number of Dispenses Tab Calcium in month 2)no_dspns_tab_mnth_3 (Number of Dispenses Tab Calcium in month 3)no_hb_test_mnth_1 (Number of HB test done in month 1)no_hb_test_mnth_2 (Number of HB test done in month 2)no_hb_test_mnth_3 (Number of HB test done in month 3)no_vdrl_test_mnth_1 (Number of VDRL / Syphilis test done in month 1)no_vdrl_test_mnth_2 (Number of VDRL / Syphilis test done in month 2)no_vdrl_test_mnth_3 (Number of VDRL / Syphilis test done in month 3)no_hiv_done_mnth_1 (No of HIV test done in month 1)no_hiv_done_mnth_2 (No of HIV test done in month 2)no_hiv_done_mnth_3 (No of HIV test done in month 3)no_malar_mnth_1 (No of Malaria test done in month 1 )no_malar_mnth_2 (No of Malaria test done in month 2)no_malar_mnth_3 (No of Malaria test done in month 3)no_hbsag_done_month_1 (No of HbsAg test done in month 1)no_hbsag_done_month_2 (No of HbsAg test done in month 2)no_hbsag_done_month_3 (No of HbsAg test done in month 3)no_albm_done_mnth_1 (No of Albumin test done in month1)no_albm_done_mnth_2 (No of Albumin test done in month2)no_albm_done_mnth_3 (No of Albumin test done in month 3)no_sugar_done_month_1 (Number of sugar test done in month 1)no_sugar_done_month_2 (Number of sugar test done in month 2)no_sugar_done_month_3 (Number of sugar test done in month 3)no_insertion_mnth_1 (Number of Insertion of Cut done in month 1)no_insertion_mnth_2 (Number of Insertion of Cut done in month 2)no_insertion_mnth_3 (Number of Insertion of Cut done in month 3)no_disp_given_month_1 (Number of Dispensing contraceptive pills give...)no_disp_given_month_2 (Number of Dispensing contraceptive pills give...)no_disp_given_month_3 (Number of Dispensing contraceptive pills give...)no_icds_done_month_1 (Number of ICDS Anganwadi referrals done in mo...)no_icds_done_month_2 (Number of ICDS Anganwadi referrals done in mo...)no_icds_done_month_3 (Number of ICDS Anganwadi referrals done in mo...)no_schl_pgrm_mnth_1 (Number of School health program done in month 1)no_schl_pgrm_mnth_2 (Number of School health program done in month 2)no_schl_pgrm_mnth_3 (Number of School health program done in month 3)no_anc_camps_month_1 (Number of ANC camps done in month 1)no_anc_camps_month_2 (Number of ANC camps done in month 2)no_anc_camps_month_3 (Number of ANC camps done in month 3)no_genral_hlth_month_1 (Number of General health camps - Diabetes do...)no_genral_hlth_month_2 (Number of General health camps - Diabetes do...)no_genral_hlth_month_3 (Number of General health camps - Diabetes do...)no_gnrl_thyr_cmp_mnth_1 (Number of General health camps - Thyroid do...)no_gnrl_thyr_cmp_mnth_2 (Number of General health camps - Thyroid do...)no_gnrl_thyr_cmp_mnth_3 (Number of General health camps - Thyroid do...)no_hlth_camps_htn_mnth1 (Number of General health camps - HTN done i...)no_hlth_camps_htn_mnth2 (Number of General health camps - HTN done i...)no_hlth_camps_htn_mnth3 (Number of General health camps - HTN done i...)no_nutrn_ref_mnth_1 (Number of Nutrition rehabilitation referrals do...)no_nutrn_ref_mnth_2 (Number of Nutrition rehabilitation referrals do...)no_nutrn_ref_mnth_3 (Number of Nutrition rehabilitation referrals do...)no_mahila_mnth_1 (Number of Conducting Mahila Arogya Samiti done in ...)no_mahila_mnth_2 (Number of Conducting Mahila Arogya Samiti done in ...)no_mahila_mnth_3 (Number of Conducting Mahila Arogya Samiti done in ...)specify_other (Specify other)no_other_month_1 (Number of Any other related to ANC done in month 1)no_other_month_2 (Number of Any other related to ANC done in month 2)no_other_month_3 (Number of Any other related to ANC done in month 3)spec_antibio ( 4.2.3.a If YES, specify what is available)spec_antihyper ( 4.2.4.a If YES, specify what is available)spec_antidia ( 4.2.5.a If YES, specify what is available)spec_antipyre (4.2.6.a If YES, specify what is available)oth_antntl ( 4.2.8.a If Yes, Specify)oth_spec ( Any other specify)field_investigator_name ( Field Investigator name)date (Date)supervisor_name (Supervisor name)date_2 (Date)taluk_coordinator_name (Taluk coordinator name)date_3 (Date)par_joindate (Install Date)par_joindate_utc (Install Date (UTC))par_timezone (Participant Timezone)par_code (Participant Code)
Search query Begin typing to search the project data, then click an item in the list to navigate to that record.	Searching...

NOTICE: This project is currently in Development status. Real data should NOT be entered until the project has been moved to Production status.