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National Rural Health Mission - Amravati

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Format B – Monthly Report<br />

1. Name of ASHA:<br />

2. Name of village:<br />

3. Stock of SN packs at the beginning of the month:<br />

4. Stock of SN packs at the end of the month:<br />

5. Cost of transporting from SC to village:<br />

S.<br />

No.<br />

Total #<br />

of girls<br />

Sunday meetings held and attendance by<br />

category<br />

Date #. of<br />

girls<br />

# of VHSC<br />

members<br />

ANM AWW<br />

Number of SN<br />

packs sold<br />

The following are the important area states consider to strategies and formulate the PIP<br />

S.No. Name of cities<br />

identified for<br />

implementing UHPs.<br />

In the State PIPs.<br />

Under<br />

Urban RCH, so far<br />

Major urban<br />

health<br />

strategies/activitie<br />

s carried out<br />

under Urban RCH<br />

so far, city‐wise<br />

Information in respect of Special Schemes (for each city)<br />

Name of city ‐<br />

Sl. No. Govt. <strong>Health</strong> Facilities ‐<br />

under Grant‐in‐aid<br />

from GOI<br />

No. of <strong>Health</strong> Posts<br />

Type A<br />

Type B<br />

Type C<br />

Type D<br />

No. of Urban Family<br />

Welfare Centres<br />

Type I<br />

Type II<br />

Type III<br />

Controlling agency<br />

(SG/LB/VO/Ors.)<br />

Urban health<br />

strategies/activities<br />

as proposed now in<br />

the State PIP under<br />

Urban RCH, city‐<br />

wise<br />

Status<br />

(Functional/closed)<br />

Amount of<br />

incentive<br />

earned<br />

Brief on<br />

activities<br />

being<br />

supported by<br />

external<br />

agencies<br />

Brief<br />

summary of<br />

activities being<br />

carried out

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