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ANC Coverage process (50)PID 22
My Projects Project Home Project Setup Online Designer Data Dictionary Codebook

The Codebook is a human-readable, read-only version of the project's Data Dictionary and serves as a quick reference for viewing the attributes of any given field in the project without having to download and interpret the Data Dictionary. Note: Checkbox fields have their coded values displayed both in the format defined by users in the Online Designer/Data Dictionary as well as in the extended format seen in data imports and exports (i.e., field___code).

Data Dictionary Codebook 07/05/2025 1:38am
Field finder: — When viewing this page, collapse:
Data Dictionary Codebook
ANC Coverage process (50) (PID: 22)
07/05/2025 1:38am
Instruments
Instrument Form Name
Process Coverage Of Services process_coverage_of_services
# Variable / Field Name Field Label
Field Note
 Field Attributes (Field Type, Validation, Choices, Calculations, etc.)
Instrument:Process Coverage Of Services(process_coverage_of_services)
1 [record_id] Record ID text
2 [par_joindate] Install Date text (datetime_seconds_ymd)
Field Annotation: @MC-PARTICIPANT-JOINDATE @HIDDEN
3 [par_joindate_utc] Install Date (UTC) text (datetime_seconds_ymd)
Field Annotation: @MC-PARTICIPANT-JOINDATE-UTC @HIDDEN
4 [par_timezone] Participant Timezone text
Field Annotation: @MC-PARTICIPANT-TIMEZONE @HIDDEN
5 [par_code] Participant Code text
Field Annotation: @MC-PARTICIPANT-CODE @HIDDEN
6 [nurse_name] Field Nurse name text, Required
7 [mcp_card] Section 1: Demographic and pregnancy details 1.MCP card available yesno, Required
1Yes
0No
8 [rch_id]
Show the field ONLY if:
[mcp_card] = '1'
1.1 RCH-ID / MCP card text (number, Min: 1.00E+11, Max: 1.00E+12)
Field Annotation: @FORCE-MINMAX @PLACEHOLDER = '12 digit number'
9 [receive_date]
Show the field ONLY if:
[mcp_card] = '1'
Date when received text (date_dmy), Required
Field Annotation: @FORCE-MINMAX
10 [district] 1.1.1 Pregnant woman's District radio, Required
1Sangrur
2Other
11 [other_district_name]
Show the field ONLY if:
[district] = '2'
Other district name text
12 [taluk] 1.1.2 Pregnant woman's Taluk radio, Required
1Sangrur
2Sunam
3Dhuri
4Bhawanigarh
5Moonak
6Other
13 [other_taluka_name]
Show the field ONLY if:
[taluk] = '6'
Other taluka name text
14 [name_of_the_asha] 1.1.3 Name of the ASHA text, Required
15 [mobile_number_of_the_as_ha] 1.1.4 Mobile Number of the ASHA text (number, Min: 1000000000, Max: 9999999999), Required
Field Annotation: @PLACEHOLDER='10 Digits Number' @FORCE-MINMAX
16 [name_of_the_mother] 1.2 Name of the mother text, Required
17 [age_mother] Age of the mother text (number)
18 [name_of_the_spouse] 1.3 Name of the husband text, Required
19 [mobile1] 1.4 Mobile No 1 text (number, Min: 1000000000, Max: 9999999999), Required
Field Annotation: @PLACEHOLDER='10 Digits Number' @FORCE-MINMAX
20 [mobile2] 1.5 Mobile No 2 text (number, Min: 1000000000, Max: 9999999999), Required
Field Annotation: @PLACEHOLDER='10 Digits Number' @FORCE-MINMAX
21 [education] 1.6 Education dropdown, Required
1Formal
2Non - formal
3Informal
22 [ration_card] 1.7 Ration Card yesno, Required
1Yes
0No
23 [yes_ration_card]
Show the field ONLY if:
[ration_card] = '1'
Type of ration card dropdown, Required
1BPL (Green colour)
2APL (Red colour)
3Other
24 [ration_card_other]
Show the field ONLY if:
[yes_ration_card] = '3'
Specify text, Required
25 [caste] 1.8 Caste radio, Required
1General
2SC or ST
3Other
26 [other_caste]
Show the field ONLY if:
[caste] = '3'
Specify text, Required
27 [present_address] 1.9 Present Address House Number and Street :
{house_number_and_street} City / Town / Village name:
{city_town_village_name} District: {district_address} Pin Code : {pin_code} 		descriptive
28 [house_number_and_street] House Number and Street text, Required
29 [city_town_village_name] City / Town / Village Name text, Required
30 [district_address] District radio, Required
1Sangrur
2Other
31 [other_district_name_1]
Show the field ONLY if:
[district_address] = '2'
Other district name text
32 [pin_code] Pin Code text (number), Required
Field Annotation: @FORCE-MINMAX
33 [present_same_address] 1.9.a Is the present address same as the permanent address? yesno, Required
1Yes
0No
34 [permant_addr_2]
Show the field ONLY if:
[present_same_address] = '1'
Permanent address : [house_number_and_street]
[city_town_village_name] [district_address] [pin_code] 		descriptive
35 [permanant_address]
Show the field ONLY if:
[present_same_address] = '0'
1.10 Permanent Address House Number and Street :
{house_number_and_street_2} City / Town / Village
name : {city_town_village_name_2} District :
{district_address_2} Pin Code : {pin_code_2} 		descriptive
36 [house_number_and_street_2] House Number and Street text, Required
37 [city_town_village_name_2] City / Town / Village Name text, Required
38 [district_address_2] District text, Required
39 [pin_code_2] Pin Code text (number), Required
Field Annotation: @FORCE-MINMAX
40 [gravida] Section Header: Section 2 : Obstetric Details2.1 Gravida (number of pregnancies a woman has had)
(Specify number)
 text (number, Min: 1, Max: 15), Required
Field Annotation: @FORCE-MINMAX
41 [parity] 2.2 Parity (number of times a woman has given birth to a baby)
(Specify number)
 text (number, Min: 1, Max: 15), Required
Field Annotation: @FORCE-MINMAX
42 [living] 2.3 Living (number of children living presently)
(Specify number)
 text (number, Min: 0, Max: 20), Required
Field Annotation: @FORCE-MINMAX
43 [abortions] 2.4. Abortions
(Specify number)
 text (number, Min: 0, Max: 10), Required
Field Annotation: @FORCE-MINMAX
44 [mnth_occur]
Show the field ONLY if:
[abortions] >= 1
2.4.a Which month did the first abortion occur? text
45 [scnd_abort]
Show the field ONLY if:
[abortions] >= 2
2.4.b Which month did the second abortion occur? text
46 [stillbirths_confirmation] 2.5 Stillbirths (birth of dead fetes any time after the completion of 20 weeks of gestation) yesno
1Yes
0No
47 [stillbirths]
Show the field ONLY if:
[stillbirths_confirmation] = '1'
Stillbirths (birth of dead fetes any time after the completion of 20 weeks of gestation) text (number, Min: 0, Max: 15)
Field Annotation: @FORCE-MINMAX
48 [stllbrth_1]
Show the field ONLY if:
[stillbirths_confirmation] = '1'
2.5.a Which month did the first stillbirth occur? text (number)
49 [stllbrth_2]
Show the field ONLY if:
[stillbirths_confirmation] = '1'
2.5.b Which month did the second stillbirth occur? text
50 [neontl_count] 2.6 Number of neonatal death (death of baby within 28days of birth) text, Required
51 [neonatal_deaths]
Show the field ONLY if:
[neontl_count] >= 1
2.6 a. Which day of life did first neonatal death occur? text
52 [cause_nd]
Show the field ONLY if:
[neontl_count] >= 1
2.6.b. Cause of first neonatal death text
53 [neontl_dths]
Show the field ONLY if:
[neontl_count] >= 2
2.6.c Which day of life did second neonatal death occur? text
54 [cuse_neontl_dths]
Show the field ONLY if:
[neontl_count] >= 2
2.6.d Cause of second neonatal death text
55 [menstruation_regular] 2.7 Menstruation regular radio, Required
1Regular
2Irregular

Custom alignment: RH
56 [no_of_days_between_cycle] 2.7.1 Number of days between each menstruation cycle whether regular or not text (number, Min: 10, Max: 50), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
57 [lmp] 2.7.2 LMP text (date_dmy), Required
58 [edd] 2.7.3 EDD text (date_dmy, Min: [lmp], Max: 2025-12-31), Required
Field Annotation: @FORCE-MINMAX
59 [periconceptional_care] Part 1 (Periconceptional Care) descriptive
60 [type_cooking_fuel] Section Header: Section 3: Household, Nutrition & Medication details3.1 Type of cooking fuel used (Can answer more than one response) checkbox, Required
1type_cooking_fuel___13.1.1 Solid: firewood/charcoal/cow dung
2type_cooking_fuel___23.1.2 Liquid: kerosene
3type_cooking_fuel___33.1.3 Gas: LPG/Gobar
61 [kitchen] 3.2 Kitchen (Can answer only ONE response) radio, Required
13.2.1 With chimney
23.2.2 With exhaust fan
33.2.3 With outlet pipe
43.2.4 With no ventilation
53.2.5 With Window
62 [tobacco] 3.3 Chewing tobacco and smoking yesno, Required
1Yes
0No
63 [another_smoke_inside_home] 3.4 Another household member who smokes inside the
house 		yesno, Required
1Yes
0No
64 [screen_spcfc_dses] 3.5 Screening for specific diseases checkbox, Required
1screen_spcfc_dses___13.5.1 Anemia
2screen_spcfc_dses___23.5.2 Thyroid
3screen_spcfc_dses___33.5.3 Diabetes
4screen_spcfc_dses___43.5.4 Hypertension
5screen_spcfc_dses___53.5.5 Others
6screen_spcfc_dses___63.5.6 None
65 [oth_spcfy_3]
Show the field ONLY if:
[screen_spcfc_dses(5)] = '1'
Specify text, Required
66 [contracep_3] 3.6 Did you use any contraception
(pills/natural/condom/IUCD) before pregnancy? 		yesno, Required
1Yes
0No
67 [rcvd_angawd] 3.7 Received services from Anganwadi yesno, Required
1Yes
0No
68 [spcl_medi_3] 3.8 Special Medication yesno, Required
1Yes
0No
69 [sm_high_dose_flic_acd_prec]
Show the field ONLY if:
[spcl_medi_3]='1'
3.8.1 High dose Folic acid (0.5g per day) prescribed yesno, Required
1Yes
0No
70 [sm_took_medication]
Show the field ONLY if:
[sm_high_dose_flic_acd_prec] = '1'
Medication was prescribed, then did you take the medication (folic acid) yesno, Required
1Yes
0No
71 [sp_fa_tablets_bought]
Show the field ONLY if:
[sm_took_medication] = '1'
How many tablets were bought/given? text (number)
Field Annotation: @FORCE-MINMAX
72 [sp_fa_tablets_consumed]
Show the field ONLY if:
[sm_took_medication] = '1'
How many tablets were consumed? text (number)
Field Annotation: @FORCE-MINMAX
73 [sm_iron_prescribed]
Show the field ONLY if:
[spcl_medi_3]="1"
3.8.2 Weekly Iron Supplementation prescribed yesno, Required
1Yes
0No
74 [sm_took_iron_medication]
Show the field ONLY if:
[sm_iron_prescribed] = '1'
Medication was prescribed, then did you take the medication (Iron) yesno, Required
1Yes
0No
75 [sm_iron_tab_bought]
Show the field ONLY if:
[sm_took_iron_medication] = '1'
How many tablets were bought/given? text (number), Required
Field Annotation: @FORCE-MINMAX
76 [sm_iron_tab_consumed]
Show the field ONLY if:
[sm_took_iron_medication] = '1'
How many tablets were consumed? text (number), Required
Field Annotation: @FORCE-MINMAX
77 [anc_done] Section Header: Part 2 (Antenatal Care) Section 4 : Details of ANC visit4.1 ANC visit done yesno, Required
1Yes
0No
78 [yes_howmny_anc]
Show the field ONLY if:
[anc_done] = '1'
How many ANC visits did you have for this pregnancy? text (number, Min: 1, Max: 8), Required
Field Annotation: @FORCE-MINMAX
79 [why_no_anc]
Show the field ONLY if:
[anc_done] = '0'
Why did you not go for any ANC? text, Required
80 [obtained_previous_pregn_ancy_history_and_recorde_d]
Show the field ONLY if:
[anc_done] = '1'
4.2 Was previous pregnancy history obtained andrecorded?[If Primi mothers choose not applicable] radio, Required
1Yes
2No
3Not applicable
81 [opn_previous_preg_histry]
Show the field ONLY if:
[anc_done] = '1'
4.2.0 Anything specific you want to highlight about the previous pregnancy history obtained and
recorded? 		text
82 [complication_previous_p_regnancy]
Show the field ONLY if:
[obtained_previous_pregn_ancy_history_and_recorde_d] = '1'
4.2.1 Was there any complication/problem in any previous pregnancy? yesno, Required
1Yes
0No

Custom alignment: RH
83 [previous_preg_history]
Show the field ONLY if:
[complication_previous_p_regnancy]='1'
4.2.2. If YES, specify all that apply for any complication/problem in any previous pregnancy?[Can answer more than one response] checkbox, Required
1previous_preg_history___1Bleeding during pregnancy (APH)
2previous_preg_history___2Preeclampsia/Eclampsia/PIH (BP >140/90)
3previous_preg_history___3Anemia/Severe Anemia (Hb < 7gm/dl)
4previous_preg_history___4Previous LSCS
5previous_preg_history___5Birth injuries during delivery
6previous_preg_history___6Baby with congenital abnormalities
7previous_preg_history___7Recurrent abortion
8previous_preg_history___8Gestational diabetes
9previous_preg_history___9Rh-Negative mother
10previous_preg_history___10Puerperal sepsis
11previous_preg_history___11Preterm delivery (< 36 weeks of gestation)
12previous_preg_history___12LBW baby (< 2500 grams)
13previous_preg_history___13Others
84 [previous_lscs_if_yes_sp_ecify_reason]
Show the field ONLY if:
[previous_preg_history(4)] = '1'
LSCS: If YES, specify reason text, Required
85 [baby_with_congenital_ab_normalities_if_yes_speci_fy]
Show the field ONLY if:
[previous_preg_history(6)] = '1'
 Specify (Baby with congenital abnormalities)   text, Required
86 [others_specify_complica_tion_pre_preg]
Show the field ONLY if:
[previous_preg_history(13)] = '1'
Specify Other text
87 [medical_problem_prev_pr_eg]
Show the field ONLY if:
[obtained_previous_pregn_ancy_history_and_recorde_d] = '1'
4.3 Has been diagnosed with any medical problem before the present pregnancy? yesno, Required
1Yes
0No
88 [specify_medical_prob_pr_ev_preg]
Show the field ONLY if:
[medical_problem_prev_pr_eg]='1'
4.3.1 IF YES, Specify medical problem during the previous pregnancy checkbox, Required
1specify_medical_prob_pr_ev_preg___1Tuberculosis
2specify_medical_prob_pr_ev_preg___2Hypertension
3specify_medical_prob_pr_ev_preg___3Heart disease
4specify_medical_prob_pr_ev_preg___4Diabetes mellitus
5specify_medical_prob_pr_ev_preg___5Other
89 [other_medical_prob_prev_preg]
Show the field ONLY if:
[specify_medical_prob_pr_ev_preg(5)] = '1'
Specify text, Required
Custom alignment: RH
90 [first_anc]
Show the field ONLY if:
[yes_howmny_anc] >= 1
First anc yesno
1Yes
0No
91 [date_anc_visits_a1]
Show the field ONLY if:
[first_anc] = '1'
Date of 1st ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
92 [gestational_ages_a1]
Show the field ONLY if:
[first_anc] = '1'
Gestational age at 1st ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
93 [months_amenorrhea_a1]
Show the field ONLY if:
[first_anc] = '1'
Months of amenorrhea at 1st ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
94 [place_of_anc_visit_1]
Show the field ONLY if:
[first_anc] = '1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_1___1PHC
2place_of_anc_visit_1___2CHC
3place_of_anc_visit_1___3TH / SDH
4place_of_anc_visit_1___4DH
5place_of_anc_visit_1___5SC-HWC
6place_of_anc_visit_1___6Private Maternity homes
7place_of_anc_visit_1___7Private Hospital
95 [seen_by_1]
Show the field ONLY if:
[first_anc] = '1'
Seen by checkbox, Required
1seen_by_1___1Doctor
2seen_by_1___2Nurse
3seen_by_1___3ANM

Custom alignment: RH
96 [vomiting_anc_vst_1]
Show the field ONLY if:
[first_anc] = '1'
Vomiting yesno, Required
1Yes
0No
97 [incresed_frequncy_burning_passing_urine_anc_visit_1]
Show the field ONLY if:
[first_anc] = '1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
98 [breathles_tiredne_anc_vst_1]
Show the field ONLY if:
[first_anc] = '1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
99 [headache_blurred_vision_anc_vst_1]
Show the field ONLY if:
[first_anc] = '1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
100 [jaundice_anc_vst_1]
Show the field ONLY if:
[first_anc] = '1'
Jaundice yesno, Required
1Yes
0No
101 [abdominal_pain_anc_vst_1]
Show the field ONLY if:
[first_anc] = '1'
Abdominal pain yesno, Required
1Yes
0No
102 [bleeding_per_vagina_anc_vst_1]
Show the field ONLY if:
[first_anc] = '1'
Bleeding per vagina yesno, Required
1Yes
0No
103 [abrmal_vaginal_discharg_anc_visit_1]
Show the field ONLY if:
[first_anc] = '1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
104 [trtmnt_conception_anc_visit_1]
Show the field ONLY if:
[first_anc] = '1'
Treatment for conception yesno, Required
1Yes
0No
105 [fever_anc_vst_1]
Show the field ONLY if:
[first_anc] = '1'
Fever yesno
1Yes
0No
106 [other_anc_vist_1]
Show the field ONLY if:
[first_anc] = '1'
Other yesno
1Yes
0No
107 [other_specify_anc_visit_1]
Show the field ONLY if:
[other_anc_vist_1]='1'
Other, specify text
108 [ht_checked_anc_visit_1]
Show the field ONLY if:
[first_anc] = '1'
Height checked for ANC visit 1 yesno, Required
1Yes
0No

Custom alignment: RH
109 [checked_height_a1]
Show the field ONLY if:
[ht_checked_anc_visit_1] = '1'
Height at the 1st ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
110 [wt_checked_anc_visit_1]
Show the field ONLY if:
[first_anc] = '1'
Weight checked for ANC visit 1 yesno, Required
1Yes
0No

Custom alignment: RH
111 [checked_weight_a1]
Show the field ONLY if:
[wt_checked_anc_visit_1] = '1'
Weight at the 1st ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
112 [bp_checked_anc_visit_1]
Show the field ONLY if:
[first_anc] = '1'
Blood Pressure checked for ANC visit 1 yesno, Required
1Yes
0No

Custom alignment: RH
113 [checked_sbp_a1]
Show the field ONLY if:
[bp_checked_anc_visit_1] = '1'
SBP value at the 1st ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
114 [checked_dbp_a1]
Show the field ONLY if:
[bp_checked_anc_visit_1] = '1'
DBP value at the 1st ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
115 [checkd_pallor_1]
Show the field ONLY if:
[first_anc] = '1'
Checked for Pallor at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
116 [oedema_a1]
Show the field ONLY if:
[first_anc] = '1'
Checked for Pedal Oedema at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
117 [breasts_examined_a1]
Show the field ONLY if:
[first_anc] = '1'
Breasts Examined at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
118 [prob_breasts_examined_a1]
Show the field ONLY if:
[breasts_examined_a1] = '1'
Any specific problems observed during breast examination at the 1st ANC visit? checkbox, Required
1prob_breasts_examined_a1___1Inverted Nipple
2prob_breasts_examined_a1___2Flat Nipple
3prob_breasts_examined_a1___3Dry Skin

Custom alignment: RH
119 [pre_scar_a1]
Show the field ONLY if:
[first_anc] = '1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
120 [rcrd_symp_1]
Show the field ONLY if:
[first_anc] = '1'
Record symphysis fundal height (SFH) at the 1st ANC visit yesno, Required
1Yes
0No
121 [sfh_a1]
Show the field ONLY if:
[rcrd_symp_1] = '1'
Symphysis fundal height (SFH) at the 1st ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
122 [rcrd_fhr_1]
Show the field ONLY if:
[first_anc] = '1'
Record FHR [>22wks] at 1st Visit yesno, Required
1Yes
0No
123 [fhr_a1]
Show the field ONLY if:
[rcrd_fhr_1] = '1'
Fetal Heart Rate (fhr) at the 1st ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
124 [hemo_1]
Show the field ONLY if:
[first_anc] = '1'
Hemoglobin at 1st Visit yesno, Required
1Yes
0No
125 [hb_results_a1]
Show the field ONLY if:
[hemo_1] = '1'
Record Hb results at 1st ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
126 [rndm_bld_1]
Show the field ONLY if:
[first_anc] = '1'
Random blood sugar at 1st Visit yesno, Required
1Yes
0No
127 [rbs_results_a1]
Show the field ONLY if:
[rndm_bld_1]='1'
Record Random Blood Sugar results at the 1st ANC visit if available text (number, Min: 40, Max: 1000), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
128 [vdrl_1]
Show the field ONLY if:
[first_anc] = '1'
VDRL/ Syphilis at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
129 [vdrl_results_a1]
Show the field ONLY if:
[vdrl_1] = '1'
Record VDRL results at 1st ANC visit, if available radio, Required
1Reactive
2Non-Reactive
130 [hiv_1]
Show the field ONLY if:
[first_anc] = '1'
HIV at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
131 [hiv_results_a1]
Show the field ONLY if:
[hiv_1] = '1'
Record HIV results at 1st ANC visit, if available radio, Required
1Reactive
2Non - Reactive
132 [hbsag_1]
Show the field ONLY if:
[first_anc] = '1'
HBsAG at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
133 [hbsag_results_a1]
Show the field ONLY if:
[hbsag_1] = '1'
Record HBsAG results at 1st ANC visit, if available radio, Required
1Reactive
2Non - reactive
134 [tsh_1]
Show the field ONLY if:
[first_anc] = '1'
TSH at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
135 [tsh_results_a1]
Show the field ONLY if:
[tsh_1] = '1'
Record TSH results at 1st ANC visit, if available text (number), Required
Custom alignment: RH
136 [bld_rh_1]
Show the field ONLY if:
[first_anc] = '1'
Blood group and Rh at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
137 [bg_rh_results_a1]
Show the field ONLY if:
[bld_rh_1] = '1'
Record Blood group and Rh results at the 1st ANC visit, if
available 		text, Required
Custom alignment: RH
138 [gtt_1]
Show the field ONLY if:
[first_anc] = '1'
Glucose Tolerance Test (GTT) at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
139 [gtt_results_a1]
Show the field ONLY if:
[gtt_1] = '1'
Record Glucose Tolerance Test (GTT) results at 1st ANC visit, if available text, Required
Custom alignment: RH
140 [oth_1]
Show the field ONLY if:
[first_anc] = '1'
Any other test at 1st Visit yesno, Required
1Yes
0No

Custom alignment: RH
141 [aobt_results_a1]
Show the field ONLY if:
[oth_1] = '1'
Record any other test results at the 1st ANC visit, if available text, Required
Custom alignment: RH
142 [urine_albumin_a1]
Show the field ONLY if:
[first_anc] = '1'
Urine Albumin test done at 1st ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
143 [urine_albumin_results_a1]
Show the field ONLY if:
[urine_albumin_a1] = '1'
Record Urine Albumin test results at 1st ANC visit, if available dropdown, Required
00
11+
22+
33+

Custom alignment: RH
144 [urine_sugar_a1]
Show the field ONLY if:
[first_anc] = '1'
Urine Sugar test done at 1st ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
145 [urine_sugar_test_results_a1]
Show the field ONLY if:
[urine_sugar_a1] = '1'
Record urine sugar test results at 1st ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
146 [urine_micro_a1]
Show the field ONLY if:
[first_anc] = '1'
Urine Microscopy test done at 1st ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
147 [urine_microscopy_results_a1]
Show the field ONLY if:
[urine_micro_a1] = '1'
Record urine microscopy results at 1st ANC visit, if available text, Required
Custom alignment: RH
148 [usg_a1]
Show the field ONLY if:
[first_anc] = '1'
Did ultrasonography on the 1st ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
149 [where_done_usg_a1]
Show the field ONLY if:
[usg_a1] = '1'
Where was it done at 1st ANC visit? dropdown
1Public
2Private

Custom alignment: RH
150 [ga_in_weeks_usg_a1]
Show the field ONLY if:
[usg_a1] = '1'
GA in weeks at 1st ANC visit text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
151 [usg_f_a1]
Show the field ONLY if:
[usg_a1] = '1'
Finding (congenital anomaly [CA] / FGR) at 1st ANC visit[Congenital anomaly/FGR] text, Required
152 [doppler_done_a1]
Show the field ONLY if:
[first_anc] = '1'
Doppler done on 1st ANC visit? yesno, Required
1Yes
0No
153 [doppler_date_a1]
Show the field ONLY if:
[doppler_done_a1] = '1'
Date of Doppler at 1st ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
154 [where_done_doppler_a1]
Show the field ONLY if:
[doppler_done_a1] = '1'
Where was the Doppler done at 1st ANC visit? dropdown, Required
1Public
2Private
155 [doppler_findings_a1]
Show the field ONLY if:
[doppler_done_a1] = '1'
Findings of Doppler at 1st ANC visit text, Required
156 [any_oth_radiological_tests_a1]
Show the field ONLY if:
[first_anc] = '1'
Any other Radiological tests done in the 1st ANC visit? yesno, Required
1Yes
0No
157 [oth_investigation_test_name_a1]
Show the field ONLY if:
[any_oth_radiological_tests_a1] = '1'
Name of any other radiological test done at the 1st ANC visit text, Required
158 [oth_investigation_test_date_a1]
Show the field ONLY if:
[any_oth_radiological_tests_a1] = '1'
Date of the Radiological test at the 1st ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
159 [where_done_oth_investigation_a1]
Show the field ONLY if:
[any_oth_radiological_tests_a1] = '1'
Where was the Radiological test done at the 1st ANC visit? dropdown, Required
1Public
2Private
160 [oth_investigation_findings_a1]
Show the field ONLY if:
[any_oth_radiological_tests_a1] = '1'
Findings of the Radiological test at the 1st ANC visit

 text, Required
161 [second_anc_visit]
Show the field ONLY if:
[yes_howmny_anc] >= 2
Second ANC visit yesno
1Yes
0No
162 [date_anc_visits_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Date of 2nd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
163 [gestational_ages_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Gestational age at 2nd ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
164 [months_amenorrhea_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Months of amenorrhea at 2nd ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
165 [place_of_anc_visit_2]
Show the field ONLY if:
[second_anc_visit]='1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_2___1PHC
2place_of_anc_visit_2___2CHC
3place_of_anc_visit_2___3TH / SDH
4place_of_anc_visit_2___4DH
5place_of_anc_visit_2___5SC-HWC
6place_of_anc_visit_2___6Private Maternity homes
7place_of_anc_visit_2___7Private Hospital
166 [seen_by_2]
Show the field ONLY if:
[second_anc_visit]='1'
Seen by checkbox, Required
1seen_by_2___1Doctor
2seen_by_2___2Nurse
3seen_by_2___3ANM

Custom alignment: RH
167 [vomiting_anc_vst_2]
Show the field ONLY if:
[second_anc_visit]='1'
Vomiting yesno, Required
1Yes
0No
168 [incresed_frequncy_burning_passing_urine_anc_visit_2]
Show the field ONLY if:
[second_anc_visit]='1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
169 [breathles_tiredne_anc_vst_2]
Show the field ONLY if:
[second_anc_visit]='1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
170 [headache_blurred_vision_anc_vst_2]
Show the field ONLY if:
[second_anc_visit]='1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
171 [jaundice_anc_vst_2]
Show the field ONLY if:
[second_anc_visit]='1'
Jaundice yesno, Required
1Yes
0No
172 [abdominal_pain_anc_vst_2]
Show the field ONLY if:
[second_anc_visit]='1'
Abdominal pain yesno, Required
1Yes
0No
173 [bleeding_per_vagina_anc_vst_2]
Show the field ONLY if:
[second_anc_visit]='1'
Bleeding per vagina yesno, Required
1Yes
0No
174 [abrmal_vaginal_discharg_anc_visit_2]
Show the field ONLY if:
[second_anc_visit]='1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
175 [trtmnt_conception_anc_visit_2]
Show the field ONLY if:
[second_anc_visit]='1'
Treatment for conception yesno, Required
1Yes
0No
176 [fever_anc_vst_2]
Show the field ONLY if:
[second_anc_visit]='1'
Fever yesno
1Yes
0No
177 [other_anc_vist_2]
Show the field ONLY if:
[second_anc_visit]='1'
Other yesno
1Yes
0No
178 [other_specify_anc_visit_2]
Show the field ONLY if:
[other_anc_vist_2]='1'
Other, specify text
179 [ht_checked_anc_visit_2]
Show the field ONLY if:
[second_anc_visit]='1'
Height checked for ANC visit 2 yesno, Required
1Yes
0No

Custom alignment: RH
180 [checked_height_a2]
Show the field ONLY if:
[ht_checked_anc_visit_2] = '1'
Height at the 2nd ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
181 [wt_checked_anc_visit_2]
Show the field ONLY if:
[second_anc_visit]='1'
Weight checked for ANC visit 2 yesno, Required
1Yes
0No

Custom alignment: RH
182 [checked_weight_a2]
Show the field ONLY if:
[wt_checked_anc_visit_2] = '1'
Weight at the 2nd ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Field Annotation: @FORCE-MINMAX
183 [bp_checked_anc_visit_2]
Show the field ONLY if:
[second_anc_visit]='1'
Blood Pressure checked for ANC visit 2 yesno, Required
1Yes
0No

Custom alignment: RH
184 [checked_sbp_a2]
Show the field ONLY if:
[bp_checked_anc_visit_2] = '1'
SBP value at the 2nd ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
185 [checked_dbp_a2]
Show the field ONLY if:
[bp_checked_anc_visit_2] = '1'
DBP value at the 2nd ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
186 [checkd_pallor_2]
Show the field ONLY if:
[second_anc_visit]='1'
Checked for Pallor at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
187 [oedema_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Checked for Pedal Oedema at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
188 [breasts_examined_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Breasts Examined at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
189 [prob_breasts_examined_a2]
Show the field ONLY if:
[breasts_examined_a2] = '1'
Any specific problems observed during breast examination at the 2nd ANC visit? checkbox, Required
1prob_breasts_examined_a2___1Inverted Nipple
2prob_breasts_examined_a2___2Flat Nipple
3prob_breasts_examined_a2___3Dry Skin

Custom alignment: RH
190 [pre_scar_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
191 [rcrd_symp_2]
Show the field ONLY if:
[second_anc_visit]='1'
Record symphysis fundal height (SFH) at the 2nd ANC visit yesno, Required
1Yes
0No
192 [sfh_a2]
Show the field ONLY if:
[rcrd_symp_2]='1'
Symphysis fundal height (SFH) at the 2nd ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
193 [rcrd_fhr_2]
Show the field ONLY if:
[second_anc_visit]='1'
Record FHR [>22wks] at 2nd Visit yesno, Required
1Yes
0No
194 [fhr_a2]
Show the field ONLY if:
[rcrd_fhr_2] = '1'
Fetal Heart Rate (fhr) at the 2nd ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
195 [hemo_2]
Show the field ONLY if:
[second_anc_visit]='1'
Hemoglobin at 2nd Visit yesno, Required
1Yes
0No
196 [hb_results_a2]
Show the field ONLY if:
[hemo_2] = '1'
Record Hb results at 2nd ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
197 [rndm_bld_2]
Show the field ONLY if:
[second_anc_visit]='1'
Random blood sugar at 2nd Visit yesno, Required
1Yes
0No
198 [rbs_results_a2]
Show the field ONLY if:
[rndm_bld_2]='1'
Record Random Blood Sugar results at the 2nd ANC visit if available text (number, Min: 40, Max: 1000), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
199 [vdrl_2]
Show the field ONLY if:
[second_anc_visit]='1'
VDRL/ Syphilis at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
200 [vdrl_results_a2]
Show the field ONLY if:
[vdrl_2] = '1'
Record VDRL results at 2nd ANC visit, if available dropdown, Required
1Reactive
2Non-Reactive

Custom alignment: RH
201 [hiv_2]
Show the field ONLY if:
[second_anc_visit]='1'
HIV at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
202 [hiv_results_a2]
Show the field ONLY if:
[hiv_2] = '1'
Record HIV results at 2nd ANC visit, if available dropdown, Required
1Reactive
2Non - Reactive

Custom alignment: RH
203 [hbsag_2]
Show the field ONLY if:
[second_anc_visit]='1'
HBsAG at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
204 [hbsag_results_a2]
Show the field ONLY if:
[hbsag_2] = '1'
Record HBsAG results at 2nd ANC visit, if available dropdown, Required
1Reactive
2Non - reactive

Custom alignment: RH
205 [tsh_2]
Show the field ONLY if:
[second_anc_visit]='1'
TSH at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
206 [tsh_results_a2]
Show the field ONLY if:
[tsh_2] = '1'
Record TSH results at 2nd ANC visit, if available text (number), Required
Custom alignment: RH
207 [bld_rh_2]
Show the field ONLY if:
[second_anc_visit]='1'
Blood group and Rh at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
208 [bg_rh_results_a2]
Show the field ONLY if:
[bld_rh_2] = '1'
Record Blood group and Rh results at the 2nd ANC visit, if
available 		text, Required
Custom alignment: RH
209 [gtt_2]
Show the field ONLY if:
[second_anc_visit]='1'
Glucose Tolerance Test (GTT) at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
210 [gtt_results_a2]
Show the field ONLY if:
[gtt_2] = '1'
Record Glucose Tolerance Test (GTT) results at 2nd ANC visit, if available text, Required
Custom alignment: RH
211 [oth_2]
Show the field ONLY if:
[second_anc_visit]='1'
Any other test at 2nd Visit yesno, Required
1Yes
0No

Custom alignment: RH
212 [aobt_results_a2]
Show the field ONLY if:
[oth_2] = '1'
Record any other test results at the 2nd ANC visit, if available text, Required
Custom alignment: RH
213 [urine_albumin_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Urine Albumin test done at 2nd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
214 [urine_albumin_results_a2]
Show the field ONLY if:
[urine_albumin_a2] = '1'
Record Urine Albumin test results at 2nd ANC visit, if available dropdown, Required
00
11+
22+
33+

Custom alignment: RH
215 [urine_sugar_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Urine Sugar test done at 2nd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
216 [urine_sugar_test_results_a2]
Show the field ONLY if:
[urine_sugar_a2] = '1'
Record urine sugar test results at 2nd ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
217 [urine_micro_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Urine Microscopy test done at 2nd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
218 [urine_microscopy_results_a2]
Show the field ONLY if:
[urine_micro_a2] = '1'
Record urine microscopy results at 2nd ANC visit, if available text, Required
Custom alignment: RH
219 [usg_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Did ultrasonography on the 2nd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
220 [usgda_a2]
Show the field ONLY if:
[usg_a2] = '1'
Date of ultrasonography at 2nd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
221 [where_done_usg_a2]
Show the field ONLY if:
[usg_a2] = '1'
Where was it done at 2nd ANC visit? dropdown
1Public
2Private

Custom alignment: RH
222 [ga_in_weeks_usg_a2]
Show the field ONLY if:
[usg_a2] = '1'
GA in weeks at 2nd ANC visit text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
223 [usg_f_a2]
Show the field ONLY if:
[usg_a2] = '1'
Finding (congenital anomaly [CA] / FGR) at 2nd ANC visit[Congenital anomaly/FGR] text, Required
224 [doppler_done_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Doppler done on 2nd ANC visit ? yesno, Required
1Yes
0No
225 [doppler_date_a2]
Show the field ONLY if:
[doppler_done_a2] = '1'
Date of Doppler at 2nd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
226 [where_done_doppler_a2]
Show the field ONLY if:
[doppler_done_a2] = '1'
Where was the Doppler done at 2nd ANC visit? dropdown, Required
1Public
2Private
227 [doppler_findings_a2]
Show the field ONLY if:
[doppler_done_a2] = '1'
Findings of Doppler at 2nd ANC visit text, Required
228 [any_oth_radiological_tests_a2]
Show the field ONLY if:
[second_anc_visit]='1'
Any other Radiological tests done in the 2nd ANC visit? yesno, Required
1Yes
0No
229 [oth_investigation_test_name_a2]
Show the field ONLY if:
[any_oth_radiological_tests_a2] = '1'
Name of any other radiological test done at the 2nd ANC visit text, Required
230 [oth_investigation_test_date_a2]
Show the field ONLY if:
[any_oth_radiological_tests_a2] = '1'
Date of the Radiological test at the 2nd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
231 [where_done_oth_investigation_a2]
Show the field ONLY if:
[any_oth_radiological_tests_a2] = '1'
Where was the Radiological test done at the 2nd ANC visit? dropdown, Required
1Public
2Private
232 [oth_investigation_findings_a2]
Show the field ONLY if:
[any_oth_radiological_tests_a2] = '1'
Findings of the Radiological test at the 2nd ANC visit text, Required
233 [third_anc_visit_done]
Show the field ONLY if:
[yes_howmny_anc] >= 3
Third ANC visit done yesno
1Yes
0No
234 [date_anc_visits_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Date of 3rd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
235 [gestational_ages_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Gestational age at 3rd ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
236 [months_amenorrhea_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Months of amenorrhea at 3rd ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
237 [place_of_anc_visit_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_3___1PHC
2place_of_anc_visit_3___2CHC
3place_of_anc_visit_3___3TH / SDH
4place_of_anc_visit_3___4DH
5place_of_anc_visit_3___5SC-HWC
6place_of_anc_visit_3___6Private Maternity homes
7place_of_anc_visit_3___7Private Hospital
238 [seen_by_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Seen by checkbox, Required
1seen_by_3___1Doctor
2seen_by_3___2Nurse
3seen_by_3___3ANM

Custom alignment: RH
239 [vomiting_anc_vst_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Vomiting yesno, Required
1Yes
0No
240 [incresed_frequncy_burning_passing_urine_anc_visit_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
241 [breathles_tiredne_anc_vst_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
242 [headache_blurred_vision_anc_vst_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
243 [jaundice_anc_vst_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Jaundice yesno, Required
1Yes
0No
244 [abdominal_pain_anc_vst_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Abdominal pain yesno, Required
1Yes
0No
245 [bleeding_per_vagina_anc_vst_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Bleeding per vagina yesno, Required
1Yes
0No
246 [abrmal_vaginal_discharg_anc_visit_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
247 [trtmnt_conception_anc_visit_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Treatment for conception yesno, Required
1Yes
0No
248 [fever_anc_vst_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Fever yesno
1Yes
0No
249 [other_anc_vist_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Other yesno
1Yes
0No
250 [other_specify_anc_visit_3]
Show the field ONLY if:
[other_anc_vist_3]='1'
Other, specify text
251 [ht_checked_anc_visit_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Height checked for ANC visit 3 yesno, Required
1Yes
0No

Custom alignment: RH
252 [checked_height_a3]
Show the field ONLY if:
[ht_checked_anc_visit_3] = '1'
Height at the 3rd ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
253 [wt_checked_anc_visit_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Weight checked for ANC visit 3 yesno, Required
1Yes
0No

Custom alignment: RH
254 [checked_weight_a3]
Show the field ONLY if:
[wt_checked_anc_visit_3] = '1'
Weight at the 3rd ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Field Annotation: @FORCE-MINMAX
255 [bp_checked_anc_visit_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Blood Pressure checked for ANC visit 3 yesno, Required
1Yes
0No

Custom alignment: RH
256 [checked_sbp_a3]
Show the field ONLY if:
[bp_checked_anc_visit_3] = '1'
SBP value at the 3rd ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
257 [checked_dbp_a3]
Show the field ONLY if:
[bp_checked_anc_visit_3] = '1'
DBP value at the 3rd ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
258 [checkd_pallor_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Checked for Pallor at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
259 [oedema_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Checked for Pedal Oedema at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
260 [breasts_examined_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Breasts Examined at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
261 [prob_breasts_examined_a3]
Show the field ONLY if:
[breasts_examined_a3] = '1'
Any specific problems observed during breast examination at the 3rd ANC visit? checkbox, Required
1prob_breasts_examined_a3___1Inverted Nipple
2prob_breasts_examined_a3___2Flat Nipple
3prob_breasts_examined_a3___3Dry Skin

Custom alignment: RH
262 [pre_scar_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
263 [rcrd_symp_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Record symphysis fundal height (SFH) at the 3rd ANC visit yesno, Required
1Yes
0No
264 [sfh_a3]
Show the field ONLY if:
[rcrd_symp_3] = '1'
Symphysis fundal height (SFH) at the 3rd ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
265 [rcrd_fhr_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Record FHR [>22wks] at 3rd Visit yesno
1Yes
0No
266 [fhr_a3]
Show the field ONLY if:
[rcrd_fhr_3] = '1'
Fetal Heart Rate (fhr) at the 3rd ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
267 [hemo_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Hemoglobin at 3rd Visit yesno, Required
1Yes
0No
268 [hb_results_a3]
Show the field ONLY if:
[hemo_3] = '1'
Record Hb results at 3rd ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
269 [rndm_bld_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Random blood sugar at 3rd Visit yesno, Required
1Yes
0No
270 [rbs_results_a3]
Show the field ONLY if:
[rndm_bld_3]='1'
Record Random Blood Sugar results at the 3rd ANC visit if available text (number, Min: 40, Max: 1000), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
271 [vdrl_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
VDRL/ Syphilis at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
272 [vdrl_results_a3]
Show the field ONLY if:
[vdrl_3] = '1'
Record VDRL results at 3rd ANC visit, if available dropdown, Required
1Reactive
2Non-Reactive

Custom alignment: RH
273 [hiv_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
HIV at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
274 [hiv_results_a3]
Show the field ONLY if:
[hiv_3] = '1'
Record HIV results at 3rd ANC visit, if available dropdown, Required
1Reactive
2Non - Reactive

Custom alignment: RH
275 [hbsag_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
HBsAG at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
276 [hbsag_results_a3]
Show the field ONLY if:
[hbsag_3] = '1'
Record HBsAG results at 3rd ANC visit, if available dropdown, Required
1Reactive
2Non - reactive

Custom alignment: RH
277 [tsh_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
TSH at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
278 [tsh_results_a3]
Show the field ONLY if:
[tsh_3] = '1'
Record TSH results at 3rd ANC visit, if available text (number), Required
Custom alignment: RH
279 [bld_rh_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Blood group and Rh at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
280 [bg_rh_results_a3]
Show the field ONLY if:
[bld_rh_3] = '1'
Record Blood group and Rh results at the 3rd ANC visit, if
available 		text, Required
Custom alignment: RH
281 [gtt_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Glucose Tolerance Test (GTT) at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
282 [gtt_results_a3]
Show the field ONLY if:
[gtt_3] = '1'
Record Glucose Tolerance Test (GTT) results at 3rd ANC visit, if available text, Required
Custom alignment: RH
283 [oth_3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Any other test at 3rd Visit yesno, Required
1Yes
0No

Custom alignment: RH
284 [aobt_results_a3]
Show the field ONLY if:
[oth_3] = '1'
Record any other test results at the 3rd ANC visit, if available text, Required
Custom alignment: RH
285 [urine_albumin_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Urine Albumin test done at 3rd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
286 [urine_albumin_results_a3]
Show the field ONLY if:
[urine_albumin_a3] = '1'
Record Urine Albumin test results at 3rd ANC visit, if available dropdown, Required
00
11+
22+
33+

Custom alignment: RH
287 [urine_sugar_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Urine Sugar test done at 3rd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
288 [urine_sugar_test_results_a3]
Show the field ONLY if:
[urine_sugar_a3] = '1'
Record urine sugar test results at 3rd ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
289 [urine_micro_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Urine Microscopy test done at 3rd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
290 [urine_microscopy_results_a3]
Show the field ONLY if:
[urine_micro_a3] = '1'
Record urine microscopy results at 3rd ANC visit, if available text, Required
Custom alignment: RH
291 [usg_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Did ultrasonography on the 3rd ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
292 [usgda_a3]
Show the field ONLY if:
[usg_a3]='1'
Date of ultrasonography at 3rd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
293 [where_done_usg_a3]
Show the field ONLY if:
[usg_a3]='1'
Where was it done at 3rd ANC visit? dropdown
1Public
2Private

Custom alignment: RH
294 [ga_in_weeks_usg_a3]
Show the field ONLY if:
[usg_a3]='1'
GA in weeks at 3rd ANC visit text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
295 [usg_f_a3]
Show the field ONLY if:
[usg_a3]='1'
Finding (congenital anomaly [CA] / FGR) at 3rd ANC visit[Congenital anomaly/FGR] text, Required
296 [doppler_done_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Doppler done on 3rd ANC visit ? yesno, Required
1Yes
0No
297 [doppler_date_a3]
Show the field ONLY if:
[doppler_done_a3]='1'
Date of Doppler at 3rd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
298 [where_done_doppler_a3]
Show the field ONLY if:
[doppler_done_a3]='1'
Where was the Doppler done at 3rd ANC visit? dropdown, Required
1Public
2Private
299 [doppler_findings_a3]
Show the field ONLY if:
[doppler_done_a3]='1'
Findings of Doppler at 3rd ANC visit

 text, Required
300 [any_oth_radiological_tests_a3]
Show the field ONLY if:
[third_anc_visit_done]='1'
Any other Radiological tests done in the 3rd ANC visit? yesno, Required
1Yes
0No
301 [oth_investigation_test_name_a3]
Show the field ONLY if:
[any_oth_radiological_tests_a3]='1'
Name of any other radiological test done at the 3rd ANC visit text, Required
302 [oth_investigation_test_date_a3]
Show the field ONLY if:
[any_oth_radiological_tests_a3]='1'
Date of the Radiological test at the 3rd ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
303 [where_done_oth_investigation_a3]
Show the field ONLY if:
[any_oth_radiological_tests_a3]='1'
Where was the Radiological test done at the 3rd ANC visit? dropdown, Required
1Public
2Private
304 [oth_investigation_findings_a3]
Show the field ONLY if:
[any_oth_radiological_tests_a3]='1'
Findings of the Radiological test at the 3rd ANC visit text, Required
305 [fourth_anc_visit]
Show the field ONLY if:
[yes_howmny_anc] >= 4
Fourth ANC visit yesno
1Yes
0No
306 [date_anc_visits_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Date of 4th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
307 [gestational_ages_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Gestational age at 4th ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
308 [months_amenorrhea_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Months of amenorrhea at 4th ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
309 [place_of_anc_visit_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_4___1PHC
2place_of_anc_visit_4___2CHC
3place_of_anc_visit_4___3TH / SDH
4place_of_anc_visit_4___4DH
5place_of_anc_visit_4___5SC-HWC
6place_of_anc_visit_4___6Private Maternity homes
7place_of_anc_visit_4___7Private Hospital
310 [seen_by_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Seen by checkbox, Required
1seen_by_4___1Doctor
2seen_by_4___2Nurse
3seen_by_4___3ANM

Custom alignment: RH
311 [vomiting_anc_vst_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Vomiting yesno, Required
1Yes
0No
312 [incresed_frequncy_burning_passing_urine_anc_visit_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
313 [breathles_tiredne_anc_vst_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
314 [headache_blurred_vision_anc_vst_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
315 [jaundice_anc_vst_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Jaundice yesno, Required
1Yes
0No
316 [abdominal_pain_anc_vst_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Abdominal pain yesno, Required
1Yes
0No
317 [bleeding_per_vagina_anc_vst_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Bleeding per vagina yesno, Required
1Yes
0No
318 [abrmal_vaginal_discharg_anc_visit_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
319 [trtmnt_conception_anc_visit_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Treatment for conception yesno, Required
1Yes
0No
320 [fever_anc_vst_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Fever yesno
1Yes
0No
321 [other_anc_vist_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Other yesno
1Yes
0No
322 [other_specify_anc_visit_4]
Show the field ONLY if:
[other_anc_vist_1]='1'
Other, specify text
323 [ht_checked_anc_visit_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Height checked for ANC visit 4th yesno, Required
1Yes
0No

Custom alignment: RH
324 [checked_height_a4]
Show the field ONLY if:
[ht_checked_anc_visit_4] = '1'
Height at the 4th ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
325 [wt_checked_anc_visit_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Weight checked for ANC visit 4th yesno, Required
1Yes
0No

Custom alignment: RH
326 [checked_weight_a4]
Show the field ONLY if:
[wt_checked_anc_visit_4] = '1'
Weight at the 4th ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Field Annotation: @FORCE-MINMAX
327 [bp_checked_anc_visit_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Blood Pressure checked for ANC visit 4th yesno, Required
1Yes
0No

Custom alignment: RH
328 [checked_sbp_a4]
Show the field ONLY if:
[bp_checked_anc_visit_4] = '1'
SBP value at the 4th ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
329 [checked_dbp_a4]
Show the field ONLY if:
[bp_checked_anc_visit_4] = '1'
DBP value at the 4th ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
330 [checkd_pallor_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Checked for Pallor at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
331 [oedema_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Checked for Pedal Oedema at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
332 [breasts_examined_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Breasts Examined at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
333 [prob_breasts_examined_a4]
Show the field ONLY if:
[breasts_examined_a4] = '1'
Any specific problems observed during breast examination at the 4th ANC visit? checkbox, Required
1prob_breasts_examined_a4___1Inverted Nipple
2prob_breasts_examined_a4___2Flat Nipple
3prob_breasts_examined_a4___3Dry Skin

Custom alignment: RH
334 [pre_scar_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
335 [rcrd_symp_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Record symphysis fundal height (SFH) at the 4th ANC visit yesno, Required
1Yes
0No

Custom alignment: RH
336 [sfh_a4]
Show the field ONLY if:
[rcrd_symp_4] = '1'
Symphysis fundal height (SFH) at the 4th ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
337 [rcrd_fhr_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Record FHR [>22wks] at 4th Visit yesno
1Yes
0No
338 [fhr_a4]
Show the field ONLY if:
[rcrd_fhr_4] = '1'
Fetal Heart Rate (fhr) at the 4th ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
339 [hemo_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Hemoglobin at 4th Visit yesno, Required
1Yes
0No
340 [hb_results_a4]
Show the field ONLY if:
[hemo_4] = '1'
Record Hb results at 4th ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
341 [rndm_bld_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Random blood sugar at 4th Visit yesno, Required
1Yes
0No
342 [rbs_results_a4]
Show the field ONLY if:
[rndm_bld_4]='1'
Record Random Blood Sugar results at the 4th ANC visit if available text (number, Min: 40, Max: 1000), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
343 [vdrl_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
VDRL/ Syphilis at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
344 [vdrl_results_a4]
Show the field ONLY if:
[vdrl_4] = '1'
Record VDRL results at 4th ANC visit, if available dropdown, Required
1Reactive
2Non-Reactive

Custom alignment: RH
345 [hiv_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
HIV at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
346 [hiv_results_a4]
Show the field ONLY if:
[hiv_4] = '1'
Record HIV results at 4th ANC visit, if available dropdown, Required
1Reactive
2Non - Reactive

Custom alignment: RH
347 [hbsag_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
HBsAG at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
348 [hbsag_results_a4]
Show the field ONLY if:
[hbsag_4] = '1'
Record HBsAG results at 4th ANC visit, if available dropdown, Required
1Reactive
2Non - reactive

Custom alignment: RH
349 [tsh_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
TSH at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
350 [tsh_results_a4]
Show the field ONLY if:
[tsh_4] = '1'
Record TSH results at 4th ANC visit, if available text (number), Required
Custom alignment: RH
351 [bld_rh_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Blood group and Rh at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
352 [bg_rh_results_a4]
Show the field ONLY if:
[bld_rh_4] = '1'
Record Blood group and Rh results at the 4th ANC visit, if
available 		text, Required
Custom alignment: RH
353 [gtt_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Glucose Tolerance Test (GTT) at 4thVisit yesno, Required
1Yes
0No

Custom alignment: RH
354 [gtt_results_a4]
Show the field ONLY if:
[gtt_4] = '1'
Record Glucose Tolerance Test (GTT) results at 4th ANC visit, if available text, Required
Custom alignment: RH
355 [oth_4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Any other test at 4th Visit yesno, Required
1Yes
0No

Custom alignment: RH
356 [aobt_results_a4]
Show the field ONLY if:
[oth_4] = '1'
Record any other test results at the 4th ANC visit, if available text, Required
Custom alignment: RH
357 [urine_albumin_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Urine Albumin test done at 4th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
358 [urine_albumin_results_a4]
Show the field ONLY if:
[urine_albumin_a4] = '1'
Record Urine Albumin test results at 4th ANC visit, if available dropdown, Required
00
11+
22+
33+

Custom alignment: RH
359 [urine_sugar_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Urine Sugar test done at 4th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
360 [urine_sugar_test_results_a4]
Show the field ONLY if:
[urine_sugar_a4] = '1'
Record urine sugar test results at 4th ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
361 [urine_micro_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Urine Microscopy test done at 4th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
362 [urine_microscopy_results_a4]
Show the field ONLY if:
[urine_micro_a4] = '1'
Record urine microscopy results at 4th ANC visit, if available text, Required
Custom alignment: RH
363 [usg_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Did ultrasonography on the 4thANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
364 [usgda_a4]
Show the field ONLY if:
[usg_a4] = '1'
Date of ultrasonography at 4th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
365 [where_done_usg_a4]
Show the field ONLY if:
[usg_a4] = '1'
Where was it done at 4th ANC visit? dropdown
1Public
2Private

Custom alignment: RH
366 [ga_in_weeks_usg_a4]
Show the field ONLY if:
[usg_a4] = '1'
GA in weeks at 4th ANC visit text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
367 [usg_f_a4]
Show the field ONLY if:
[usg_a4] = '1'
Finding (congenital anomaly [CA] / FGR) at 4th ANC visit[Congenital anomaly/FGR] text, Required
368 [doppler_done_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Doppler done on 4th ANC visit ? yesno, Required
1Yes
0No
369 [doppler_date_a4]
Show the field ONLY if:
[doppler_done_a4]='1'
Date of Doppler at 4th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
370 [where_done_doppler_a4]
Show the field ONLY if:
[doppler_done_a4]='1'
Where was the Doppler done at 4th ANC visit? dropdown, Required
1Public
2Private
371 [doppler_findings_a4]
Show the field ONLY if:
[doppler_done_a4]='1'
Findings of Doppler at 4th ANC visit

 text, Required
372 [any_oth_radiological_tests_a4]
Show the field ONLY if:
[fourth_anc_visit]='1'
Any other Radiological tests done in the 4th ANC visit? yesno, Required
1Yes
0No
373 [oth_investigation_test_name_a4]
Show the field ONLY if:
[any_oth_radiological_tests_a4]='1'
Name of any other radiological test done at the 4th ANC visit text, Required
374 [oth_investigation_test_date_a4]
Show the field ONLY if:
[any_oth_radiological_tests_a4]='1'
Date of the Radiological test at the 4th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
375 [where_done_oth_investigation_a4]
Show the field ONLY if:
[any_oth_radiological_tests_a4]='1'
Where was the Radiological test done at the 4th ANC visit? dropdown, Required
1Public
2Private
376 [oth_investigation_findings_a4]
Show the field ONLY if:
[any_oth_radiological_tests_a4]='1'
Findings of the Radiological test at the 4th ANC visit text, Required
377 [fifth_anc_visit_done]
Show the field ONLY if:
[yes_howmny_anc] >= 5
Fifth ANC visit done yesno
1Yes
0No
378 [date_anc_visits_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Date of 5th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
379 [gestational_ages_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Gestational age at 5th ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
380 [months_amenorrhea_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Months of amenorrhea at 5th ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
381 [place_of_anc_visit_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_5___1PHC
2place_of_anc_visit_5___2CHC
3place_of_anc_visit_5___3TH / SDH
4place_of_anc_visit_5___4DH
5place_of_anc_visit_5___5SC-HWC
6place_of_anc_visit_5___6Private Maternity homes
7place_of_anc_visit_5___7Private Hospital
382 [seen_by_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Seen by checkbox, Required
1seen_by_5___1Doctor
2seen_by_5___2Nurse
3seen_by_5___3ANM

Custom alignment: RH
383 [vomiting_anc_vst_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Vomiting yesno, Required
1Yes
0No
384 [incresed_frequncy_burning_passing_urine_anc_visit_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
385 [breathles_tiredne_anc_vst_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
386 [headache_blurred_vision_anc_vst_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
387 [jaundice_anc_vst_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Jaundice yesno, Required
1Yes
0No
388 [abdominal_pain_anc_vst_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Abdominal pain yesno, Required
1Yes
0No
389 [bleeding_per_vagina_anc_vst_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Bleeding per vagina yesno, Required
1Yes
0No
390 [abrmal_vaginal_discharg_anc_visit_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
391 [trtmnt_conception_anc_visit_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Treatment for conception yesno, Required
1Yes
0No
392 [fever_anc_vst_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Fever yesno
1Yes
0No
393 [other_anc_vist_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Other yesno
1Yes
0No
394 [other_specify_anc_visit_5]
Show the field ONLY if:
[other_anc_vist_1]='1'
Other, specify text
395 [ht_checked_anc_visit_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Height checked for ANC visit 5th yesno, Required
1Yes
0No

Custom alignment: RH
396 [checked_height_a5]
Show the field ONLY if:
[ht_checked_anc_visit_5] = '1'
Height at the 5th ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
397 [wt_checked_anc_visit_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Weight checked for ANC visit 5th yesno, Required
1Yes
0No

Custom alignment: RH
398 [checked_weight_a5]
Show the field ONLY if:
[wt_checked_anc_visit_5] = '1'
Weight at the 5th ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Field Annotation: @FORCE-MINMAX
399 [bp_checked_anc_visit_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Blood Pressure checked for ANC visit 5th yesno, Required
1Yes
0No

Custom alignment: RH
400 [checked_sbp_a5]
Show the field ONLY if:
[bp_checked_anc_visit_5] = '1'
SBP value at the 5th ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
401 [checked_dbp_a5]
Show the field ONLY if:
[bp_checked_anc_visit_5] = '1'
DBP value at the 5th ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
402 [checkd_pallor_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Checked for Pallor at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
403 [oedema_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Checked for Pedal Oedema at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
404 [breasts_examined_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Breasts Examined at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
405 [prob_breasts_examined_a5]
Show the field ONLY if:
[breasts_examined_a5] = '1'
Any specific problems observed during breast examination at the 5th ANC visit? checkbox, Required
1prob_breasts_examined_a5___1Inverted Nipple
2prob_breasts_examined_a5___2Flat Nipple
3prob_breasts_examined_a5___3Dry Skin

Custom alignment: RH
406 [pre_scar_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
407 [rcrd_symp_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Record symphysis fundal height (SFH) at the 5th ANC visit yesno, Required
1Yes
0No
408 [sfh_a5]
Show the field ONLY if:
[rcrd_symp_5] = '1'
Symphysis fundal height (SFH) at the 5th ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
409 [rcrd_fhr_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Record FHR [>22wks] at 5th Visit yesno
1Yes
0No
410 [fhr_a5]
Show the field ONLY if:
[rcrd_fhr_5] = '1'
Fetal Heart Rate (fhr) at the 5th ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
411 [hemo_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Hemoglobin at 5th Visit yesno, Required
1Yes
0No
412 [hb_results_a5]
Show the field ONLY if:
[hemo_5] = '1'
Record Hb results at 5th ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
413 [rndm_bld_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Random blood sugar at 5th Visit yesno, Required
1Yes
0No
414 [rbs_results_a5]
Show the field ONLY if:
[rndm_bld_5]='1'
Record Random Blood Sugar results at the 5th ANC visit if available text (number, Min: 40, Max: 1000), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
415 [vdrl_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
VDRL/ Syphilis at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
416 [vdrl_results_a5]
Show the field ONLY if:
[vdrl_5] = '1'
Record VDRL results at 5th ANC visit, if available dropdown, Required
1Reactive
2Non-Reactive

Custom alignment: RH
417 [hiv_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
HIV at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
418 [hiv_results_a5]
Show the field ONLY if:
[hiv_5] = '1'
Record HIV results at 5th ANC visit, if available dropdown, Required
1Reactive
2Non - Reactive

Custom alignment: RH
419 [hbsag_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
HBsAG at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
420 [hbsag_results_a5]
Show the field ONLY if:
[hbsag_5] = '1'
Record HBsAG results at 5th ANC visit, if available dropdown, Required
1Reactive
2Non - reactive

Custom alignment: RH
421 [tsh_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
TSH at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
422 [tsh_results_a5]
Show the field ONLY if:
[tsh_5] = '1'
Record TSH results at 5th ANC visit, if available text (number), Required
Custom alignment: RH
423 [bld_rh_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Blood group and Rh at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
424 [bg_rh_results_a5]
Show the field ONLY if:
[bld_rh_5] = '1'
Record Blood group and Rh results at the 5th ANC visit, if
available 		text, Required
Custom alignment: RH
425 [gtt_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Glucose Tolerance Test (GTT) at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
426 [gtt_results_a5]
Show the field ONLY if:
[gtt_5] = '1'
Record Glucose Tolerance Test (GTT) results at 5th ANC visit, if available text, Required
Custom alignment: RH
427 [oth_5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Any other test at 5th Visit yesno, Required
1Yes
0No

Custom alignment: RH
428 [aobt_results_a5]
Show the field ONLY if:
[oth_5] = '1'
Record any other test results at the 5th ANC visit, if available text, Required
Custom alignment: RH
429 [urine_albumin_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Urine Albumin test done at 5th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
430 [urine_albumin_results_a5]
Show the field ONLY if:
[urine_albumin_a5] = '1'
Record Urine Albumin test results at 5th ANC visit, if available dropdown, Required
00
11+
22+
33+

Custom alignment: RH
431 [urine_sugar_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Urine Sugar test done at 5th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
432 [urine_sugar_test_results_a5]
Show the field ONLY if:
[urine_sugar_a5] = '1'
Record urine sugar test results at 5th ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
433 [urine_micro_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Urine Microscopy test done at 5th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
434 [urine_microscopy_results_a5]
Show the field ONLY if:
[urine_micro_a5] = '1'
Record urine microscopy results at 5th ANC visit, if available text, Required
Custom alignment: RH
435 [usg_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Did ultrasonography on the 5th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
436 [usgda_a5]
Show the field ONLY if:
[usg_a5] = '1'
Date of ultrasonography at 5th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
437 [where_done_usg_a5]
Show the field ONLY if:
[usg_a5] = '1'
Where was it done at 5th ANC visit? dropdown
1Public
2Private

Custom alignment: RH
438 [ga_in_weeks_usg_a5]
Show the field ONLY if:
[usg_a5] = '1'
GA in weeks at 5th ANC visit text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
439 [usg_f_a5]
Show the field ONLY if:
[usg_a5] = '1'
Finding (congenital anomaly [CA] / FGR) at 5th ANC visit[Congenital anomaly/FGR] text, Required
440 [doppler_done_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Doppler done on 5th ANC visit ? yesno, Required
1Yes
0No
441 [doppler_date_a5]
Show the field ONLY if:
[doppler_done_a5] = '1'
Date of Doppler at 5th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
442 [where_done_doppler_a5]
Show the field ONLY if:
[doppler_done_a5] = '1'
Where was the Doppler done at 5th ANC visit? dropdown, Required
1Public
2Private
443 [doppler_findings_a5]
Show the field ONLY if:
[doppler_done_a5] = '1'
Findings of Doppler at 5th ANC visit

 text, Required
444 [any_oth_radiological_tests_a5]
Show the field ONLY if:
[fifth_anc_visit_done]='1'
Any other Radiological tests done in the 5th ANC visit? yesno, Required
1Yes
0No
445 [oth_investigation_test_name_a5]
Show the field ONLY if:
[any_oth_radiological_tests_a5]='1'
Name of any other radiological test done at the 5th ANC visit text, Required
446 [oth_investigation_test_date_a5]
Show the field ONLY if:
[any_oth_radiological_tests_a5]='1'
Date of the Radiological test at the 5th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
447 [where_done_oth_investigation_a5]
Show the field ONLY if:
[any_oth_radiological_tests_a5]='1'
Where was the Radiological test done at the 5th ANC visit? dropdown, Required
1Public
2Private
448 [oth_investigation_findings_a5]
Show the field ONLY if:
[any_oth_radiological_tests_a5]='1'
Findings of the Radiological test at the 5th ANC visit text, Required
449 [sixth_anc_visit]
Show the field ONLY if:
[yes_howmny_anc] >= 6
Sixth ANC visit yesno
1Yes
0No
450 [date_anc_visits_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Date of 6th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
451 [gestational_ages_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Gestational age at 6th ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
452 [months_amenorrhea_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Months of amenorrhea at 6th ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
453 [place_of_anc_visit_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_6___1PHC
2place_of_anc_visit_6___2CHC
3place_of_anc_visit_6___3TH / SDH
4place_of_anc_visit_6___4DH
5place_of_anc_visit_6___5SC-HWC
6place_of_anc_visit_6___6Private Maternity homes
7place_of_anc_visit_6___7Private Hospital
454 [seen_by_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Seen by checkbox, Required
1seen_by_6___1Doctor
2seen_by_6___2Nurse
3seen_by_6___3ANM

Custom alignment: RH
455 [vomiting_anc_vst_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Vomiting yesno, Required
1Yes
0No
456 [incresed_frequncy_burning_passing_urine_anc_visit_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
457 [breathles_tiredne_anc_vst_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
458 [headache_blurred_vision_anc_vst_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
459 [jaundice_anc_vst_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Jaundice yesno, Required
1Yes
0No
460 [abdominal_pain_anc_vst_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Abdominal pain yesno, Required
1Yes
0No
461 [bleeding_per_vagina_anc_vst_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Bleeding per vagina yesno, Required
1Yes
0No
462 [abrmal_vaginal_discharg_anc_visit_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
463 [trtmnt_conception_anc_visit_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Treatment for conception yesno, Required
1Yes
0No
464 [fever_anc_vst_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Fever yesno
1Yes
0No
465 [other_anc_vist_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Other yesno
1Yes
0No
466 [other_specify_anc_visit_6]
Show the field ONLY if:
[other_anc_vist_6]='1'
Other, specify text
467 [ht_checked_anc_visit_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Height checked for ANC visit 6th yesno, Required
1Yes
0No

Custom alignment: RH
468 [checked_height_a6]
Show the field ONLY if:
[ht_checked_anc_visit_6] = '1'
Height at the 6th ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
469 [wt_checked_anc_visit_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Weight checked for ANC visit 6th yesno, Required
1Yes
0No

Custom alignment: RH
470 [checked_weight_a6]
Show the field ONLY if:
[wt_checked_anc_visit_6] = '1'
Weight at the 6th ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Field Annotation: @FORCE-MINMAX
471 [bp_checked_anc_visit_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Blood Pressure checked for ANC visit 6th yesno, Required
1Yes
0No

Custom alignment: RH
472 [checked_sbp_a6]
Show the field ONLY if:
[bp_checked_anc_visit_6] = '1'
SBP value at the 6th ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
473 [checked_dbp_a6]
Show the field ONLY if:
[bp_checked_anc_visit_6] = '1'
DBP value at the 6th ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
474 [checkd_pallor_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Checked for Pallor at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
475 [oedema_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Checked for Pedal Oedema at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
476 [breasts_examined_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Breasts Examined at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
477 [prob_breasts_examined_a6]
Show the field ONLY if:
[breasts_examined_a6] = '1'
Any specific problems observed during breast examination at the 6th ANC visit? checkbox, Required
1prob_breasts_examined_a6___1Inverted Nipple
2prob_breasts_examined_a6___2Flat Nipple
3prob_breasts_examined_a6___3Dry Skin

Custom alignment: RH
478 [pre_scar_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
479 [rcrd_symp_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Record symphysis fundal height (SFH) at the 6th ANC visit yesno, Required
1Yes
0No
480 [sfh_a6]
Show the field ONLY if:
[rcrd_symp_6] = '1'
Symphysis fundal height (SFH) at the 6th ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
481 [rcrd_fhr_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Record FHR [>22wks] at 6th Visit yesno
1Yes
0No
482 [fhr_a6]
Show the field ONLY if:
[rcrd_fhr_6] = '1'
Fetal Heart Rate (fhr) at the 6th ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
483 [hemo_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Hemoglobin at 6th Visit yesno, Required
1Yes
0No
484 [hb_results_a6]
Show the field ONLY if:
[hemo_6] = '1'
Record Hb results at 6th ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
485 [rndm_bld_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Random blood sugar at 6th Visit yesno, Required
1Yes
0No
486 [rbs_results_a6]
Show the field ONLY if:
[rndm_bld_6]='1'
Record Random Blood Sugar results at the 6th ANC visit if available text (number, Min: 40, Max: 1000), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
487 [vdrl_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
VDRL/ Syphilis at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
488 [vdrl_results_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Record VDRL results at 6th ANC visit, if available dropdown, Required
1Reactive
2Non-Reactive

Custom alignment: RH
489 [hiv_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
HIV at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
490 [hiv_results_a6]
Show the field ONLY if:
[hiv_6] = '1'
Record HIV results at 6th ANC visit, if available dropdown, Required
1Reactive
2Non - Reactive

Custom alignment: RH
491 [hbsag_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
HBsAG at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
492 [hbsag_results_a6]
Show the field ONLY if:
[hbsag_6] = '1'
Record HBsAG results at 3rd ANC visit, if available dropdown, Required
1Reactive
2Non - reactive

Custom alignment: RH
493 [tsh_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
TSH at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
494 [tsh_results_a6]
Show the field ONLY if:
[tsh_6] = '1'
Record TSH results at 6th ANC visit, if available text (number), Required
Custom alignment: RH
495 [bld_rh_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Blood group and Rh at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
496 [bg_rh_results_a6]
Show the field ONLY if:
[bld_rh_6] = '1'
Record Blood group and Rh results at the 6th ANC visit, if
available 		text, Required
Custom alignment: RH
497 [gtt_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Glucose Tolerance Test (GTT) at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
498 [gtt_results_a6]
Show the field ONLY if:
[gtt_6] = '1'
Record Glucose Tolerance Test (GTT) results at 6th ANC visit, if available text, Required
Custom alignment: RH
499 [oth_6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Any other test at 6th Visit yesno, Required
1Yes
0No

Custom alignment: RH
500 [aobt_results_a6]
Show the field ONLY if:
[oth_6] = '1'
Record any other test results at the 6th ANC visit, if available text, Required
Custom alignment: RH
501 [urine_albumin_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Urine Albumin test done at 6th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
502 [urine_albumin_results_a6]
Show the field ONLY if:
[urine_albumin_a6] = '1'
Record Urine Albumin test results at 6th ANC visit, if available dropdown, Required
00
11+
22+
33+

Custom alignment: RH
503 [urine_sugar_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Urine Sugar test done at 6th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
504 [urine_sugar_test_results_a6]
Show the field ONLY if:
[urine_sugar_a6] = '1'
Record urine sugar test results at 6th ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
505 [urine_micro_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Urine Microscopy test done at 6th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
506 [urine_microscopy_results_a6]
Show the field ONLY if:
[urine_micro_a6] = '1'
Record urine microscopy results at 6th ANC visit, if available text, Required
Custom alignment: RH
507 [usg_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Did ultrasonography on the 6th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
508 [usgda_a6]
Show the field ONLY if:
[usg_a6] = '1'
Date of ultrasonography at 6th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
509 [where_done_usg_a6]
Show the field ONLY if:
[usg_a6] = '1'
Where was it done at 6th ANC visit? dropdown
1Public
2Private

Custom alignment: RH
510 [ga_in_weeks_usg_a6]
Show the field ONLY if:
[usg_a6] = '1'
GA in weeks at 6th ANC visit text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
511 [usg_f_a6]
Show the field ONLY if:
[usg_a6] = '1'
Finding (congenital anomaly [CA] / FGR) at 6th ANC visit[Congenital anomaly/FGR] text, Required
512 [doppler_done_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Doppler done on 6th ANC visit ? yesno, Required
1Yes
0No
513 [doppler_date_a6]
Show the field ONLY if:
[doppler_done_a6] = '1'
Date of Doppler at 6th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
514 [where_done_doppler_a6]
Show the field ONLY if:
[doppler_done_a6] = '1'
Where was the Doppler done at 6th ANC visit? dropdown, Required
1Public
2Private
515 [doppler_findings_a6]
Show the field ONLY if:
[doppler_done_a6] = '1'
Findings of Doppler at 6th ANC visit

 text, Required
516 [any_oth_radiological_tests_a6]
Show the field ONLY if:
[sixth_anc_visit]='1'
Any other Radiological tests done in the 6th ANC visit? yesno, Required
1Yes
0No
517 [oth_investigation_test_name_a6]
Show the field ONLY if:
[any_oth_radiological_tests_a6] = '1'
Name of any other radiological test done at the 6th ANC visit text, Required
518 [oth_investigation_test_date_a6]
Show the field ONLY if:
[any_oth_radiological_tests_a6] = '1'
Date of the Radiological test at the 6th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
519 [where_done_oth_investigation_a6]
Show the field ONLY if:
[any_oth_radiological_tests_a6] = '1'
Where was the Radiological test done at the 6th ANC visit? dropdown, Required
1Public
2Private
520 [oth_investigation_findings_a6]
Show the field ONLY if:
[any_oth_radiological_tests_a6] = '1'
Findings of the Radiological test at the 6th ANC visit text, Required
521 [seventh_anc_visit]
Show the field ONLY if:
[yes_howmny_anc] >= 7
Seventh ANC visit yesno
1Yes
0No
522 [date_anc_visits_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Date of 7th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
523 [gestational_ages_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Gestational age at 7th ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
524 [months_amenorrhea_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Months of amenorrhea at 7th ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
525 [place_of_anc_visit_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_7___1PHC
2place_of_anc_visit_7___2CHC
3place_of_anc_visit_7___3TH / SDH
4place_of_anc_visit_7___4DH
5place_of_anc_visit_7___5SC-HWC
6place_of_anc_visit_7___6Private Maternity homes
7place_of_anc_visit_7___7Private Hospital
526 [seen_by_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Seen by checkbox, Required
1seen_by_7___1Doctor
2seen_by_7___2Nurse
3seen_by_7___3ANM

Custom alignment: RH
527 [vomiting_anc_vst_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Vomiting yesno, Required
1Yes
0No
528 [incresed_frequncy_burning_passing_urine_anc_visit_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
529 [breathles_tiredne_anc_vst_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
530 [headache_blurred_vision_anc_vst_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
531 [jaundice_anc_vst_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Jaundice yesno, Required
1Yes
0No
532 [abdominal_pain_anc_vst_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Abdominal pain yesno, Required
1Yes
0No
533 [bleeding_per_vagina_anc_vst_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Bleeding per vagina yesno, Required
1Yes
0No
534 [abrmal_vaginal_discharg_anc_visit_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
535 [trtmnt_conception_anc_visit_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Treatment for conception yesno, Required
1Yes
0No
536 [fever_anc_vst_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Fever yesno
1Yes
0No
537 [other_anc_vist_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Other yesno
1Yes
0No
538 [other_specify_anc_visit_7]
Show the field ONLY if:
[other_anc_vist_7]='1'
Other, specify text
539 [ht_checked_anc_visit_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Height checked for ANC visit 7th yesno, Required
1Yes
0No

Custom alignment: RH
540 [checked_height_a7]
Show the field ONLY if:
[ht_checked_anc_visit_7] = '1'
Height at the 7th ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
541 [wt_checked_anc_visit_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Weight checked for ANC visit 7th yesno, Required
1Yes
0No

Custom alignment: RH
542 [checked_weight_a7]
Show the field ONLY if:
[wt_checked_anc_visit_7] = '1'
Weight at the 7th ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Field Annotation: @FORCE-MINMAX
543 [bp_checked_anc_visit_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Blood Pressure checked for ANC visit 7th yesno, Required
1Yes
0No

Custom alignment: RH
544 [checked_sbp_a7]
Show the field ONLY if:
[bp_checked_anc_visit_7] = '1'
SBP value at the 7th ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
545 [checked_dbp_a7]
Show the field ONLY if:
[bp_checked_anc_visit_7] = '1'
DBP value at the 7th ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
546 [checkd_pallor_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Checked for Pallor at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
547 [oedema_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Checked for Pedal Oedema at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
548 [breasts_examined_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Breasts Examined at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
549 [prob_breasts_examined_a7]
Show the field ONLY if:
[breasts_examined_a7] = '1'
Any specific problems observed during breast examination at the 7th ANC visit? checkbox, Required
1prob_breasts_examined_a7___1Inverted Nipple
2prob_breasts_examined_a7___2Flat Nipple
3prob_breasts_examined_a7___3Dry Skin

Custom alignment: RH
550 [pre_scar_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
551 [rcrd_symp_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Record symphysis fundal height (SFH) at the 7th ANC visit yesno, Required
1Yes
0No
552 [sfh_a7]
Show the field ONLY if:
[rcrd_symp_7] = '1'
Symphysis fundal height (SFH) at the 7th ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
553 [rcrd_fhr_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Record FHR [>22wks] at 7th Visit yesno
1Yes
0No
554 [fhr_a7]
Show the field ONLY if:
[rcrd_fhr_7] = '1'
Fetal Heart Rate (fhr) at the 7th ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
555 [hemo_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Hemoglobin at 7th Visit yesno, Required
1Yes
0No
556 [hb_results_a7]
Show the field ONLY if:
[hemo_7] = '1'
Record Hb results at 7th ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
557 [rndm_bld_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Random blood sugar at 7th Visit yesno, Required
1Yes
0No
558 [rbs_results_a7]
Show the field ONLY if:
[rndm_bld_7]='1'
Record Random Blood Sugar results at the 7th ANC visit if available text (number, Min: 40, Max: 1000), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
559 [vdrl_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
VDRL/ Syphilis at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
560 [vdrl_results_a7]
Show the field ONLY if:
[vdrl_7] = '1'
Record VDRL results at 7th ANC visit, if available dropdown, Required
1Reactive
2Non-Reactive

Custom alignment: RH
561 [hiv_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
HIV at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
562 [hiv_results_a7]
Show the field ONLY if:
[hiv_7] = '1'
Record HIV results at 7th ANC visit, if available dropdown, Required
1Reactive
2Non - Reactive

Custom alignment: RH
563 [hbsag_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
HBsAG at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
564 [hbsag_results_a7]
Show the field ONLY if:
[hbsag_7] = '1'
Record HBsAG results at 7th ANC visit, if available dropdown, Required
1Reactive
2Non - reactive

Custom alignment: RH
565 [tsh_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
TSH at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
566 [tsh_results_a7]
Show the field ONLY if:
[tsh_7] = '1'
Record TSH results at 7th ANC visit, if available text (number), Required
Custom alignment: RH
567 [bld_rh_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Blood group and Rh at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
568 [bg_rh_results_a7]
Show the field ONLY if:
[bld_rh_7] = '1'
Record Blood group and Rh results at the 7th ANC visit, if
available 		text, Required
Custom alignment: RH
569 [gtt_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Glucose Tolerance Test (GTT) at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
570 [gtt_results_a7]
Show the field ONLY if:
[gtt_7] = '1'
Record Glucose Tolerance Test (GTT) results at 7th ANC visit, if available text, Required
Custom alignment: RH
571 [oth_7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Any other test at 7th Visit yesno, Required
1Yes
0No

Custom alignment: RH
572 [aobt_results_a7]
Show the field ONLY if:
[oth_7] = '1'
Record any other test results at the 7th ANC visit, if available text, Required
Custom alignment: RH
573 [urine_albumin_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Urine Albumin test done at 7th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
574 [urine_albumin_results_a7]
Show the field ONLY if:
[urine_albumin_a7] = '1'
Record Urine Albumin test results at 7th ANC visit, if available dropdown, Required
00
11+
22+
33+
44+
575 [urine_sugar_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Urine Sugar test done at 7th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
576 [urine_sugar_test_results_a7]
Show the field ONLY if:
[urine_sugar_a7] = '1'
Record urine sugar test results at 7th ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
577 [urine_micro_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Urine Microscopy test done at 7th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
578 [urine_microscopy_results_a7]
Show the field ONLY if:
[urine_micro_a7] = '1'
Record urine microscopy results at 7th ANC visit, if available text, Required
Custom alignment: RH
579 [usg_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Did ultrasonography on the 6th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
580 [usgda_a7]
Show the field ONLY if:
[usg_a7] = '1'
Date of ultrasonography at 7th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
581 [where_done_usg_a7]
Show the field ONLY if:
[usg_a7] = '1'
Where was it done at 7th ANC visit? dropdown
1Public
2Private

Custom alignment: RH
582 [ga_in_weeks_usg_a7]
Show the field ONLY if:
[usg_a7] = '1'
GA in weeks at 7th ANC visit text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
583 [usg_f_a7]
Show the field ONLY if:
[usg_a7] = '1'
Finding (congenital anomaly [CA] / FGR) at 7th ANC visit[Congenital anomaly/FGR] text, Required
584 [doppler_done_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Doppler done on 7th ANC visit ? yesno, Required
1Yes
0No
585 [doppler_date_a7]
Show the field ONLY if:
[doppler_done_a7] = '1'
Date of Doppler at 7th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
586 [where_done_doppler_a7]
Show the field ONLY if:
[doppler_done_a7] = '1'
Where was the Doppler done at 7th ANC visit? dropdown, Required
1Public
2Private
587 [doppler_findings_a7]
Show the field ONLY if:
[doppler_done_a7] = '1'
Findings of Doppler at 7th ANC visit

 text, Required
588 [any_oth_radiological_tests_a7]
Show the field ONLY if:
[seventh_anc_visit]='1'
Any other Radiological tests done in the 7th ANC visit? yesno, Required
1Yes
0No
589 [oth_investigation_test_name_a7]
Show the field ONLY if:
[any_oth_radiological_tests_a7] = '1'
Name of any other radiological test done at the 7th ANC visit text, Required
590 [oth_investigation_test_date_a7]
Show the field ONLY if:
[any_oth_radiological_tests_a7] = '1'
Date of the Radiological test at the 7th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
591 [where_done_oth_investigation_a7]
Show the field ONLY if:
[any_oth_radiological_tests_a7] = '1'
Where was the Radiological test done at the 7th ANC visit? dropdown, Required
1Public
2Private
592 [oth_investigation_findings_a7]
Show the field ONLY if:
[any_oth_radiological_tests_a7] = '1'
Findings of the Radiological test at the 7th ANC visit text, Required
593 [eighth_anc_visit]
Show the field ONLY if:
[yes_howmny_anc] >= 8
Eighth ANC visit yesno
1Yes
0No
594 [date_anc_visits_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Date of 8th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
595 [gestational_ages_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Gestational age at 8th ANC visit(in weeks) text (number, Min: 1, Max: 45), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
596 [months_amenorrhea_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Months of amenorrhea at 8th ANC visit text (number, Min: 1, Max: 10), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
597 [place_of_anc_visit_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Place of ANC visit checkbox, Required
1place_of_anc_visit_8___1PHC
2place_of_anc_visit_8___2CHC
3place_of_anc_visit_8___3TH / SDH
4place_of_anc_visit_8___4DH
5place_of_anc_visit_8___5SC-HWC
6place_of_anc_visit_8___6Private Maternity homes
7place_of_anc_visit_8___7Private Hospital
598 [seen_by_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Seen by checkbox, Required
1seen_by_8___1Doctor
2seen_by_8___2Nurse
3seen_by_8___3ANM

Custom alignment: RH
599 [vomiting_anc_vst_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Vomiting yesno, Required
1Yes
0No
600 [incresed_frequncy_burning_passing_urine_anc_visit_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Increased frequency / burning while passing urine yesno, Required
1Yes
0No
601 [breathles_tiredne_anc_vst_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Any breathlessness / tiredness yesno, Required
1Yes
0No
602 [headache_blurred_vision_anc_vst_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Headache / blurred vision / swelling of legs and body yesno, Required
1Yes
0No
603 [jaundice_anc_vst_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Jaundice yesno, Required
1Yes
0No
604 [abdominal_pain_anc_vst_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Abdominal pain yesno, Required
1Yes
0No
605 [bleeding_per_vagina_anc_vst_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Bleeding per vagina yesno, Required
1Yes
0No
606 [abrmal_vaginal_discharg_anc_visit_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Abnormal vaginal discharge and itching yesno, Required
1Yes
0No
607 [trtmnt_conception_anc_visit_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Treatment for conception yesno, Required
1Yes
0No
608 [fever_anc_vst_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Fever yesno
1Yes
0No
609 [other_anc_vist_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Other yesno
1Yes
0No
610 [other_specify_anc_visit_8]
Show the field ONLY if:
[other_anc_vist_8]='1'
Other, specify text
611 [ht_checked_anc_visit_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Height checked for ANC visit 8th yesno, Required
1Yes
0No

Custom alignment: RH
612 [checked_height_a8]
Show the field ONLY if:
[ht_checked_anc_visit_8] = '1'
Height at the 8th ANC visit(in cms) text (number, Min: 100, Max: 200), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
613 [wt_checked_anc_visit_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Weight checked for ANC visit 8th yesno, Required
1Yes
0No

Custom alignment: RH
614 [checked_weight_a8]
Show the field ONLY if:
[wt_checked_anc_visit_8] = '1'
Weight at the 8th ANC visit(in kgs) text (number, Min: 25, Max: 200), Required
Field Annotation: @FORCE-MINMAX
615 [bp_checked_anc_visit_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Blood Pressure checked for ANC visit 8th yesno, Required
1Yes
0No

Custom alignment: RH
616 [checked_sbp_a8]
Show the field ONLY if:
[bp_checked_anc_visit_8] = '1'
SBP value at the 8th ANC visit text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
617 [checked_dbp_a8]
Show the field ONLY if:
[bp_checked_anc_visit_8] = '1'
DBP value at the 8th ANC visit text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
618 [checkd_pallor_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Checked for Pallor at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
619 [oedema_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Checked for Pedal Oedema at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
620 [breasts_examined_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Breasts Examined at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
621 [prob_breasts_examined_a8]
Show the field ONLY if:
[breasts_examined_a8] = '1'
Any specific problems observed during breast examination at the 8th ANC visit? checkbox, Required
1prob_breasts_examined_a8___1Inverted Nipple
2prob_breasts_examined_a8___2Flat Nipple
3prob_breasts_examined_a8___3Dry Skin

Custom alignment: RH
622 [pre_scar_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Checked for Previous Scar yesno, Required
1Yes
0No

Custom alignment: RH
623 [rcrd_symp_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Record symphysis fundal height (SFH) at the 8th ANC visit yesno, Required
1Yes
0No
624 [sfh_a8]
Show the field ONLY if:
[rcrd_symp_8] = '1'
Symphysis fundal height (SFH) at the 8th ANC visit text (number, Min: 12, Max: 36), Required
Field Annotation: @FORCE-MINMAX
625 [rcrd_fhr_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Record FHR [>22wks] at 8th Visit yesno
1Yes
0No
626 [fhr_a8]
Show the field ONLY if:
[rcrd_fhr_8] = '1'
Fetal Heart Rate (fhr) at the 8th ANC visit text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
627 [hemo_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Hemoglobin at 8th Visit yesno, Required
1Yes
0No
628 [hb_results_a8]
Show the field ONLY if:
[hemo_8] = '1'
Record Hb results at 8th ANC visit, if available text (number, Min: 2, Max: 20), Required
Field Annotation: @FORCE-MINMAX
629 [rndm_bld_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Random blood sugar at 8th Visit yesno, Required
1Yes
0No
630 [rbs_results_a8]
Show the field ONLY if:
[rndm_bld_8]='1'
Record Random Blood Sugar results at the 8th ANC visit,
if available 		text, Required
631 [vdrl_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
VDRL/ Syphilis at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
632 [vdrl_results_a8]
Show the field ONLY if:
[vdrl_8] = '1'
Record VDRL results at 8th ANC visit, if available dropdown, Required
1Reactive
2Non-Reactive

Custom alignment: RH
633 [hiv_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
HIV at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
634 [hiv_results_a8]
Show the field ONLY if:
[hiv_8] = '1'
Record HIV results at 8th ANC visit, if available dropdown, Required
1Reactive
2Non - Reactive

Custom alignment: RH
635 [hbsag_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
HBsAG at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
636 [hbsag_results_a8]
Show the field ONLY if:
[hbsag_8] = '1'
Record HBsAG results at 8th ANC visit, if available dropdown, Required
1Reactive
2Non - reactive

Custom alignment: RH
637 [tsh_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
TSH at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
638 [tsh_results_a8]
Show the field ONLY if:
[tsh_8] = '1'
Record TSH results at 8th ANC visit, if available text (number), Required
Custom alignment: RH
639 [bld_rh_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Blood group and Rh at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
640 [bg_rh_results_a8]
Show the field ONLY if:
[bld_rh_8] = '1'
Record Blood group and Rh results at the 8th ANC visit, if
available 		text, Required
Custom alignment: RH
641 [gtt_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Glucose Tolerance Test (GTT) at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
642 [gtt_results_a8]
Show the field ONLY if:
[gtt_8] = '1'
Record Glucose Tolerance Test (GTT) results at 8th ANC visit, if available text, Required
Custom alignment: RH
643 [oth_8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Any other test at 8th Visit yesno, Required
1Yes
0No

Custom alignment: RH
644 [aobt_results_a8]
Show the field ONLY if:
[oth_8] = '1'
Record any other test results at the 8th ANC visit, if available text, Required
Custom alignment: RH
645 [urine_albumin_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Urine Albumin test done at 8th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
646 [urine_albumin_results_a8]
Show the field ONLY if:
[urine_albumin_a8] = '1'
Record Urine Albumin test results at 8th ANC visit, if
available 		dropdown, Required
00
11+
22+
33+
44+
647 [urine_sugar_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Urine Sugar test done at 8th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
648 [urine_sugar_test_results_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Record urine sugar test results at 8th ANC visit, if available dropdown, Required
00
11+
22+
33+
44+

Custom alignment: RH
649 [urine_micro_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Urine Microscopy test done at 8th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
650 [urine_microscopy_results_a8]
Show the field ONLY if:
[urine_micro_a8] = '1'
Record urine microscopy results at 8th ANC visit, if available text, Required
Custom alignment: RH
651 [usg_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Did ultrasonography on the 8th ANC visit? yesno, Required
1Yes
0No

Custom alignment: RH
652 [usgda_a8]
Show the field ONLY if:
[usg_a8] = '1'
Date of ultrasonography at 8th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
653 [where_done_usg_a8]
Show the field ONLY if:
[usg_a8] = '1'
Where was the Radiological test done at the 8th ANC visit? dropdown, Required
1Public
2Private
654 [ga_in_weeks_usg_a8]
Show the field ONLY if:
[usg_a8] = '1'
GA in weeks at 8th ANC visit text (number, Min: 1, Max: 45), Required
Field Annotation: @FORCE-MINMAX
655 [usg_f_a8]
Show the field ONLY if:
[usg_a8] = '1'
Findings of the Radiological test at the 8th ANC visit text, Required
656 [doppler_done_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Doppler done on 8th ANC visit?[Expected at 18-20 weeks with severe SGA/FGR] yesno, Required
1Yes
0No
657 [doppler_date_a8]
Show the field ONLY if:
[doppler_done_a8] = '1'
Date of Doppler at 8th ANC visit text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
658 [where_done_doppler_a8]
Show the field ONLY if:
[doppler_done_a8] = '1'
Where was the Doppler done at 8th ANC visit? radio, Required
1Public
2Private
659 [doppler_findings_a8]
Show the field ONLY if:
[doppler_done_a8] = '1'
Findings of Doppler at 8th ANC visit text, Required
660 [any_oth_radiological_tests_a8]
Show the field ONLY if:
[eighth_anc_visit]='1'
Any other Radiological tests done in the 8th ANC visit? yesno
1Yes
0No
661 [oth_investigation_test_name_a8]
Show the field ONLY if:
[any_oth_radiological_tests_a8] = '1'
Name of any other radiological test done at the 8th ANC
visit 		text, Required
662 [oth_investigation_test_date_a8]
Show the field ONLY if:
[any_oth_radiological_tests_a8] = '1'
Date of the Radiological test at the 8th ANC visit text (date_dmy, Min: [lmp], Max: today)
Field Annotation: @FORCE-MINMAX
663 [where_done_oth_investigation_a8]
Show the field ONLY if:
[any_oth_radiological_tests_a8] = '1'
Where was the Radiological test done at the 8th ANC
visit? 		radio, Required
1Public
2Private
664 [oth_investigation_findings_a8]
Show the field ONLY if:
[any_oth_radiological_tests_a8] = '1'
Findings of the Radiological test at the 8th ANC visit text, Required
665 [recived_any_medication] (Section Header: Section 5Care during Pregnancy) descriptive
666 [prescribe_folic_acid_iron] 5.1.1. Iron & Folic acid(only in 1st trimester)   yesno, Required
1Yes
0No
667 [took_iron_folic_acid]
Show the field ONLY if:
[prescribe_folic_acid_iron] = '1'
Took the medication (Iron & Folic acid) yesno, Required
1Yes
0No
668 [folic_acid_details]
Show the field ONLY if:
[took_iron_folic_acid] = '1'
How many tablets were bought/given text (number), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
669 [iron_fa_tablets_comsumed]
Show the field ONLY if:
[took_iron_folic_acid] = '1'
How many tablets were consumed? text (number), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
670 [prescribed_ca] 5.1.2. Calcium yesno, Required
1Yes
0No

Custom alignment: RH
671 [taken_ca]
Show the field ONLY if:
[prescribed_ca] = '1'
Taken medication Calcium? yesno, Required
1Yes
0No

Custom alignment: RH
672 [details_ca_medication]
Show the field ONLY if:
[taken_ca] = '1'
Details of calcium medication radio, Required
1Regular (5/7or 24/30)
2Irregular

Custom alignment: RH
673 [prescribed_asp] 5.1.3. Low dose Aspirin yesno, Required
1Yes
0No

Custom alignment: RH
674 [taken_asp]
Show the field ONLY if:
[prescribed_asp] = '1'
Taken Medication Aspirin? yesno, Required
1Yes
0No

Custom alignment: RH
675 [details_asp_medication]
Show the field ONLY if:
[taken_asp] = '1'
Details radio, Required
1Regular (5/7or 24/30)
2Irregular

Custom alignment: RH
676 [pih_hypertension] 5.1.4. PIH/ Hypertension yesno, Required
1Yes
0No

Custom alignment: RH
677 [took_pih_hyp_medication]
Show the field ONLY if:
[pih_hypertension] = '1'
Then specify if you took the medication yesno, Required
1Yes
0No

Custom alignment: RH
678 [pih_hyp_names]
Show the field ONLY if:
[took_pih_hyp_medication] = '1'
Name text, Required
679 [details_pih_hyp_medication]
Show the field ONLY if:
[took_pih_hyp_medication] = '1'
Details radio, Required
1Regular (5/7or 24/30)
2Irregular
680 [prescribed_inj_tt] 5.1.5 Injection TT(on registration, then 1 month after the rst dose preferably a monthbefore EDD. If woman misses a ANC, then still give it next visit) / dT? yesno, Required
1Yes
0No
681 [taken_inj_tt]
Show the field ONLY if:
[prescribed_inj_tt] = '1'
Took the medication Injection TT? yesno, Required
1Yes
0No
682 [date_1st_tt]
Show the field ONLY if:
[taken_inj_tt] = '1'
Date of 1st dose text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
683 [date_2nd_tt]
Show the field ONLY if:
[taken_inj_tt] = '1'
Date of 2nd dose text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
684 [date_of_booster_dose]
Show the field ONLY if:
[taken_inj_tt] = '1'
Date of Booster Dose text (date_dmy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
685 [prescribed_inj_iron] 5.1.6 Prescribed Injection Iron? yesno, Required
1Yes
0No
686 [took_inj_iron]
Show the field ONLY if:
[prescribed_inj_iron] = '1'
Then specify if you took the medication yesno, Required
1Yes
0No
687 [date_inj_iron]
Show the field ONLY if:
[took_inj_iron] = '1'
Date text (date_dmy, Min: [lmp], Max: today)
Field Annotation: @FORCE-MINMAX
688 [prescribed_antibiotics] 5.1.7 Anti-D yesno, Required
1Yes
0No
689 [taken_antibiotics]
Show the field ONLY if:
[prescribed_antibiotics] ='1'
Taken Anti-D? yesno, Required
1Yes
0No
690 [date_antibiotics]
Show the field ONLY if:
[taken_antibiotics] = '1'
Date text (date_mdy, Min: [lmp], Max: today), Required
Field Annotation: @FORCE-MINMAX
691 [prescribed_diab_medication] 5.1.8 Diabetes yesno, Required
1Yes
0No
692 [took_diabetes_medication]
Show the field ONLY if:
[prescribed_diab_medication] = '1'
Then specify if you took the medication yesno
1Yes
0No
693 [name_diab_medication]
Show the field ONLY if:
[took_diabetes_medication] = '1'
Name text, Required
694 [details_diabetes_medication]
Show the field ONLY if:
[took_diabetes_medication] = '1'
Details radio, Required
1Regular (5/7or 24/30)
2Irregular
695 [thyroid_medication_prescribed] 5.1.9 Thyroid supplement yesno, Required
1Yes
0No
696 [took_thyroid_medication]
Show the field ONLY if:
[thyroid_medication_prescribed] = '1'
Then specify if you took the medication yesno, Required
1Yes
0No
697 [name_thyroid_medication]
Show the field ONLY if:
[took_thyroid_medication]= '1'
Name text, Required
698 [details_thyroid_medication]
Show the field ONLY if:
[took_thyroid_medication]= '1'
Details radio, Required
1Regular (5/7or 24/30)
2Irregular
699 [oth_tablets_prescribed] 5.1.10 Other tablets / Syrup yesno, Required
1Yes
0No
700 [took_oth_medication]
Show the field ONLY if:
[oth_tablets_prescribed] ='1'
then specify if you took the medication yesno, Required
1Yes
0No
701 [name_oth_medication]
Show the field ONLY if:
[took_oth_medication] ='1'
Name text, Required
702 [oth_inj_medication] 5.1.11 Other injections yesno, Required
1Yes
0No
703 [took_oth_inj]
Show the field ONLY if:
[oth_inj_medication] ='1'
then specify if you took the medication yesno, Required
1Yes
0No
704 [oth_inj_name]
Show the field ONLY if:
[took_oth_inj] = '1'
Name text, Required
705 [counseling_information_given] Check if any counseling/information was given and recorded during ANC visit Source (MCP/report/ CI) descriptive
706 [take_adequate_rest] a. Take adequate rest. yesno, Required
1Yes
0No
707 [who_gave_information]
Show the field ONLY if:
[take_adequate_rest]='1'
Who gave information radio
1CHW
2HCP
708 [complied_counselling_1]
Show the field ONLY if:
[take_adequate_rest]='1'
Complied yesno
1Yes
0No
709 [sleep_side_right_or_left] b. Sleep on a side (right or left side) yesno, Required
1Yes
0No
710 [who_gave_information_2]
Show the field ONLY if:
[sleep_side_right_or_left]='1'
Who gave information radio
1CHW
2HCP
711 [complied_counselling_2]
Show the field ONLY if:
[sleep_side_right_or_left]='1'
Complied yesno
1Yes
0No
712 [perform_adequate_physical] c. Perform adequate physical activity. yesno, Required
1Yes
0No
713 [who_gave_information_3]
Show the field ONLY if:
[perform_adequate_physical]='1'
Who gave information radio
1CHW
2HCP
714 [complied_counselling_3]
Show the field ONLY if:
[perform_adequate_physical]='1'
Complied yesno
1Yes
0No
715 [consume_a_balanced_diet] d. Consume a balanced diet / Take dietary supplements from ICDS. yesno, Required
1Yes
0No
716 [who_gave_information_4]
Show the field ONLY if:
[consume_a_balanced_diet] = '1'
Who gave information radio
1CHW
2HCP
717 [complied_counselling_4]
Show the field ONLY if:
[consume_a_balanced_diet] = '1'
Complied yesno
1Yes
0No
718 [take_medications_prescrib] e. Take medications prescribed. yesno, Required
1Yes
0No
719 [who_gave_information_5]
Show the field ONLY if:
[take_medications_prescrib]='1'
Who gave information radio
1CHW
2HCP
720 [complied_counselling_5]
Show the field ONLY if:
[take_medications_prescrib]='1'
Complied yesno
1Yes
0No
721 [check_daily_fetal_movement] f. Check daily fetal movement (FM begins 16-22 weeks. Women with HRP are preferable to be aware of and monitor movements by 26 weeks. < 6 movements in 2 hours must be reported. Women without HRP can be monitored from the third trimester-28 weeks). yesno, Required
1Yes
0No
722 [who_gave_information_6]
Show the field ONLY if:
[check_daily_fetal_movement]='1'
Who gave information radio
1CHW
2HCP
723 [complied_counselling_6]
Show the field ONLY if:
[check_daily_fetal_movement]='1'
Complied yesno
1Yes
0No
724 [look_danger_signs_report] g. Look for danger signs and report yesno, Required
1Yes
0No
725 [specify_which_of_following]
Show the field ONLY if:
[look_danger_signs_report]='1'
specify which of the following were mentioned checkbox
1specify_which_of_following___1â–¡ Fever
2specify_which_of_following___2â–¡ Leaking PV
3specify_which_of_following___3â–¡ Bleeding PV
4specify_which_of_following___4â–¡ Headache / blurred vision/convulsions
5specify_which_of_following___5â–¡ Breathlessness at rest
6specify_which_of_following___6â–¡ Pain abdomen
7specify_which_of_following___7â–¡ Absent or Reduced Fetal Movements
726 [who_gave_information_7]
Show the field ONLY if:
[look_danger_signs_report]='1'
Who gave information checkbox
1who_gave_information_7___1CHW
2who_gave_information_7___2HCP
727 [complied_counselling_7]
Show the field ONLY if:
[look_danger_signs_report]='1'
Complied yesno
1Yes
0No
728 [birth_preparednes_and_plan] h. Birth preparedness and plan yesno, Required
1Yes
0No
729 [specify_details_birth_prep]
Show the field ONLY if:
[birth_preparednes_and_plan]='1'
specify details checkbox
1specify_details_birth_prep___1Birth companion
2specify_details_birth_prep___2Blood donor, if needed during an emergency
3specify_details_birth_prep___3Facility for childbirth
4specify_details_birth_prep___4Transportation
5specify_details_birth_prep___5Finances
6specify_details_birth_prep___6Breastfeeding
7specify_details_birth_prep___7Kangaroo Mother Care
8specify_details_birth_prep___8Safe sex and contraception
730 [who_gave_information_8]
Show the field ONLY if:
[birth_preparednes_and_plan]='1'
Who gave information radio
1CHW
2HCP
731 [complied_counselling_8]
Show the field ONLY if:
[birth_preparednes_and_plan]='1'
Complied yesno
1Yes
0No
732 [refer_higher_level_faci] 5.2 Was the mother referred to seek care at a higher level facility?
 yesno, Required
1Yes
0No
733 [moth_referal_reason]
Show the field ONLY if:
[refer_higher_level_faci] ='1'
Why was she referred? Specify text, Required
Custom alignment: RH
734 [admitted_during_preg] 5.3 Was admitted any time during pregnancy? yesno, Required
1Yes
0No

Custom alignment: RH
735 [yes_admitted_during_preg]
Show the field ONLY if:
[admitted_during_preg] ='1'
5.3.1 Why text, Required
Custom alignment: RH
736 [when_admitted_during_preg]
Show the field ONLY if:
[admitted_during_preg] ='1'
5.3.2 When was she admitted text (date_dmy, Min: [lmp], Max: today), Required
Custom alignment: RH
737 [where_admitted_during_preg]
Show the field ONLY if:
[admitted_during_preg] ='1'
5.3.3 Where was she admitted during pregnancy? radio, Required
1SDH
2DH
3MCH
4Private
5Other
738 [othr_where_admitted_during_preg]
Show the field ONLY if:
[where_admitted_during_preg]="5"
Other specify text
739 [no_admitted_during_preg]
Show the field ONLY if:
[admitted_during_preg] ='1'
5.3.4 How many times was she admitted during pregnancy? text (number), Required
Custom alignment: RH
740 [same_health_facility]
Show the field ONLY if:
[admitted_during_preg] ='1'
5.3.5 Did she go to the same health facility?[If admitted once, choose not applicable] radio, Required
1Yes
2No
3Not Applicable
741 [no_where_why]
Show the field ONLY if:
[same_health_facility] = '2'
5.3.6 Where did she go? and why? text, Required
Custom alignment: RH
742 [incentives] 5.4 Received any incentives? yesno, Required
1Yes
0No
743 [which_recvd]
Show the field ONLY if:
[incentives]='1'
5.4.1 If Yes, specify which of the following were received text
744 [pmmvy_incevtive]
Show the field ONLY if:
[incentives] = '1'
a. Pradhana Mantri Matru Vandana Yojana (PMMVY) yesno, Required
1Yes
0No
745 [early_reg_preg_incentives]
Show the field ONLY if:
[pmmvy_incevtive] = '1'
Early registration of Pregnancy yesno, Required
1Yes
0No
746 [pmmvy_ea_reg_incen_aftr_d_m]
Show the field ONLY if:
[early_reg_preg_incentives] = '1'
Please specify how many days/ months after the registration it was received: text, Required
Custom alignment: RH
747 [anc_incentive_reci]
Show the field ONLY if:
[pmmvy_incevtive] = '1'
ANC visit (After 6 months of pregnancy with at least one ANC check up)(After six months of pregnancy with at least one ANC check-up) yesno, Required
1Yes
0No

Custom alignment: RH
748 [pmmvy_anc_incen_aftr_d_m]
Show the field ONLY if:
[anc_incentive_reci] = '1'
please specify how many days/ months after the registration it was received text, Required
Custom alignment: RH
749 [pmsma]
Show the field ONLY if:
[incentives]='1'
b. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) yesno, Required
1Yes
0No

Custom alignment: RH
750 [jsy]
Show the field ONLY if:
[incentives]='1'
c. Janani Suraksha Yojana (JSY) yesno, Required
1Yes
0No

Custom alignment: RH
751 [food_suppl] 5.5. Received any food supplements during pregnancy? yesno, Required
1Yes
0No

Custom alignment: RH
752 [specify_food_suppl]
Show the field ONLY if:
[food_suppl] = '1'
5.5.1 If YES, specify which of the following were received? checkbox, Required
1specify_food_suppl___1Anganwadi
2specify_food_suppl___2Janani Shishu Suraksha Karyakran (JSSK) (Duringhospitalization)
3specify_food_suppl___3Any other
753 [oth_food_supplements]
Show the field ONLY if:
[specify_food_suppl(3)] ='1'
Any other text, Required
754 [labour_admit_confir] Section Header: Management of a Woman during Labour Part 3
Section 6: Details of Admission
6.1 was the mother admitted? 		yesno, Required
1Yes
0No
755 [moth_admit_6]
Show the field ONLY if:
[labour_admit_confir]="1"
6.1 Where was the mother admitted? radio, Required
1District Hospital (DH)
2Taluk Hospital (TH)
3Community Health Center (CHC)
424/7 Primary Health Center (24/7 PHC)
5Private maternity home
6SDH
7Other
756 [name_taluk_hosp]
Show the field ONLY if:
[moth_admit_6] = '2'
Name of the taluk hospital text, Required
757 [name_comm_hlth]
Show the field ONLY if:
[moth_admit_6] = '3'
Name of community health center text, Required
758 [name_prim_hlth]
Show the field ONLY if:
[moth_admit_6] = '4'
Name of primary health center text, Required
759 [name_priv_mtrnty]
Show the field ONLY if:
[moth_admit_6] = '5'
Name of private maternity home text, Required
760 [name_sdh]
Show the field ONLY if:
[moth_admit_6] = '6'
Name of SDH text, Required
761 [any_oth_spec]
Show the field ONLY if:
[moth_admit_6] = '7'
Specify text, Required
762 [dt_admis_6]
Show the field ONLY if:
[labour_admit_confir]="1"
6.2 Date of admission text (date_dmy, Max: today), Required
Field Annotation: @FORCE-MINMAX
763 [time_admis_6]
Show the field ONLY if:
[labour_admit_confir]="1"
6.3 Time of Admission text (time), Required
764 [mode_trans_6]
Show the field ONLY if:
[labour_admit_confir]="1"
6.4 How did she get to the hospital (Mode of transport)? dropdown, Required
1Ambulance
2Two-wheeler
3Auto
4Car
5Bus
6Other
765 [other_7]
Show the field ONLY if:
[mode_trans_6] = '6'
Specify text, Required
766 [asha_6]
Show the field ONLY if:
[labour_admit_confir]="1"
6.5 Did the ASHA accompany her? yesno, Required
1Yes
0No
767 [vital_clinic_6]
Show the field ONLY if:
[labour_admit_confir]="1"
6.6 What vital clinical parameters were checked when the mother was admitted to the hospital? checkbox, Required
1vital_clinic_6___1Mother's temperature
2vital_clinic_6___2Mother's blood pressure
3vital_clinic_6___3Mother's pulse rate
4vital_clinic_6___4Gestational Age in weeks
5vital_clinic_6___5Fetal Heart Rate
6vital_clinic_6___6Contraction
7vital_clinic_6___7Investigations
768 [value_moth_temp]
Show the field ONLY if:
[vital_clinic_6(1)] = '1'
Value of mother's temperature

(in Celsius) 		text (number, Min: 25, Max: 105), Required
Field Annotation: @FORCE-MINMAX
769 [value_bp_6]
Show the field ONLY if:
[vital_clinic_6(2)] = '1'
Value of blood pressure text, Required
770 [value_pulrt_6]
Show the field ONLY if:
[vital_clinic_6(3)] = '1'
Value of pulse rate text, Required
771 [value_ga_6]
Show the field ONLY if:
[vital_clinic_6(4)] = '1'
Value of gestational age text, Required
772 [value_ftlhrtrt_6]
Show the field ONLY if:
[vital_clinic_6(5)] = '1'
Value of fetal heart text, Required
773 [freq_10_mins]
Show the field ONLY if:
[vital_clinic_6(6)] = '1'
Number in 10 mins text, Required
774 [duratn_scnds]
Show the field ONLY if:
[vital_clinic_6(6)] = '1'
Duration in seconds text, Required
775 [val_invest]
Show the field ONLY if:
[vital_clinic_6(7)] = '1'
Value for Investigations checkbox, Required
1val_invest___1HB
2val_invest___2HIV
3val_invest___3VDRL
4val_invest___4Hepatitis B
5val_invest___5Group and Type
6val_invest___6Other
776 [value_hb]
Show the field ONLY if:
[val_invest(1)] = '1'
Value of HB text
777 [value_hiv]
Show the field ONLY if:
[val_invest(2)] = '1'
Value of HIV text, Required
778 [value_vdrl]
Show the field ONLY if:
[val_invest(3)] = '1'
Value of VDRL text, Required
779 [value_hepatits]
Show the field ONLY if:
[val_invest(4)] = '1'
Value of hepatitis text, Required
780 [value_other_type]
Show the field ONLY if:
[val_invest(5)] = '1'
Bloof Group and Type, Specify text, Required
781 [oth_spec_6]
Show the field ONLY if:
[val_invest(6)] = '1'
Any other, specify text, Required
782 [perfom_chk_6] 6.7 Who performed this check? checkbox
4perfom_chk_6___4Doctor
5perfom_chk_6___5Nurse
6perfom_chk_6___6ANM
7perfom_chk_6___7Other
783 [perfom_chk_6_other]
Show the field ONLY if:
[perfom_chk_6(4)] = '1'
Specify other text
784 [dirct_admis_6] 6.8 Was it direct admission? yesno, Required
1Yes
0No
785 [rsn_drtadmsn_6]
Show the field ONLY if:
[dirct_admis_6] = '1'
6.9 If YES, management for this admission checkbox, Required
1rsn_drtadmsn_6___1Labour pain at term/ abdominal pain at term / No other problem
2rsn_drtadmsn_6___2Bleeding per vagina
3rsn_drtadmsn_6___3Fever
4rsn_drtadmsn_6___4Preeclampsia /Eclampsia
5rsn_drtadmsn_6___5Preterm Labour /Premature rupture of membranes PROM / Preterm Premature rupture of membranes PPROM
6rsn_drtadmsn_6___6Obstetric problems
7rsn_drtadmsn_6___7Fetal problems
8rsn_drtadmsn_6___8History of major medical illness
786 [yes_preclmp]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1'
If Preeclampsia / Eclampsia checkbox, Required
1yes_preclmp___1Severe headache
2yes_preclmp___2Blurred vision
3yes_preclmp___3Vomiting
4yes_preclmp___4High BP
5yes_preclmp___5Convulsions
787 [yes_preterm]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1'
If Preterm Labour checkbox, Required
1yes_preterm___1Leaking per vagina (Premature rupture of membranes-PROM)
2yes_preterm___2Preterm premature rupture of membranes PPROM
3yes_preterm___3Preterm Labour
788 [yes_obst_pblms]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1'
If Obstetric problems checkbox, Required
1yes_obst_pblms___1Present mal-position or mal-presentation / Obstructed labour
2yes_obst_pblms___2Present transverse lie
3yes_obst_pblms___3Abruptio placentapresenting with abdominal pain
4yes_obst_pblms___4Previous bad obstetrical history
5yes_obst_pblms___5Multiple pregnancy
6yes_obst_pblms___6Previous LSCS
789 [yes_fetal_pblms]
Show the field ONLY if:
[rsn_drtadmsn_6(7)] = '1'
If Fetal problems checkbox, Required
1yes_fetal_pblms___1Absent or Reduced Fetal Movement
2yes_fetal_pblms___2Cord prolapse
3yes_fetal_pblms___3Cord around the neck
4yes_fetal_pblms___4Present Fetal Growth Retardation
5yes_fetal_pblms___5Already diagnosed stillbirth
790 [yes_history]
Show the field ONLY if:
[rsn_drtadmsn_6(8)] = '1'
For History of major medical illness checkbox, Required
1yes_history___1Asthma
2yes_history___2COPD
3yes_history___3Heart disease
4yes_history___4Bleeding disorder
5yes_history___5Other
791 [other_hstry_6]
Show the field ONLY if:
[yes_history(5)] = '1'
Any other-specify text, Required
792 [urgnt_emerg_6]
Show the field ONLY if:
[dirct_admis_6] = '0'
6.10 If NO for a direct admission, was it an urgent /emergency referral? yesno
1Yes
0No
793 [where_moth_refer]
Show the field ONLY if:
[dirct_admis_6] = '0'
6.10.1 From where was the mother referred? dropdown, Required
1District Hospital (DH)
2Taluk Hospital (TH) or SDH
3Community Health Center (CHC)
4Primary Health Center (PHC)
5Private Maternity home
6Others
794 [oth_spec_6_10]
Show the field ONLY if:
[where_moth_refer] = '6'
Other, specify text, Required
795 [date_refer_6]
Show the field ONLY if:
[dirct_admis_6] = '0'
6.10.2 Date of referral text (date_dmy, Max: today), Required
796 [time_refer_6]
Show the field ONLY if:
[dirct_admis_6] = '0'
6.10.3 Time of referral text (time_hh_mm_ss)
797 [initi_refer_facili]
Show the field ONLY if:
[dirct_admis_6] = '0'
6.11 Was the initial management given at the referral facility? yesno, Required
1Yes
0No
798 [para_reordrd_6_11]
Show the field ONLY if:
[initi_refer_facili] = '1'
6.11.1 Were the following parameters recorded checkbox, Required
1para_reordrd_6_11___1Mother's temperature
2para_reordrd_6_11___2Mother's blood pressure
3para_reordrd_6_11___3Mother's pulse rate
4para_reordrd_6_11___4Gestational age in weeks
5para_reordrd_6_11___5Fetal Heart Rate
6para_reordrd_6_11___6Contraction
799 [temp_6_1]
Show the field ONLY if:
[para_reordrd_6_11(1)] ='1'
Value of Mother's Temperature
( in Celsius) 		text (number, Min: 25, Max: 110), Required
Field Annotation: @FORCE-MINMAX
800 [bp_6_1]
Show the field ONLY if:
[para_reordrd_6_11(2)] ='1'
Value of mother's Blood Pressure text, Required
801 [pulse_6_1]
Show the field ONLY if:
[para_reordrd_6_11(3)] ='1'
Value of mother's Pulse rate text, Required
802 [ga_6_1]
Show the field ONLY if:
[para_reordrd_6_11(4)] ='1'
Value of mother's gestational age in weeks text, Required
803 [fhr_6_1]
Show the field ONLY if:
[para_reordrd_6_11(5)] ='1'
Value of fetal heart rate text, Required
804 [resn_refer_6]
Show the field ONLY if:
[para_reordrd_6_11(6)]="1"
Frequency in 10 Mins checkbox, Required
1resn_refer_6___1No reason, no complication evident]
2resn_refer_6___2Bleeding per vagina
3resn_refer_6___3Fever
4resn_refer_6___4Preeclampsia / Eclampsia
5resn_refer_6___5Preterm Labour / PROM / PPROM
6resn_refer_6___6Obstetric problems
7resn_refer_6___7Fetal problems
8resn_refer_6___8History of major medical illness
805 [vagi_bleed_6]
Show the field ONLY if:
[resn_refer_6(2)] = '1'
Were the following documented at the referral facility checkbox, Required
1vagi_bleed_6___1Severity of bleeding
2vagi_bleed_6___2Was IV fuids started?
806 [hgh_fvr_6]
Show the field ONLY if:
[resn_refer_6(3)] = '1'
Were the following documented at the referral facility? checkbox, Required
1hgh_fvr_6___1Temperature >38 C
2hgh_fvr_6___2Foul-smelling vaginal discharge:
3hgh_fvr_6___3Rupture of membranes>12 hours without labour/>18 hours with labour
4hgh_fvr_6___4First dose of antibiotic given
807 [dose_drug_6]
Show the field ONLY if:
[hgh_fvr_6(4)] = '1'
If YES specify dose and name of drug? text, Required
808 [pre_eclamp_6]
Show the field ONLY if:
[resn_refer_6(4)] = '1'
Were the following documented at the referral facility? checkbox, Required
1pre_eclamp_6___1Headache
2pre_eclamp_6___2Vomiting
3pre_eclamp_6___3Blurred vision
4pre_eclamp_6___4Abdominal pain
5pre_eclamp_6___5Loss of sensorium
6pre_eclamp_6___6Convulsions
7pre_eclamp_6___7Any antihypertensive given
8pre_eclamp_6___8First dose of MgSO4 given
809 [eclamp_dose_drug_6]
Show the field ONLY if:
[pre_eclamp_6(7)] = '1'
Specify dose and name of drug text, Required
810 [eclamp_spec_dose]
Show the field ONLY if:
[pre_eclamp_6(8)] = '1'
Specify dose text, Required
811 [prom_6]
Show the field ONLY if:
[resn_refer_6(5)] = '1'
Were the following documented at the referral facility? checkbox, Required
1prom_6___1Colour of amniotic uid recorded
2prom_6___2First dose of antenatal corticosteroids given
3prom_6___3Any other medication
812 [spec_6]
Show the field ONLY if:
[prom_6(2)] = '1'
If YES specify dose and name of drug? text, Required
813 [yes_any_oth]
Show the field ONLY if:
[prom_6(3)] = '1'
Specify if YES text, Required
814 [no_obst]
Show the field ONLY if:
[resn_refer_6(6)] = '1'
If Obstetric problems checkbox
1no_obst___1Present mal-position or mal presentation / Obstructed labour
2no_obst___2Present transverse lie
3no_obst___3Abruptio placenta presenting with abdominal pain
4no_obst___4Previous bad obstetrical history
5no_obst___5Multiple pregnancy
6no_obst___6Previous LSCS
815 [no_fetal]
Show the field ONLY if:
[resn_refer_6(7)] = '1'
If Fetal problems checkbox, Required
1no_fetal___1Absent or Reduced Fetal Movement
2no_fetal___2Cord prolapse
3no_fetal___3Cord around the neck
4no_fetal___4Present Fetal Growth Retardation
816 [no_histry]
Show the field ONLY if:
[resn_refer_6(8)] = '1'
If History of major medical illness checkbox, Required
1no_histry___1Asthma
2no_histry___2COPD
3no_histry___3Heart disease
4no_histry___4Bleeding disorder
5no_histry___5Gestational diabetes
6no_histry___6Other
817 [no_oth]
Show the field ONLY if:
[no_histry(6)] = '1'
Any other-specify text, Required
818 [pw_info_6]
Show the field ONLY if:
[dirct_admis_6] = '0' or [initi_refer_facili] = '1'
6.12 Was the pregnant woman/family member informed about the referral yesno, Required
1Yes
0No
819 [doc_stf_infomd]
Show the field ONLY if:
[dirct_admis_6] = '0' or [initi_refer_facili] = '1'
6.13 Was the doctor/staff at the referred facility informed about the referral facility yesno, Required
1Yes
0No
820 [labourcarecard_maintained]
Show the field ONLY if:
[dirct_admis_6] = '0' or [rsn_drtadmsn_6(1)] = '1'
(Section Header: Section 7.1: Woman with NO Complications Active management at the admitting facility Complete the following [SourceCR / CI])7.1.1. Was Labour Care Card maintained yesno, Required
1Yes
0No
821 [fhr_recorded_half_hourly]
Show the field ONLY if:
[labourcarecard_maintained] = '1'
Was FHR recorded every half hour yesno, Required
1Yes
0No
822 [pr_mothr_half_hourly]
Show the field ONLY if:
[labourcarecard_maintained] = '1'
Was the pulse rate of the mother recorded every half hour yesno, Required
1Yes
0No
823 [contra_half_hourly]
Show the field ONLY if:
[labourcarecard_maintained] = '1'
Were contractions recorded every half hour yesno, Required
1Yes
0No
824 [amniotic_fluid_colour]
Show the field ONLY if:
[labourcarecard_maintained] = '1'
Was amniotic fluid color recorded every 4th hour yesno, Required
1Yes
0No
825 [cervical_dilatation]
Show the field ONLY if:
[labourcarecard_maintained] = '1'
Was cervical dilatation recorded every 4th hour yesno, Required
1Yes
0No
826 [art_rupt_memb]
Show the field ONLY if:
[rsn_drtadmsn_6(1)] = '1' or [resn_refer_6(1)] = '1'
7.1.2 Was artificial rupture of membraned performed and documented yesno, Required
1Yes
0No
827 [yes_time]
Show the field ONLY if:
[art_rupt_memb] = '1'
Time text (time)
828 [yes_date]
Show the field ONLY if:
[art_rupt_memb] = '1'
Date text (date_dmy, Min: [lmp], Max: today)
Field Annotation: @FORCE-MINMAX
829 [labour_augmen]
Show the field ONLY if:
[rsn_drtadmsn_6(1)] = '1' or [resn_refer_6(1)] = '1'
7.1.3 Was labour augmented? yesno, Required
1Yes
0No
830 [yes_augm_time]
Show the field ONLY if:
[labour_augmen] = '1'
When was augmentation started - Time text (time_hh_mm_ss), Required
831 [yes_date_augm]
Show the field ONLY if:
[labour_augmen] = '1'
Date of start of augmentation text (date_dmy, Max: today)
Field Annotation: @FORCE-MINMAX
832 [name_of_drugs]
Show the field ONLY if:
[labour_augmen] = '1'
Name of the drugs text
833 [dosage_of_drug]
Show the field ONLY if:
[labour_augmen] = '1'
Dosage of drug text
834 [other_medica]
Show the field ONLY if:
[rsn_drtadmsn_6(1)] = '1' or [resn_refer_6(1)] = '1'
7.1.4 Any other medication given yesno, Required
1Yes
0No
835 [name_dose_drug]
Show the field ONLY if:
[other_medica] = '1'
Name of drug (E.g Epidural ) text, Required
836 [dose_of_drug_e_g_epidural]
Show the field ONLY if:
[other_medica] = '1'
Dose of drug (E.g Epidural ) text
837 [immed_interven]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
(Section Header: Section 7.2: Active management at the admitting facility Pregnant Woman with Bleeding per VaginaComplete the following (Source: CI/RR-Case Sheet) and then Section 4, 5, 6)7.2.1 Immediate intervention at the facility descriptive
838 [iv_fluids_given]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
i. Was IV fluids given yesno, Required
1Yes
0No
839 [nst_cardiot_done]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
ii. Was NST / Cardiotocography connected, or monitoring done
 yesno, Required
1Yes
0No
840 [fhr_noted]
Show the field ONLY if:
[nst_cardiot_done] = '1'
Was FHR noted yesno, Required
1Yes
0No
841 [value]
Show the field ONLY if:
[fhr_noted]="1"
Value text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
842 [yes_declartns]
Show the field ONLY if:
[nst_cardiot_done] = '1'
Were decelerations recorded radio, Required
1EARLY
2LATE
3VARIABLE
843 [cont_monit]
Show the field ONLY if:
[nst_cardiot_done] = '1'
Were contractions monitored yesno, Required
1Yes
0No
844 [vitals_check_docum]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
iii. Were vitals checked and documented yesno, Required
1Yes
0No
845 [pulse_rate_noted]
Show the field ONLY if:
[vitals_check_docum] = '1'
Were pulse rate noted yesno, Required
1Yes
0No
846 [value_pulrat]
Show the field ONLY if:
[pulse_rate_noted] = '1'
Value text, Required
847 [bp_noted]
Show the field ONLY if:
[vitals_check_docum] = '1'
Was blood pressure noted yesno, Required
1Yes
0No
848 [sbp_bp_noted]
Show the field ONLY if:
[bp_noted] = '1'
SBP text (number, Min: 80, Max: 220), Required
Field Annotation: @FORCE-MINMAX
849 [dbp_bp_noted]
Show the field ONLY if:
[bp_noted] = '1'
DBP text (number, Min: 40, Max: 150)
Field Annotation: @FORCE-MINMAX
850 [temp_noted]
Show the field ONLY if:
[vitals_check_docum] = '1'
was temperature noted yesno, Required
1Yes
0No
851 [value_temp]
Show the field ONLY if:
[temp_noted] = '1'
Value text (number, Min: 25, Max: 105), Required
Field Annotation: @FORCE-MINMAX
852 [blood_tst_perform]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
Was blood test performed? yesno, Required
1Yes
0No
853 [clot_bleed_time_check]
Show the field ONLY if:
[blood_tst_perform] = '1'
Was clotting time checked yesno, Required
1Yes
0No
854 [value_bloodtest]
Show the field ONLY if:
[clot_bleed_time_check] ='1'
Value text, Required
855 [bleeding_time]
Show the field ONLY if:
[blood_tst_perform] = '1'
Was bleeding time checked yesno, Required
1Yes
0No
856 [value_bleddingtst]
Show the field ONLY if:
[bleeding_time]='1'
Value text, Required
857 [hb_checked]
Show the field ONLY if:
[blood_tst_perform] = '1'
Was Hb checked yesno, Required
1Yes
0No
858 [value_hbchecked]
Show the field ONLY if:
[hb_checked] = '1'
Value text (number, Min: 5, Max: 20), Required
Field Annotation: @FORCE-MINMAX
859 [blood_bld_pdt_given]
Show the field ONLY if:
[blood_tst_perform] = '1'
Was blood or blood products given to woman ? yesno, Required
1Yes
0No
860 [speci_volu]
Show the field ONLY if:
[blood_bld_pdt_given] = '1'
Specify what and volume text, Required
861 [obset_mngnt]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
7.2.2 Obstetric management descriptive
862 [art_rupt_memb_perform]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
i. Was artificial rupture of membraned performed and documented yesno, Required
1Yes
0No
863 [yes_time_obst]
Show the field ONLY if:
[art_rupt_memb_perform]= '1'
Time text (time), Required
864 [yes_date_obst]
Show the field ONLY if:
[art_rupt_memb_perform] = '1'
Date text (date_dmy, Max: today), Required
Field Annotation: @FORCE-MINMAX
865 [labour_augmen_obst]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
ii. Was labour augmented? yesno, Required
1Yes
0No
866 [art_rupt_mem_d_t_obst]
Show the field ONLY if:
[labour_augmen_obst] = '1'
when was augmentation started - Time text (time_hh_mm_ss), Required
867 [date_augmen_obst]
Show the field ONLY if:
[labour_augmen_obst] = '1'
Date of start of augmentation text (date_dmy, Max: today), Required
Field Annotation: @FORCE-MINMAX
868 [name_drug_obst]
Show the field ONLY if:
[labour_augmen_obst] = '1'
Name drug used and dosage text, Required
869 [oth_medi_obst]
Show the field ONLY if:
[rsn_drtadmsn_6(2)] = '1' or [resn_refer_6(2)] = '1'
iii. Was any other medication given yesno, Required
1Yes
0No
870 [namedrug_obst]
Show the field ONLY if:
[oth_medi_obst] = '1'
Name drug used and dosage yesno, Required
1Yes
0No

Custom alignment: RH
871 [immed_interven_7_3]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
(Section Header: Section 7.3: Active management at the admitting facility for a Pregnant Woman with Fever Complete the following(Source: CI/RR-Case Sheet) and then Section 9-11)7.3.1 Immediate intervention at the facility descriptive
872 [iv_fluids_given_7_3]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
i. Was IV fluids given yesno, Required
1Yes
0No

Custom alignment: RH
873 [nst_cardioto_7_3]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
ii. Was NST / Cardiotocography connected, or monitoring done
 yesno, Required
1Yes
0No

Custom alignment: RH
874 [fhr_noted_7_3]
Show the field ONLY if:
[nst_cardioto_7_3] = '1'
Was FHR noted yesno, Required
1Yes
0No
875 [value_7_3]
Show the field ONLY if:
[fhr_noted_7_3] = '1'
Value text (number, Min: 50, Max: 220), Required
Field Annotation: @FORCE-MINMAX
876 [cont_monit_7_3]
Show the field ONLY if:
[nst_cardioto_7_3] = '1'
Were contractions monitored yesno, Required
1Yes
0No
877 [vitals_noted_7_3]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
iii. Were vitals checked and documented yesno, Required
1Yes
0No
878 [pr_noted_7_3]
Show the field ONLY if:
[vitals_noted_7_3] = '1'
Were pulse rate noted yesno, Required
1Yes
0No
879 [value_pr_7_3]
Show the field ONLY if:
[pr_noted_7_3] = '1'
Value text, Required
Custom alignment: RH
880 [bp_noted_7_3]
Show the field ONLY if:
[vitals_noted_7_3] = '1'
Was blood pressure noted yesno, Required
1Yes
0No

Custom alignment: RH
881 [sbp_bp_7_3]
Show the field ONLY if:
[bp_noted_7_3] = '1'
SBP text (number, Min: 80, Max: 220)
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
882 [dbp_bp_7_3]
Show the field ONLY if:
[bp_noted_7_3] = '1'
DBP text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
883 [temp_noted_7_3]
Show the field ONLY if:
[vitals_noted_7_3] = '1'
Was temperature noted yesno, Required
1Yes
0No

Custom alignment: RH
884 [value_temp_7_3]
Show the field ONLY if:
[temp_noted_7_3] = '1'
Value text (number, Min: 25, Max: 105)
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
885 [urine_micro_7_3]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
iv. Was urine microscopy done? yesno, Required
1Yes
0No

Custom alignment: RH
886 [res_8_3]
Show the field ONLY if:
[urine_micro_7_3] = '1'
Result text, Required
Custom alignment: RH
887 [obst_mngmt_7_3]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
7.3.2 Obstetric management descriptive
888 [art_rupt_memb_7_3]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
i. Was artificial rupture of membraned performed and documented yesno, Required
1Yes
0No

Custom alignment: RH
889 [time_7_3_2]
Show the field ONLY if:
[art_rupt_memb_7_3] = '1'
Time text (time), Required
Custom alignment: RH
890 [date_8_7_2]
Show the field ONLY if:
[art_rupt_memb_7_3] = '1'
Date text (date_dmy, Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
891 [foul_noted_7_3_2]
Show the field ONLY if:
[art_rupt_memb_7_3] = '1'
Was foul smelling vaginal discharge noted yesno, Required
1Yes
0No

Custom alignment: RH
892 [labour_augmen_7_3_2]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
ii. Was labour augmented? yesno, Required
1Yes
0No

Custom alignment: RH
893 [augmen_start_7_3_2]
Show the field ONLY if:
[labour_augmen_7_3_2] = '1'
When was augmentation started - Time text (time), Required
Custom alignment: RH
894 [date_augmem_7_3_2]
Show the field ONLY if:
[labour_augmen_7_3_2] = '1'
Date of start of augmentation text (date_dmy, Max: today)
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
895 [name_drug_7_3_2]
Show the field ONLY if:
[labour_augmen_7_3_2] = '1'
Name drug used and dosage text, Required
Custom alignment: RH
896 [oth_medi_7_3_2]
Show the field ONLY if:
[rsn_drtadmsn_6(3)] = '1' or [resn_refer_6(3)] = '1'
iii. Was any other medication given yesno, Required
1Yes
0No

Custom alignment: RH
897 [name_drug_7_3_2_2]
Show the field ONLY if:
[oth_medi_7_3_2] = '1'
Name drug used and dosage text, Required
Custom alignment: RH
898 [immed_interv_7_4]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
(Section Header: Section 7.4: Active management at the admitting facility for a Pregnant Woman with Preeclampsia / Eclampsia Complete the following (Source: CI/RR-Case Sheet) and then Section 9-11)7.4.1 Immediate intervention at the facility descriptive
899 [iv_given_7_4]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
i. Was IV fluids given yesno, Required
1Yes
0No

Custom alignment: RH
900 [mgso4_given_7_4]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
ii. Was MgSO4 given yesno, Required
1Yes
0No

Custom alignment: RH
901 [dosage_7_4]
Show the field ONLY if:
[mgso4_given_7_4] = '1'
Dosage text, Required
Custom alignment: RH
902 [antihypertensive_7_4]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
iii. Was antihypertensive given yesno, Required
1Yes
0No

Custom alignment: RH
903 [name_drug_7_4]
Show the field ONLY if:
[antihypertensive_7_4] ='1'
Name of drug and dosage text, Required
Custom alignment: RH
904 [nst_cardioto_7_4]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
iv. Was NST / Cardiotocography connected, or monitoring done
 yesno, Required
1Yes
0No

Custom alignment: RH
905 [fhr_noted_7_4]
Show the field ONLY if:
[nst_cardioto_7_4] = '1'
Was FHR noted yesno, Required
1Yes
0No

Custom alignment: RH
906 [value_7_4]
Show the field ONLY if:
[fhr_noted_7_4] = '1'
Value text (number, Min: 50, Max: 200), Required
Custom alignment: RH
907 [contra_noted_7_4]
Show the field ONLY if:
[nst_cardioto_7_4] = '1'
Were contractions monitored yesno, Required
1Yes
0No

Custom alignment: RH
908 [vitals_moniter_7_4]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
v. Were vitals checked and documented yesno, Required
1Yes
0No

Custom alignment: RH
909 [pr_noted_7_4]
Show the field ONLY if:
[vitals_moniter_7_4] = '1'
Were pulse rate noted yesno, Required
1Yes
0No

Custom alignment: RH
910 [value_vitals_7_4]
Show the field ONLY if:
[pr_noted_7_4] = '1'
Value text, Required
Custom alignment: RH
911 [bp_noted_7_4]
Show the field ONLY if:
[vitals_moniter_7_4] = '1'
Was blood pressure noted yesno, Required
1Yes
0No

Custom alignment: RH
912 [sbp_bp_7_4]
Show the field ONLY if:
[bp_noted_7_4] = '1'
SBP text (number, Min: 80, Max: 220)
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
913 [dbp_bp_7_4]
Show the field ONLY if:
[bp_noted_7_4] = '1'
DBP text (number, Min: 50, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
914 [temp_noted_7_4]
Show the field ONLY if:
[vitals_moniter_7_4] = '1'
Was temperature noted yesno, Required
1Yes
0No

Custom alignment: RH
915 [value_temp_7_4]
Show the field ONLY if:
[temp_noted_7_4] = '1'
Value text (number, Min: 25, Max: 105), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
916 [reflex_mgso4_7_4]
Show the field ONLY if:
[vitals_moniter_7_4] = '1'
Reflexes checked for MgSO4 toxicity yesno, Required
1Yes
0No

Custom alignment: RH
917 [obsct_mnmgt_7_4_2]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
7.4.2 Obstetric management descriptive
918 [art_rupt_memb_7_4_2]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
i. Was artificial rupture of membraned performed and documented yesno, Required
1Yes
0No

Custom alignment: RH
919 [time_7_4_2]
Show the field ONLY if:
[art_rupt_memb_7_4_2] = '1'
Time text (time), Required
Custom alignment: RH
920 [date_7_4_2]
Show the field ONLY if:
[art_rupt_memb_7_4_2] = '1'
Date text (date_dmy, Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
921 [labour_augmen_7_4_2]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
ii. Was labour augmented? yesno, Required
1Yes
0No

Custom alignment: RH
922 [augmen_time_7_4_2]
Show the field ONLY if:
[labour_augmen_7_4_2] = '1'
when was augmentation started - Time text (time), Required
Custom alignment: RH
923 [date_augmen_7_4_2]
Show the field ONLY if:
[labour_augmen_7_4_2] = '1'
Date of start of augmentation text (date_dmy, Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
924 [augmen_drug_7_4_2]
Show the field ONLY if:
[labour_augmen_7_4_2] = '1'
Name drug used and dosage text, Required
Custom alignment: RH
925 [yes_dosge]
Show the field ONLY if:
[labour_augmen_7_4_2] = '1'
Dosage text, Required
Custom alignment: RH
926 [oth_medi_7_4_2]
Show the field ONLY if:
[rsn_drtadmsn_6(4)] = '1' or [resn_refer_6(4)] = '1'
iii. Was any other medication given yesno, Required
1Yes
0No

Custom alignment: RH
927 [oth_medi_drug_dose_7_4_2]
Show the field ONLY if:
[oth_medi_7_4_2] = '1'
Name drug used and dosage. text, Required
Custom alignment: RH
928 [interven_7_5]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
Section Header: Section 7.5: Active management at the admitting facility for a Pregnant Woman withPROM/PPROM Complete the following(Source: CI/RR-Case Sheet) and then Section 4, 5, 67.5.1 Immediate intervention at the facility descriptive
929 [iv_given_7_5]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
i. Was IV fluids given yesno, Required
1Yes
0No

Custom alignment: RH
930 [anten_cortico_7_5]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
ii. Were antenatal corticosteroids given yesno, Required
1Yes
0No

Custom alignment: RH
931 [name_dos_7_5]
Show the field ONLY if:
[anten_cortico_7_5] = '1'
Name and Dosage yesno, Required
1Yes
0No

Custom alignment: RH
932 [antibiotics_given_7_5]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
iii. Was antibiotics given yesno, Required
1Yes
0No

Custom alignment: RH
933 [name_dos_anti_7_5]
Show the field ONLY if:
[antibiotics_given_7_5] = '1'
Antibiotic 1 Name and Dosage text, Required
Custom alignment: RH
934 [name_dos_anti_7_6]
Show the field ONLY if:
[antibiotics_given_7_5] = '1'
Antibiotic 2 Name and Dosage text, Required
Custom alignment: RH
935 [nst_cardioto_7_5]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
iv. Was NST / Cardiotocography connected, or monitoring done
 yesno, Required
1Yes
0No

Custom alignment: RH
936 [fhr_noted_7_5]
Show the field ONLY if:
[nst_cardioto_7_5] = '1'
Was FHR noted yesno, Required
1Yes
0No

Custom alignment: RH
937 [value_fhr_7_5]
Show the field ONLY if:
[fhr_noted_7_5] = '1'
Value yesno, Required
1Yes
0No

Custom alignment: RH
938 [contra_noted_7_5]
Show the field ONLY if:
[nst_cardioto_7_5] = '1'
Were contractions monitored yesno, Required
1Yes
0No

Custom alignment: RH
939 [amnio_flu_7_5]
Show the field ONLY if:
[nst_cardioto_7_5] = '1'
Color of amniotic fluid noted yesno, Required
1Yes
0No

Custom alignment: RH
940 [colour_7_5]
Show the field ONLY if:
[amnio_flu_7_5] = '1'
Colour: radio, Required
1Meconium
2Clear
3Bloody

Custom alignment: RH
941 [vitals_7_5]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
v. Were vitals checked and documented yesno, Required
1Yes
0No

Custom alignment: RH
942 [pr_noted_7_5]
Show the field ONLY if:
[vitals_7_5] = '1'
Were pulse rate noted yesno, Required
1Yes
0No

Custom alignment: RH
943 [value_7_5]
Show the field ONLY if:
[pr_noted_7_5] = '1'
Value text, Required
Custom alignment: RH
944 [bp_noted_7_5]
Show the field ONLY if:
[vitals_7_5] = '1'
Was blood pressure noted yesno, Required
1Yes
0No

Custom alignment: RH
945 [sbp_bp_noted_7_5]
Show the field ONLY if:
[bp_noted_7_5] = '1'
SBP text (number, Min: 70, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
946 [dbp_bp_noted_7_5]
Show the field ONLY if:
[bp_noted_7_5] = '1'
DBP text (number, Min: 40, Max: 150), Required
Custom alignment: RH
947 [temp_noted_7_5]
Show the field ONLY if:
[vitals_7_5] = '1'
Was temperature noted yesno, Required
1Yes
0No

Custom alignment: RH
948 [value_temp_7_5]
Show the field ONLY if:
[temp_noted_7_5]='1'
Value of Temperature text (number, Min: 25, Max: 105), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
949 [obsct_mnmgt_7_5_2]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
7.5.2 Obstetric management descriptive
950 [labour_augmen_7_5_2]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
i. Was labour augmented? yesno, Required
1Yes
0No

Custom alignment: RH
951 [augmen_time_7_5_2]
Show the field ONLY if:
[labour_augmen_7_5_2] = '1'
When was augmentation started - Time text (time), Required
Custom alignment: RH
952 [date_augmen_7_5_2]
Show the field ONLY if:
[labour_augmen_7_5_2] = '1'
Date of start of augmentation text (date_dmy, Max: today), Required
Custom alignment: RH
953 [labour_augmen_drug_7_5_2]
Show the field ONLY if:
[labour_augmen_7_5_2] = '1'
Name drug used and dosage text, Required
Custom alignment: RH
954 [yes_dsge]
Show the field ONLY if:
[labour_augmen_7_5_2] = '1'
Dosage(drops /minute) text, Required
Custom alignment: RH
955 [oth_medi_7_5_2]
Show the field ONLY if:
[rsn_drtadmsn_6(5)] = '1' or [resn_refer_6(5)] = '1'
ii. Was any other medication given yesno, Required
1Yes
0No

Custom alignment: RH
956 [oth_medi_drug_dose_7_5_2]
Show the field ONLY if:
[oth_medi_7_5_2] = '1'
Name drug used and dosage text, Required
Custom alignment: RH
957 [immed_interven_7_6]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1' or [rsn_drtadmsn_6(7)] = '1' or [resn_refer_6(6)] = '1' or [resn_refer_6(7)] = '1'
(Section Header: Section 7.6: Active management at the admitting facility for a Pregnant Woman with Other Obstetric or Fetal Complications Complete the following(Source: CI/RR-Case Sheet) and then Section 9-11)7.6.1 Immediate intervention at the facility descriptive
958 [iv_given_7_6]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1' or [rsn_drtadmsn_6(7)] = '1' or [resn_refer_6(6)] = '1' or [resn_refer_6(7)] = '1'
i. Was IV fluids given yesno, Required
1Yes
0No

Custom alignment: RH
959 [nst_cardioto_7_6]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1' or [rsn_drtadmsn_6(7)] = '1' or [resn_refer_6(6)] = '1' or [resn_refer_6(7)] = '1'
ii. Was NST / Cardiotocography connected or monitoring done
 yesno, Required
1Yes
0No

Custom alignment: RH
960 [fhr_7_6]
Show the field ONLY if:
[nst_cardioto_7_6] = '1'
Was FHR noted yesno, Required
1Yes
0No

Custom alignment: RH
961 [yes_acclrtns]
Show the field ONLY if:
[nst_cardioto_7_6] = '1'
Were accelerations recorded radio, Required
1EARLY
2LATE
3VARIABLE

Custom alignment: RH
962 [contra_7_6]
Show the field ONLY if:
[nst_cardioto_7_6] = '1'
Were contractions monitored yesno, Required
1Yes
0No

Custom alignment: RH
963 [amnio_fld_7_6]
Show the field ONLY if:
[nst_cardioto_7_6] = '1'
Color of amniotic fluid noted yesno, Required
1Yes
0No

Custom alignment: RH
964 [colour_7_6]
Show the field ONLY if:
[amnio_fld_7_6] = '1'
Color: radio, Required
1Meconium
2Clear
3Bloody

Custom alignment: RH
965 [lbr_care_guide]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1' or [rsn_drtadmsn_6(7)] = '1' or [resn_refer_6(6)] = '1' or [resn_refer_6(7)] = '1'
iii. Was Labour Care Guide / Partograph used yesno, Required
1Yes
0No

Custom alignment: RH
966 [yes_poorprgrs]
Show the field ONLY if:
[lbr_care_guide]='1'
Was poor progress of labour noted yesno, Required
1Yes
0No

Custom alignment: RH
967 [yes_caput]
Show the field ONLY if:
[lbr_care_guide]='1'
Was Caput noted yesno, Required
1Yes
0No

Custom alignment: RH
968 [yes_molding]
Show the field ONLY if:
[lbr_care_guide]='1'
Was molding noted yesno, Required
1Yes
0No

Custom alignment: RH
969 [yes_postn]
Show the field ONLY if:
[lbr_care_guide]='1'
Was position of fetus mentioned as radio, Required
1Anterior
2Posterior
3Transverse

Custom alignment: RH
970 [yes_cpd]
Show the field ONLY if:
[lbr_care_guide]='1'
Was CPD suspected yesno, Required
1Yes
0No

Custom alignment: RH
971 [duration_frst_lbr]
Show the field ONLY if:
[lbr_care_guide]='1'
Duration of first stage of labour text, Required
Custom alignment: RH
972 [duration_scnd_lbr]
Show the field ONLY if:
[lbr_care_guide]='1'
Duration of second stage of labour text, Required
Custom alignment: RH
973 [vitals_7_6]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1' or [rsn_drtadmsn_6(7)] = '1' or [resn_refer_6(6)] = '1' or [resn_refer_6(7)] = '1'
iv. Were vitals checked and documented text, Required
Custom alignment: RH
974 [pr_noted_7_6]
Show the field ONLY if:
[vitals_7_6] = '1'
Were pulse rate noted yesno, Required
1Yes
0No

Custom alignment: RH
975 [value_7_6]
Show the field ONLY if:
[pr_noted_7_6] = '1'
Value text, Required
Custom alignment: RH
976 [bp_7_6]
Show the field ONLY if:
[vitals_7_6] = '1'
Was blood pressure noted yesno, Required
1Yes
0No

Custom alignment: RH
977 [sbp_bp_noted_7_6]
Show the field ONLY if:
[bp_7_6] = '1'
SBP text (number, Min: 80, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
978 [dbp_noted_7_6]
Show the field ONLY if:
[bp_7_6] = '1'
DBP text (number, Min: 40, Max: 150), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
979 [temp_noted_7_6]
Show the field ONLY if:
[vitals_7_6] = '1'
Was temperature noted yesno, Required
1Yes
0No

Custom alignment: RH
980 [value_temp_7_6]
Show the field ONLY if:
[temp_noted_7_6]='1'
Value of Temperature text (number, Min: 25, Max: 105), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
981 [labour_augmen_7_6]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1' or [rsn_drtadmsn_6(7)] = '1' or [resn_refer_6(6)] = '1' or [resn_refer_6(7)] = '1'
Was labour augmented? yesno, Required
1Yes
0No

Custom alignment: RH
982 [time_augmen_7_6]
Show the field ONLY if:
[labour_augmen_7_6] = '1'
When was augmentation started - Time text (time), Required
Custom alignment: RH
983 [date_augmen_7_6]
Show the field ONLY if:
[labour_augmen_7_6] = '1'
Date of start of augmentation text (date_dmy, Max: today), Required
Custom alignment: RH
984 [labour_augmen_drug_7_6]
Show the field ONLY if:
[labour_augmen_7_6] = '1'
Name drug used text, Required
Custom alignment: RH
985 [yes_dosage_6]
Show the field ONLY if:
[labour_augmen_7_6] = '1'
Dosage(drops/min) text, Required
Custom alignment: RH
986 [oth_medi_7_6]
Show the field ONLY if:
[rsn_drtadmsn_6(6)] = '1' or [rsn_drtadmsn_6(7)] = '1' or [resn_refer_6(6)] = '1' or [resn_refer_6(7)] = '1'
v. Was any other medication given yesno, Required
1Yes
0No

Custom alignment: RH
987 [oth_medi_drug_7_6]
Show the field ONLY if:
[oth_medi_7_6] = '1'
Name drug used and dosage. yesno, Required
1Yes
0No

Custom alignment: RH
988 [immed_interven_7_7]
Show the field ONLY if:
[rsn_drtadmsn_6(8)] = '1' or [resn_refer_6(8)] = '1'
(Section Header: Section 7.7: Active management at the admitting facility for a Pregnant Woman with Medical Conditions (Asthma / COPD / Heart disease /Bleeding disorder /Gestational diabetes / Any other specify) Complete the following (Source: CI/RR-Case Sheet) and then Section 9-11)7.7.1 Immediate intervention at the facility descriptive
989 [iv_7_7]
Show the field ONLY if:
[rsn_drtadmsn_6(8)] = '1' or [resn_refer_6(8)] = '1'
i. Was IV fluids given yesno, Required
1Yes
0No

Custom alignment: RH
990 [nst_cardioto_7_7]
Show the field ONLY if:
[rsn_drtadmsn_6(8)] = '1' or [resn_refer_6(8)] = '1'
ii. Was NST / Cardiotocography connected or monitoring done yesno, Required
1Yes
0No

Custom alignment: RH
991 [fhr_noted_7_7]
Show the field ONLY if:
[nst_cardioto_7_7] = '1'
Was FHR noted yesno, Required
1Yes
0No

Custom alignment: RH
992 [value_7_7]
Show the field ONLY if:
[fhr_noted_7_7] = '1'
Value text (number, Min: 50, Max: 220), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
993 [contact_monit_7_7]
Show the field ONLY if:
[nst_cardioto_7_7] = '1'
Were contractions monitored yesno, Required
1Yes
0No

Custom alignment: RH
994 [vitals_7_7]
Show the field ONLY if:
[rsn_drtadmsn_6(8)] = '1' or [resn_refer_6(8)] = '1'
iii. Were vitals checked and documented yesno, Required
1Yes
0No

Custom alignment: RH
995 [pr_noted_7_7]
Show the field ONLY if:
[vitals_7_7] = '1'
Were pulse rate noted yesno, Required
1Yes
0No

Custom alignment: RH
996 [value_vitals_7_7]
Show the field ONLY if:
[pr_noted_7_7] = '1'
Values text, Required
Custom alignment: RH
997 [bp_noted_7_7]
Show the field ONLY if:
[vitals_7_7] = '1'
Was blood pressure noted yesno, Required
1Yes
0No

Custom alignment: RH
998 [sbp_noted_7_7]
Show the field ONLY if:
[bp_noted_7_7] = '1'
SBP text (number, Min: 80, Max: 220), Required
Custom alignment: RH
999 [dbp_noted_7_7]
Show the field ONLY if:
[bp_noted_7_7] = '1'
DBP text (number, Min: 40, Max: 150), Required
Custom alignment: RH
1000 [temp_noted_7_7]
Show the field ONLY if:
[vitals_7_7] = '1'
Was temperature noted yesno, Required
1Yes
0No

Custom alignment: RH
1001 [value_temp_7_7]
Show the field ONLY if:
[temp_noted_7_7]='1'
Value of Temperature text (number, Min: 25, Max: 105), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
1002 [labour_augmen_7_7]
Show the field ONLY if:
[rsn_drtadmsn_6(8)] = '1' or [resn_refer_6(8)] = '1'
iv. Was labour augmented? yesno, Required
1Yes
0No

Custom alignment: RH
1003 [augmen_time_7_7]
Show the field ONLY if:
[labour_augmen_7_7] = '1'
When was augmentation started - Time text (time), Required
Custom alignment: RH
1004 [date_augmen_7_7]
Show the field ONLY if:
[labour_augmen_7_7] = '1'
Date of start of augmentation text (date_dmy, Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
1005 [drug_used_7_7]
Show the field ONLY if:
[labour_augmen_7_7] = '1'
Name drug used and dosage text, Required
Custom alignment: RH
1006 [oth_medi_7_7]
Show the field ONLY if:
[rsn_drtadmsn_6(8)] = '1' or [resn_refer_6(8)] = '1'
Was any other medication given yesno, Required
1Yes
0No

Custom alignment: RH
1007 [drug_dos_used_7_7]
Show the field ONLY if:
[oth_medi_7_7] = '1'
Name drug used and dosage. text, Required
Custom alignment: RH
1008 [date_deliv_8] Section Header: Section 8 : Mode of Delivery8.1 Date of delivery text (date_dmy, Max: today), Required
Custom alignment: RH
Field Annotation: @FORCE-MINMAX
1009 [time_deliv_8] 8.2 Time of delivery text (time), Required
Custom alignment: RH
1010 [mode_deliv_8] 8.3 Mode of delivery radio, Required
1Vaginal
2Assisted vaginal
3LSCS

Custom alignment: RH
1011 [not_vaginal_8]
Show the field ONLY if:
[mode_deliv_8] = '2' or [mode_deliv_8] = '3'
If NOT vaginal, specify reason text, Required
Custom alignment: RH
1012 [del_perf_by_8] 8.4 Delivery performed by radio, Required
1Nurse
2Doctor
3ANM
4Other

Custom alignment: RH
1013 [who_perform]
Show the field ONLY if:
[del_perf_by_8] = '4'
Who performed the delivery? text, Required
Custom alignment: RH
1014 [no_babies_8] 8.5 Number of babies: radio, Required
1Singleton
2Twins
3Triplets

Custom alignment: RH
1015 [outcome]
Show the field ONLY if:
[no_babies_8] = '1' or [no_babies_8] = '2' or [no_babies_8] = '3'
Section 9 : Outcomes of Delivery descriptive
1016 [birth_outcomes]
Show the field ONLY if:
[no_babies_8] = '1' or [no_babies_8] = '2' or [no_babies_8] = '3'
9.1 Outcome of delivery radio, Required
1Live
2Stillbirth
1017 [if_stillbirth]
Show the field ONLY if:
[birth_outcomes]='2'
9.1.1 If stillbirth whether radio, Required
1Macerated
2Fresh
1018 [if_stlbrth]
Show the field ONLY if:
[birth_outcomes]='2'
9.1.2 If Stillbirth whether radio, Required
1Before labour started
2After labour started
1019 [sex]
Show the field ONLY if:
[no_babies_8] = '1' or [no_babies_8] = '2' or [no_babies_8] = '3'
9.2 Sex: radio, Required
1Male
2Female
3Other
1020 [specify_9]
Show the field ONLY if:
[sex] = '3'
Specify text, Required
1021 [birth_wt]
Show the field ONLY if:
[no_babies_8] = '1' or [no_babies_8] = '2' or [no_babies_8] = '3'
9.3 Weight at birth (in Grams)(in gms) text (number, Min: 500, Max: 7500), Required
1022 [baby_cry_birth]
Show the field ONLY if:
([no_babies_8] = '1' or [no_babies_8] = '2' or [no_babies_8] = '3') and [birth_outcomes] = '1'
9.4 Did the baby cry at birth? yesno, Required
1Yes
0No
1023 [baby_req_resuscitation]
Show the field ONLY if:
[baby_cry_birth] = '0'
9.4.2 If NO, Did the baby receive resuscitation? yesno, Required
1Yes
0No
1024 [yes_time_9]
Show the field ONLY if:
[baby_req_resuscitation] = '1'
9.4.3 If YES, what are all the resuscitation steps done and revived (heartbeat within 10 mins)? descriptive
1025 [tble_1]
Show the field ONLY if:
[baby_req_resuscitation] = '1'
Initial Steps done (Warmth / Dry / Stimulate / Position /
Clear airway / Resposition) {initi_steps} Time :{tme} Bag
and Mask ventilation {bag_msk_vent} Time :{tme_1}
Given Chest Compressions {chst_cmprsn} Time :{tme_2}
Given Drugs {gvn_drug} Time :{tme_3} 		descriptive
1026 [initi_steps] Initial steps done (Warmth / Dry / Stimulate / Position /
Clear airway / Reposition) 		yesno, Required
1Yes
0No
1027 [tme]
Show the field ONLY if:
[initi_steps] = '1'
Time text (time), Required
1028 [bag_msk_vent] Bag and Mask ventilation / PPV yesno, Required
1Yes
0No
1029 [tme_1]
Show the field ONLY if:
[bag_msk_vent]='1'
Time text (time_hh_mm_ss), Required
1030 [chst_cmprsn] Given Chest Compressions yesno, Required
1Yes
0No
1031 [tme_2]
Show the field ONLY if:
[chst_cmprsn]='1'
Time text (time), Required
1032 [gvn_drug] Given Drugs yesno, Required
1Yes
0No
1033 [tme_3]
Show the field ONLY if:
[gvn_drug]='1'
Time text (time), Required
1034 [no_hrtbt_9]
Show the field ONLY if:
[baby_cry_birth] = '0'
9.4.4 IF NO heartbeat after 10 minutes of resuscitation yesno, Required
1Yes
0No
1035 [tme_9_4_4]
Show the field ONLY if:
[no_hrtbt_9] = '1'
Time text (time), Required
1036 [bby_ded_resus]
Show the field ONLY if:
[no_hrtbt_9] = '1'
9.4.5 Baby died after resuscitation yesno, Required
1Yes
0No
1037 [tme_decl_dth]
Show the field ONLY if:
[bby_ded_resus] = '1'
Time of the declaration of death text (time), Required
1038 [outcome_1]
Show the field ONLY if:
[no_babies_8] = '2' or [no_babies_8] = '3'
Section 9 : Outcomes of Delivery descriptive
1039 [birth_outcomes_1]
Show the field ONLY if:
[no_babies_8] = '2' or [no_babies_8] = '3'
9.1 Outcome of delivery radio, Required
1Live
2Still Birth
1040 [if_stillbrth_1]
Show the field ONLY if:
[birth_outcomes_1]='2'
9.1.1 If stillbirth whether radio, Required
1Macerated
2Fresh
1041 [if_stillbrth_2]
Show the field ONLY if:
[birth_outcomes_1]='2'
9.1.2 If Stillbirth whether radio, Required
1Before labour started
2After labour started
1042 [sex_1]
Show the field ONLY if:
[no_babies_8] = '2' or [no_babies_8] = '3'
9.2 Sex radio, Required
1Male
2Female
3Other
1043 [specify_9_1]
Show the field ONLY if:
[sex_1] = '3'
Specify text, Required
1044 [birth_wt_1]
Show the field ONLY if:
[no_babies_8] = '2' or [no_babies_8] = '3'
9.3 Weight at birth (in Grams) text (number, Min: 500, Max: 6000), Required
Field Annotation: @FORCE-MINMAX
1045 [baby_cry_birth_1]
Show the field ONLY if:
([no_babies_8] = '2' or [no_babies_8] = '3') and [birth_outcomes_1] = '1'
9.4 Did the baby cry at birth? yesno, Required
1Yes
0No
1046 [baby_req_resuscitation_1]
Show the field ONLY if:
[baby_cry_birth_1] = '0'
9.4.2 If NO, Did the baby receive resuscitation? yesno, Required
1Yes
0No
1047 [yes_time_9_1]
Show the field ONLY if:
[baby_req_resuscitation_1] = '1'
9.4.3 If YES, what are all the resuscitation steps done and revived (heartbeat within 10 mins)? descriptive
1048 [tble_1_01]
Show the field ONLY if:
[baby_req_resuscitation_1] = '1'
Initial Steps done (Warmth / Dry / Stimulate / Position /
Clear airway / Resposition) {initi_steps_1} Time :
{tme_1_1} Bag and Mask ventilation {bag_msk_vent_1}
Time :{tme_1_01} Given Chest Compressions
{chst_cmprsn_1} Time :{tme_2_01} Given Drugs
{gvn_drug_1} Time :{tme_3_01} 		descriptive
1049 [initi_steps_1] Initial steps done (Warmth / Dry / Stimulate / Position /
Clear airway / Reposition) 		yesno, Required
1Yes
0No
1050 [tme_1_1]
Show the field ONLY if:
[initi_steps_1] = '1'
Time text (time), Required
1051 [bag_msk_vent_1] Bag and Mask ventilation / PPV yesno, Required
1Yes
0No
1052 [tme_1_01]
Show the field ONLY if:
[bag_msk_vent_1]='1'
Time text (time), Required
1053 [chst_cmprsn_1] Given Chest Compressions yesno, Required
1Yes
0No
1054 [tme_2_01]
Show the field ONLY if:
[chst_cmprsn_1]='1'
Time text (time), Required
1055 [gvn_drug_1] Given Drugs yesno, Required
1Yes
0No
1056 [tme_3_01]
Show the field ONLY if:
[gvn_drug_1]='1'
Time text (time), Required
1057 [no_hrtbt_9_01]
Show the field ONLY if:
[baby_cry_birth_1] = '0'
9.4.4 IF NO heartbeat after 10 minutes of resuscitation yesno, Required
1Yes
0No
1058 [tme_9_4_4_01]
Show the field ONLY if:
[no_hrtbt_9_01] = '1'
Time text (time), Required
1059 [bby_ded_resus_1]
Show the field ONLY if:
[no_hrtbt_9_01] = '1'
9.4.5 Baby died after resuscitation yesno, Required
1Yes
0No
1060 [tme_decl_dth_1]
Show the field ONLY if:
[bby_ded_resus_1] = '1'
Time of the declaration of death text (time), Required
1061 [outcome_2]
Show the field ONLY if:
[no_babies_8] = '3'
Section 9 : Outcomes of Delivery descriptive
1062 [birth_outcomes_2]
Show the field ONLY if:
[no_babies_8] = '3'
9.1 Outcome of delivery radio, Required
1Live
2Stillbirth
1063 [if_stillbrth_a]
Show the field ONLY if:
[birth_outcomes_2]='2'
9.1.1 If stillbirth whether radio, Required
1Macerated
2Fresh
1064 [if_stillbrth_b]
Show the field ONLY if:
[birth_outcomes_2]='2'
9.1.2 If Stillbirth whether radio, Required
1Before labour started
2After labour started
1065 [sex_2]
Show the field ONLY if:
[no_babies_8] = '3'
9.2 Sex radio, Required
1Male
2Female
3Other
1066 [specify_9_2]
Show the field ONLY if:
[sex_2] = '3'
Specify text, Required
1067 [birth_wt_2]
Show the field ONLY if:
[no_babies_8] = '3'
9.3 Weight at birth (in Grams) text (number, Min: 500, Max: 6500), Required
Field Annotation: @FORCE-MINMAX
1068 [baby_cry_birth_2]
Show the field ONLY if:
([no_babies_8] = '3') and [birth_outcomes_2] = '1'
9.4 Did the baby cry at birth? yesno, Required
1Yes
0No
1069 [baby_req_resuscitation_2]
Show the field ONLY if:
[baby_cry_birth_2] = '0'
9.4.2 If NO, Did the baby receive resuscitation? yesno, Required
1Yes
0No
1070 [yes_time_9_2]
Show the field ONLY if:
[baby_req_resuscitation_2] = '1'
9.4.3 If YES, what are all the resuscitation steps done and revived (heartbeat within 10 mins)? descriptive
1071 [tble_1_2]
Show the field ONLY if:
[baby_req_resuscitation_2] = '1'
Initial Steps done (Warmth / Dry / Stimulate / Position /
Clear airway / Resposition) {initi_steps_2} Time :
{tme_2_00_02} Bag and Mask ventilation
{bag_msk_vent_2} Time :{tme_1_2} Given Chest
Compressions {chst_cmprsn_2} Time :{tme_2_02} Given
Drugs {gvn_drug_2} Time :{tme_3_02} 		descriptive
1072 [initi_steps_2] Initial steps done (Warmth / Dry / Stimulate / Position /
Clear airway / Reposition) 		yesno, Required
1Yes
0No
1073 [tme_2_00_02]
Show the field ONLY if:
[initi_steps_2] = '1'
Time text (time), Required
1074 [bag_msk_vent_2] Bag and Mask ventilation / PPV yesno, Required
1Yes
0No
1075 [tme_1_2]
Show the field ONLY if:
[bag_msk_vent_2]='1'
Time text (time), Required
1076 [chst_cmprsn_2] Given Chest Compressions yesno, Required
1Yes
0No
1077 [tme_2_02]
Show the field ONLY if:
[chst_cmprsn_2]='1'
Time yesno, Required
1Yes
0No
1078 [gvn_drug_2] Given Drugs yesno, Required
1Yes
0No
1079 [tme_3_02]
Show the field ONLY if:
[gvn_drug_2]='1'
Time text (time), Required
1080 [no_hrtbt_9_02]
Show the field ONLY if:
[baby_cry_birth_2] = '0'
9.4.4 IF NO heartbeat after 10 minutes of resuscitation yesno, Required
1Yes
0No
1081 [tme_9_4_4_02]
Show the field ONLY if:
[no_hrtbt_9_02] = '1'
Time text (time)
1082 [bby_ded_resus_02]
Show the field ONLY if:
[no_hrtbt_9_02] = '1'
9.4.5 Baby died after resuscitation yesno, Required
1Yes
0No
1083 [tme_decl_dth_2]
Show the field ONLY if:
[bby_ded_resus_02] = '1'
Time of the declaration of death text (time), Required
1084 [birth_companion]
Show the field ONLY if:
[baby_cry_birth] = '1' or [no_hrtbt_9] = '0' or [baby_req_resuscitation] = '1' or [birth_outcomes] = '1' or [birth_outcomes] = '2' or [birth_outcomes] = '3' or [birth_outcomes_1]='1' or [birth_outcomes_1] ='2' or [birth_outcomes_1]='3' or [birth_outcomes_2]='1' or [birth_outcomes_2]='2' or [birth_outcomes_2]='3'
Section Header: Section 10 : Respectful maternity care10.1 Was there a birth companion? yesno, Required
1Yes
0No
1085 [what_birth_compan]
Show the field ONLY if:
[birth_companion] = '1'
10.1.1 IF YES, what did the birth companion do? checkbox, Required
1what_birth_compan___1Gave fluids to drink to the mother:
2what_birth_compan___2Comforted the mother:
3what_birth_compan___3Reported any danger signs to staff:
4what_birth_compan___4Was skin to skin contact initiated:
5what_birth_compan___5Was breast feeding initiated with 1 hour after birth:
1086 [status_nenatal]
Show the field ONLY if:
[baby_cry_birth] = '1' or [birth_outcomes] = '1' or [birth_outcomes_1]='1' or [birth_outcomes_2]='1'
10.2 What is the status of the baby in the early neonatal period: radio, Required
1Alive and well
2Sick
3Died
1087 [if_died_dt]
Show the field ONLY if:
[status_nenatal]='3'
Date text (date_dmy, Max: today), Required
1088 [time_dth]
Show the field ONLY if:
[status_nenatal]='3'
Time of death text (time), Required
1089 [sts_bby]
Show the field ONLY if:
[baby_cry_birth] = '1' or [birth_outcomes] = '1' or [birth_outcomes_1]='1' or [birth_outcomes_2]='1'
10.3 Where is the baby presently if alive & well or sick: radio, Required
1Baby kept with the mother and healthy
2Baby admitted in NICU / SNCU /NBSU
3Baby referred out of the district
4Was advised admission but mother left hospital with the baby
1090 [general_comments] General Comments notes
1091 [uuid] UUID text
Field Annotation: @MC-TASK-UUID @HIDDEN-SURVEY
1092 [startdate] Start Date text
Field Annotation: @MC-TASK-STARTDATE @HIDDEN-SURVEY
1093 [enddate] End Date text
Field Annotation: @MC-TASK-ENDDATE @HIDDEN-SURVEY
1094 [scheduledate] Schedule Date text
Field Annotation: @MC-TASK-SCHEDULEDATE @HIDDEN-SURVEY
1095 [status] Status dropdown
0Deleted
1Completed
2Incomplete

Field Annotation: @MC-TASK-STATUS @HIDDEN-SURVEY
1096 [supplementaldata] Supplemental Data (JSON) notes
Field Annotation: @MC-TASK-SUPPLEMENTALDATA @HIDDEN-SURVEY
1097 [serializedresult] Serialized Result file
Field Annotation: @MC-TASK-SERIALIZEDRESULT @HIDDEN-SURVEY
 
 1098 [process_coverage_of_services_complete]
Section Header: Form Status
Complete? 		dropdown
0Incomplete
1Unverified
2Complete
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