Refresher Training for Frontline Health Workers in Expanded ... - RHO
Refresher Training for Frontline Health Workers in Expanded ... - RHO
Refresher Training for Frontline Health Workers in Expanded ... - RHO
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Vacc<strong>in</strong>e <strong>in</strong> dose, AD syr<strong>in</strong>ge, mix<strong>in</strong>g syr<strong>in</strong>ge, safety box and vit. A balance<br />
No. Vacc<strong>in</strong>e/AD Syr<strong>in</strong>ge Received Used Balance Needed Remarks Compiled target diseases report<br />
Vit A No. of reported cases and status of vacc<strong>in</strong>ation<br />
Page 3<br />
Target disease Vacc<strong>in</strong>ated Not vacc<strong>in</strong>ated Unknown Death<br />
Measles<br />
Pertusis<br />
AFP/Polio<br />
Diphtheria<br />
Neonatal Tetanus<br />
Tuberculosis<br />
Yellow Fever<br />
Suggestions and Recommendations<br />
Date of<br />
report____________________<br />
Report<strong>in</strong>g officer_________________<br />
Designation_____________________<br />
Signature_______________________ Date of receipt________ Signature __________<br />
78
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