8/8/2019 pregnent wt

1/59

8/8/2019 pregnent wt

2/59

9 10.1 10.2

JSY BeneficioryRaju 2nd ANM 9493442183 18.2.90 Yes

Suresh Husband 9291586301 16.3.87 Yes

Venkanna Husband 9052858617 24.3.90 YesRaghumohan Husband 9948100695 18.5.90 Yes

Poornachandar Asha 9652698024 26.1.86 Yes

Raju 2nd ANM 9493442183 28.6.89 Yes

Saraiah Asha 9391560535 17.7.80 Yes

Raju Asha 9391560535 12.3.88 Yes

Nagaiah Asha 9652698024 4.4.90 Yes

Laxman Asha 9652698024 8.6.90 Yes

Raju Asha 9391560535 15.3.83 Yes

Husband's Name

Phone no. ohwhoom

Phonenumber

Date ofBirth

8/8/2019 pregnent wt

3/59

Caste(SC/ST/Others)BC

Sc

ScSc

BC

BC

BC

BC

BC

BC

Sc

8/8/2019 pregnent wt

4/59

14 15 16 17

Upparapally K.G.kamala 9701910297 P.madhavi

Upparapally K.G.kamala 9701910297 Ch.Sandhya

Upparapally K.G.kamala 9701910297 Ch.SandhyaUpparapally K.G.kamala 9701910297 S.chaitanya

Upparapally K.G.kamala 9701910297 S.chaitanya

Upparapally K.G.kamala 9701910297 O.Ravi

Upparapally K.G.kamala 9701910297 Ramya

Upparapally K.G.kamala 9701910297 Ramya

Upparapally K.G.kamala 9701910297 Sandhya

Upparapally K.G.kamala 9701910297 Sandhya

Upparapally K.G.kamala 9701910297 Ramya

Name ofsub_centre

Name ofANM

Phone number ofANM

Name ofassociated ASHA

8/8/2019 pregnent wt

5/59

19 19.2

Linked facilityfor delivery(sub_centre/DH/CHC/PHC etc)9640245162 DH

9652698024 DH

9652698024 DH9948990347 DH

9948990347 DH

9493442183 DH

9391560535 DH

9391560535 DH

9652698024 DH

9652698024 DH

9391560535 DH

Phone number ofASHA(ifavailable)

8/8/2019 pregnent wt

6/59

19.3 20 21 22 23

Name of Facility IMP 1st ANC 2nd ANC 3rd ANC18.6.10 28.8.10

20.6.10 8.9.10

2.7.10 15.9.1025.7.10 15.9.10

14.7.10 21.9.10

8/8/2019 pregnent wt

7/59

24 25

4th ANC TT1(immediately at detection of pregnancy

Date Date28.8.10

8.9.10

15.9.10

15.9.10

22.9.10

15.7.10 7.4.1015.7.10 7.4.10

18.8.10 16.6.10

18.8.10 16.6.10

18.8.10

23.7.10 7.4.10

8/8/2019 pregnent wt

8/59

26 27

TT2(after 1 month of adminstration) TT Booster

Date Date

8/8/2019 pregnent wt

9/59

28

IFA toblets given(Date on which 100 IFA tabs completed

Date

9.6.109.6.10

9.6.10

9.6.10

9.6.10

9.6.10

8/8/2019 pregnent wt

10/59

29

Anemia(moderate

8/8/2019 pregnent wt

11/59

30 31

complication(Hypertensive/Diabetics/APH/Malaria?Name) RTI/STI(Y/N)

No NoNo No

No No

No No

No No

No No

8/8/2019 pregnent wt

12/59

32 33.1

Date of delivery(dd/mm/yy) place of delivery(home type/institutional Type)

Home Type

23.8.1023.8.10

26.8.10

28.8.10

28.8.10

19.9.10

8/8/2019 pregnent wt

13/59

33.2 33.3 34

Delivery Type(Normal/cs/Instrumental)

Public Private

CKM NormalCKM Normal

CKM Normal

CKM Normal

CKM Normal

CKM Normal

8/8/2019 pregnent wt

14/59

35 36

Complications(y/N) Date of discharge from institution(if applicable)(dd/mm/yy)

24.8.1024.8.10

27.8.10

29.8.10

29.8.10

20.9.10

8/8/2019 pregnent wt

15/59

37 38

JSY Benefits paid (Date) Abortion(MTP12/spontaneous/None)

8/8/2019 pregnent wt

16/59

(if None,then other details to be filled)

8/8/2019 pregnent wt

17/59

39

PNC Home visit(with in 48hours/7days)

Yes

Yes

YesYes

Yes

Yes

8/8/2019 pregnent wt

18/59

40

PNC complications(PPH/sepsis/Death/Others/None)

8/8/2019 pregnent wt

19/59

41 42

PNC contraception Method(sterilisation/IUD/injectibles) PNC check up(Y/N)

8/8/2019 pregnent wt

20/59

43 44.1 44.2 44.3

Outcome Numbers0/1/2/3/4/5)0=still Birth child1 following details to be captured

Name Sex(M/F) Weight at birth(kg)

f 3000m 3000

m 3000

f 3000

8/8/2019 pregnent wt

21/59

44.4 45.1 45.2 45.3

orbeach child born for child tracking child2 following details to be captured

Initiated Brestfeeding within 1hr(Y/N) Name SexM/F) weight at birth(kg)

mch 3000

mch 3000

YesYes

Yes

Yes

8/8/2019 pregnent wt

22/59

45.4

for each child born for child tracking

Initiated Brestfeeding within 1hr(Y/N)

Yes

Yes

8/8/2019 pregnent wt

23/59

1 5 6 7 8

s.no Gram panchaytat/ Adderss ID No. Name1 Upparapally Sc colony Chinnapally pooja

2 Chennaram Bc colony Kothuri Sunitha

3 Kasagudem Bc colony Sk.Mahaboobee

4 Upparapally Bc colony Poda Anitha

5 Chennaram Sc colony Barla kalpana

6 Upparapally Bc colony Pasumuri Deepthi

7 Upparapally Bc colony Vangala Sujatha

8 Upparapally Bc colony Jannu Devayan

9 Chennaram Sc colony Pasumuri pooja

10 Upparapally Bc colony Chalkalapally radhika

11 Upparapally Bc colony tammadaboina Radika

12 Upparapally Bc colony Chinnapally elisha

13 Chennaram Bc colony Manchala Ramadevi

14 Kasagudem Bc colony Sk.ameenabegum

15 Kasagudem Sk.Asmabegum

16

8/8/2019 pregnent wt

24/59

9 10.1 10.2

JSY BeneficioryRaju Asha 9391560535 23.3.90 Yes

Ravi Husband 9642361988 18.6.90 Yes

Quasim ANM 9492442183 6.8.81 Yes

Ramu Asha 9652698024 8.2.86 Yes

somyakumar Asha 9640245162 6.2.83 Yes

Sudhakar Husband 9701047425 8.1.90 Yes

Yellaiah Husband 9951811623 18..90 Yes

Ramu self 9959467876 9.3.80 Yes

Raghu Asha 9652698024 26.6.87 Yes

Devendar Asha 9652698024 8.8.80 Yes

Raju Asha 9391560535 27.8.90 Yes

Babu Asha 9948990347 7.11.87 Yes

Anil kumar Asha 9492442183 14.9.87 Yes

Sunam shari Asha 9640245162 30.6.86 Yes

Hussain Asha 9640245162 18.7.85 Yes

Husband'sName

Phone no.oh whoom

Phonenumber

Date ofBirth

8/8/2019 pregnent wt

25/59

Caste(SC/ST/Others)ST

BC

BC

BC

SC

BC

BC

SC

BC

BC

BC

SC

BC

BC

BC

8/8/2019 pregnent wt

26/59

14 15 16 17 19

Name of ANM

Upparapally K.G.Kamala 9701910297 Ramya 9391560535

Upparapally K.G.Kamala 9701910297 P.Umadevi 9640245162

Upparapally K.G.Kamala 9701910297 P.Madavi 9640245162

Upparapally K.G.Kamala 9701910297 Ch.Sandhya 9652698024

Upparapally K.G.Kamala 9701910297 P.Madavi 9652698024

Upparapally K.G.Kamala 9701910297 Ch.Sandhya 9652698020

Upparapally K.G.Kamala 9701910297 Ch.Sandhya 9652698024

Upparapally K.G.Kamala 9701910297 P.Madavi 9640245162

Upparapally K.G.Kamala 9701910297 S.Ramya 9391560535

Upparapally K.G.Kamala 9701910297 Ch.Sandhya 9652698024

Upparapally K.G.Kamala 9701910297 S.Ramya 9391560535Upparapally K.G.Kamala 9701910297 S.chaithanya 9948990347

Upparapally K.G.Kamala 9701910297 P.Madavi 9948990347

Upparapally K.G.Kamala 9701910297 P.Madavi 9948990347

Upparapally K.G.Kamala 9701910297 P.Madavi 9948990347

Name ofsub_centre

Phonenumber ofANM

Name ofassociatedASHA

Phonenumber ofASHA(ifavailable)

8/8/2019 pregnent wt

27/59

19.2 19.3 20 21 22

Linked facilityfor delivery(sub_centre/Name of Facility IMP 1st ANC 2nd ANC

Date Date DateDH DH 28.1.10 7.4.10 5.5.10

DH DH 30.1.10 7.4.10 5.5.10

DH DH 8.2.10 7.4.10 5.5.10

DH DH 18.2.10 5.5.10 9.6.10

DH DH 24.2.10 12.5.10 16.6.10

DH DH 7.2.10 19.5.10 19.6.10

DH DH 10.2.10 19.5.10 19.6.10

DH DH 26.4.10 5.6.10 7.7.10

DH DH 16.11.09 9.6.10 7.7.10

DH DH 22.1.10 9.6.10 14.7.10

DH DH 19.11.09 16.6.10 14.7.10DH DH 5.3.10 23.6.10 28.7.10

DH DH 15.1.10 26.6.10 28.7.10

DH DH 20.4.10 15.7.10 21.8.10

DH DH 2.6.10 15.7.10 21.8.10

8/8/2019 pregnent wt

28/59

23

3rd ANC

Date2.6.10

9.6.10

9.6.10

7.7.10

14.7.10

21.7.10

21.7.10

11.8.10

11.8.10

18.8.10

18.8.101.9.10

28.8.10

28.8.10

28.8.10

8/8/2019 pregnent wt

29/59

24 25 26

4th ANC TT1(immediately at dete TT2(after 1 month of ad

Date Date Date4.7.10 7.4.10 5.5.10

7.4.10 5.5.10

7.4.10 5.5.10

5.5.10 9.6.10

12.5.10 16.6.10

15.5.10 17.6.10

19.5.10 19.6.10

5.6.10 7.7.10

9.6.10 7.7.10

9.6.10 14.7.10

16.6.10 24.7.10

23.6.10 26.7.1026.6.10 28.7.10

15.7.10 21.8.10

15.7.10 21.8.10

8/8/2019 pregnent wt

30/59

27 28

TT Booster IFA toblets given(Date on which 100

Date Date2.6.10

9.6.10

9.6.10

7.7.10

14.7.10

16.7.10

21.7.10

11.8.10

11.8.10

18.8.10

18.8.10

1.9.1028.8.10

28.8.10

28.8.10

8/8/2019 pregnent wt

31/59

29

Anemia(moderate

8/8/2019 pregnent wt

32/59

30 31 32

complication(Hypertensive/Diabetics/APH/Malaria?RTI/STI(Y/N) Date of delivery(dd/

NO

NO

NO

NO

NO

NO

NO

NO

NO

NO

NO

NONO

NO

NO

8/8/2019 pregnent wt

33/59

33.1 33.2 33.3 34

place of delivery(home type/institutional Type) Delivery Type(Normal/cs/Instrumen

Home Type Public Private

8/8/2019 pregnent wt

34/59

35 36 37 38

Complic Date of JSY BenAbortion(MTP12/spontaneous/None)(if None,then o

8/8/2019 pregnent wt

35/59

her details to be filled)

8/8/2019 pregnent wt

36/59

8/8/2019 pregnent wt

37/59

9 10.1 10.2

Husband's Name Phone number

Yakaiah Asha 9640245162 5.6.90Hyder Asha 9640245162 15.5.89

Phone no. ohwhoom

Date ofBirth

8/8/2019 pregnent wt

38/59

JSY Beneficiory Caste(SC/ST/Others)

Yes BCYes BC

8/8/2019 pregnent wt

39/59

14 15 16

Name of ANM

Upparapally K.G.Kamala 9701910297

Upparapally K.G.Kamala 9701910297

Name ofsub_centre

Phonenumber ofANM

8/8/2019 pregnent wt

40/59

17 19 19.2 19.3 20

Linked fName of Facility IMP

DateP.Madavi 9640245162 DH DH 19.5.10

P.Madavi 9640245162 DH DH 13.3.10

Name ofassociatedASHA

Phone number ofASHA(ifavailable)

8/8/2019 pregnent wt

41/59

21 22 23

1st ANC 2nd ANC 3rd ANC

Date Date Date17.7.10 21.8.10 .28.8.10

17.7.10 21.8.10 1.9.10

8/8/2019 pregnent wt

42/59

24 25 26 27 28

4th ANC TT1(immediately at TT2(after 1 monTT Booster IFA toblets giv

Date Date Date Date Date

17.7.10 21.8.10 28.8.10

17.7.10 21.8.10 1.9.10

8/8/2019 pregnent wt

43/59

29 30 31 32 33.1

Anemia(mode complication(Hy RTI/STI(Y/N) Date of deliver place of deliver

Home Type

8/8/2019 pregnent wt

44/59

33.2 33.3 34 35

y(home type/institutional Type) Delivery Type(Normal/cs/InstrComplications(y

Public Private

8/8/2019 pregnent wt

45/59

36 37 38

Date of discharge fromJSY Benefits paid (D Abortion(MTP12/spontaneo

8/8/2019 pregnent wt

46/59

us/None)(if None,then other details to be filled)

8/8/2019 pregnent wt

47/59

1 5 6 7 8

s.no Gram pancha Adderss ID No. Name

1 Upparaally BC colony Goka Gouthami2 Upparaally BC colony Manda swapna

3 Upparaally BC colony Mathapely Swathi

4 Upparaally OC colony Takkalapelly Rajitha

5 Upparaally BC colony Donikala Rajitha

6 Upparaally SC colony vashapaka Rajitha

7 Upparaally SC colony Chinnapally Rajitha

8/8/2019 pregnent wt

48/59

9 10.1 10.2

JSY Beneficiory

Raju Husband 9348489333 12.8.87 YESAshok Husband 9492442183 18.10.88 YES

Santosh Rao Husband 9391560535 26.3.89 YES

Raja Rao Husband 9951194565 8.5.87 YES

Swami Husband 9705311804 13.4.89 YES

Santosh Rao Husband 9252858617 23.7.90 YES

Yakaiah Husband 9618177781 15.3.86 YES

Husband'sName

Phone no. ohwhoom

Phonenumber

Date ofBirth

8/8/2019 pregnent wt

49/59

Caste(SC/ST/Others)

BCBC

OC

OC

BC

SC

SC

8/8/2019 pregnent wt

50/59

24 25

4th ANC TT1(immediately at detection of pregnancy

Date Date

28.7.10

31.7.10

4.8.10

7.8.10

7.8.10

10.8.10

10.8.10

8/8/2019 pregnent wt

51/59

26 27 28

TT2(after 1 month of adminstTT Booster IFA toblets given(Date

Date Date Date

28.10.10

1.11.10

28.11.10

1.12.10

1.12.10

4.12.10

4.12.10

8/8/2019 pregnent wt

52/59

29 30 31

Anemia(moderate

8/8/2019 pregnent wt

53/59

32 33.1 33.2

Date of delivery(dd/mm/yy) place of delivery(home type/institutional Typ

Home Type Public

30.3.10 DH

25.2.10 DH

8.2.10 DH

24.12.10 DH

26.2.10 DH

3.2.10 DH

30.2.10 DH

8/8/2019 pregnent wt

54/59

33.3 34 35 36 37

e) Delivery Type(Normal/cs/InsComplicatioDate of disJSY Benefit

Private

Normal NO

Normal NO

NO

normal NO

NO

NO

normal NO

8/8/2019 pregnent wt

55/59

38

Abortion(MTP12/spontaneous/None)(if None,then other details to be fille

8/8/2019 pregnent wt

56/59

d)

8/8/2019 pregnent wt

57/59

14 15 16 17

Name of ANM

Upparapally K.G.Kamala 9701910297 ch.sandhya

Upparapally K.G.Kamala 9701910297 P.Madavi

Upparapally K.G.Kamala 9701910297 Ch.Sandhya

Upparapally K.G.Kamala 9701910297 S.Ramya

Upparapally K.G.Kamala 9701910297 S.Chaithanya

Upparapally K.G.Kamala 9701910297 S.Ramya

Upparapally K.G.Kamala 9701910297 S.Ramya

Name ofsub_centre

Phonenumber ofANM

Name ofassociatedASHA

8/8/2019 pregnent wt

58/59

19 19.2 19.3 20

Linked facilityfor d Name of Facility IMP

Date9652698024 DH 23.6.10

9640245162 DH 18.5.10

9652698024 DH 1.5.10

9391560535 DH 17.3.10.

9948990347 DH 19.5.10

9391560535 DH 26.5.10

9391560535 DH 23.5.10

Phone number ofASHA(if available)

8/8/2019 pregnent wt

59/59

21 22 23

1st ANC 2nd ANC 3rd ANC

Date Date Date28.7.10

31.7.10

4.8.10

7.8.10

7.8.10

10.8.10

10.8.10