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FHSIS REPORT for the Month of JANUARY YEAR: 2014 Municipality/City Name: Municipality of Orion Province: Bataan Projected Population of the Year: __________ Target Accomplishment Preg.women w/ less than 4 visits0 Preg.women w/ 4 or more prenatal visits0 Pregnant women given 2 doses of TT0 Pregnant women given TT2 plus0 Preg.given complete iron w/folic acid0 Preg.given incomplete iron w/folic acid0 PP women with at least 1 PPV0 PP women with at least 2 PPV0 PP women given complete iron0 PP women with incomplete iron dosage0 PP women given Vitamin A0 PP women initiated breastfeeding w/in 1 hr. after delivery0 Women 10-49 years old given Iron Supplement 0 Deliveries 0 Infants given Complementary Foods not earlier than 6 months 0 New (Previous Month) Other TARGET a. Female Ster/BTL 0 0 0 0 0 0 b. Male Ster/Vasectomy 0 0 0 0 0 0 c. Pills 0 0 0 0 0 0 d. IUD 0 0 0 0 0 0 e. Injectables (DMPA) 0 0 0 0 0 0 f. NFP-CM 0 0 0 0 0 0 g. NFP-BBT 0 0 0 0 0 0 h. NFP-STM 0 0 0 0 0 0 i. NFP-SDM 0 0 0 0 0 0 j. NFP-LAM 0 0 0 0 0 0 k. Condom 0 0 0 0 0 0 l. Implant 0 0 0 0 0 0 TOTAL 0 0 0 0 0 0 Current User (End Mo.) New Acceptor (Present Month) FAMILY PLANNING Current User (Begin Mo.) ACCEPTORS Drop Out MATERNAL CARE FHSIS version 2014

FHIS Version 2014

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a revised FHIS Form implemented in the Province of Bataan

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Page 1: FHIS Version 2014

FHSIS REPORT for the Month of JANUARY YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

Current User

(End Mo.)New Acceptor

(Present Month)FAMILY PLANNING

Current User

(Begin Mo.)

ACCEPTORS

Drop Out

MATERNAL CARE

FHSIS version 2014

Page 2: FHIS Version 2014

FHSIS REPORT for the Month of FEBRUARY YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

FHSIS version 2014

New Acceptor

(Present Month)

Page 3: FHIS Version 2014

FHSIS REPORT for the Month of MARCH YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

FHSIS version 2014

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

Page 4: FHIS Version 2014

FHSIS REPORT for the Month of APRIL YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

FHSIS version 2014

Page 5: FHIS Version 2014

FHSIS REPORT for the Month of MAY YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

FHSIS version 2014

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

Page 6: FHIS Version 2014

FHSIS REPORT for the Month of JUNE YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

FHSIS version 2014

Page 7: FHIS Version 2014

FHSIS REPORT for the Month of JULY YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

FHSIS version 2014

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

Page 8: FHIS Version 2014

FHSIS REPORT for the Month of AUGUST YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

FHSIS version 2014

Page 9: FHIS Version 2014

FHSIS REPORT for the Month of SEPTEMBER YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

FHSIS version 2014

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

Page 10: FHIS Version 2014

FHSIS REPORT for the Month of OCTOBER YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

FHSIS version 2014

Page 11: FHIS Version 2014

FHSIS REPORT for the Month of NOVEMBER YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

FHSIS version 2014

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

New Acceptor

(Present Month)

Page 12: FHIS Version 2014

FHSIS REPORT for the Month of DECEMBER YEAR: 2014

Municipality/City Name: Municipality of Orion

Province: Bataan Projected Population of the Year: __________

Target Accomplishment

Preg.women w/ less than 4 visits♣ 0

Preg.women w/ 4 or more prenatal visits♣ 0

Pregnant women given 2 doses of TT♣ 0

Pregnant women given TT2 plus♣ 0

Preg.given complete iron w/folic acid♣ 0

Preg.given incomplete iron w/folic acid♣ 0

PP women with at least 1 PPV♥ 0

PP women with at least 2 PPV♥ 0

PP women given complete iron♥ 0

PP women with incomplete iron dosage♥ 0

PP women given Vitamin A♥ 0

PP women initiated breastfeeding w/in 1 hr. after delivery♥ 0

Women 10-49 years old given Iron Supplement 0

Deliveries 0

Infants given Complementary Foods not earlier than 6 months 0

New

(Previous Month)Other

TARGET

a. Female Ster/BTL 0 0 0 0 0 0

b. Male Ster/Vasectomy 0 0 0 0 0 0

c. Pills 0 0 0 0 0 0

d. IUD 0 0 0 0 0 0

e. Injectables (DMPA) 0 0 0 0 0 0

f. NFP-CM 0 0 0 0 0 0

g. NFP-BBT 0 0 0 0 0 0

h. NFP-STM 0 0 0 0 0 0

i. NFP-SDM 0 0 0 0 0 0

j. NFP-LAM 0 0 0 0 0 0

k. Condom 0 0 0 0 0 0

l. Implant 0 0 0 0 0 0

TOTAL 0 0 0 0 0 0

FHSIS version 2014

New Acceptor

(Present Month)

MATERNAL CARE

FAMILY PLANNINGCurrent User

(Begin Mo.)

ACCEPTORS

Drop OutCurrent User

(End Mo.)

Page 13: FHIS Version 2014

M-Form Page 2

Male Female Total CHILD CARE Male Female Total

Infant Given : Infant given complimentary food from 6-8 months 0 0 0

BCG 0 0 0 Infant for newborn screening: referred 0 0 0

w/ in 24

Hrs0 0 0 done 0 0 0

> 24 Hrs 0 0 0 Infant 6-11 months old received Vitamin A 0 0 0

1 0 0 0 Children 12-59 months old received Vitamin A 0 0 0

2 0 0 0 Infant 6-11 months old received Iron 0 0 0

3 0 0 0 Children 12-59 months old received Iron 0 0 0

1 0 0 0 Infant 6-11 months old received MNP 0 0 0

2 0 0 0 Children 12-59 months old received MNP 0 0 0

3 0 0 0 Sick Children 6-11 months old Seen 0 0 0

MCV 1

(AMV)0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 2

(MMR)0 0 0

Sick Children 12-59 months seen0 0 0

1 0 0 0 Children 12-59 months old given de-worming tabs 0 0 0

2 0 0 0 Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0

3 0 0 0 Infant 2-5 mos. w/ LBW received full dose iron 0 0 0

1 0 0 0 Anemic Children 6-11 mos. old seen 0 0 0

2 0 0 0 Anemic Children 6-11 mos. received full dose iron 0 0 0

3 0 0 0 Anemic Children 12-59 mos. Old seen 0 0 0

Fully Immunized Child (0-11 mos) FIC 0 0 0 Anemic Children 12-59 mos. received full dose iron 0 0 0

Completely immunized Child (12-23 mos.) 0 0 0 Diarrhea cases 0-59 mos. Old seen 0 0 0

Total Live Births 0 0 0 Diarrhea cases 0-59 mos. Received ORS 0 0 0

Child Protected at Birth (CPAB) 0 0 0 Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0

Infant age 6 months seen 0 0 0 Pneumonia cases 0-59 months old 0 0 0

Infant exclusively breastfeed until 6th month 0 0 0 Pneumonia cases 0-59 mos old completed tx 0 0 0

PCV

MCV

CHILD CARE

Month of January

Hepa B1

PENTA

OPV

ROTA

Page 14: FHIS Version 2014

M-Form Page 2

Male Female Total CHILD CARE Male Female Total

Infant Given : Infant given complimentary food from 6-8 months 0 0 0

BCG 0 0 0 Infant for newborn screening: referred 0 0 0

w/ in 24

Hrs0 0 0 done 0 0 0

> 24 Hrs 0 0 0 Infant 6-11 months old received Vitamin A 0 0 0

1 0 0 0 Children 12-59 months old received Vitamin A 0 0 0

2 0 0 0 Infant 6-11 months old received Iron 0 0 0

3 0 0 0 Children 12-59 months old received Iron 0 0 0

1 0 0 0 Infant 6-11 months old received MNP 0 0 0

2 0 0 0 Children 12-59 months old received MNP 0 0 0

3 0 0 0 Sick Children 6-11 months old Seen 0 0 0

MCV 1

(AMV)0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 2

(MMR)0 0 0

Sick Children 12-59 months seen0 0 0

1 0 0 0 Children 12-59 months old given de-worming tabs 0 0 0

2 0 0 0 Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0

3 0 0 0 Infant 2-5 mos. w/ LBW received full dose iron 0 0 0

1 0 0 0 Anemic Children 6-11 mos. old seen 0 0 0

2 0 0 0 Anemic Children 6-11 mos. received full dose iron 0 0 0

3 0 0 0 Anemic Children 12-59 mos. Old seen 0 0 0

Fully Immunized Child (0-11 mos) FIC 0 0 0 Anemic Children 12-59 mos. received full dose iron 0 0 0

Completely immunized Child (12-23 mos.) 0 0 0 Diarrhea cases 0-59 mos. Old seen 0 0 0

Total Live Births 0 0 0 Diarrhea cases 0-59 mos. Received ORS 0 0 0

Child Protected at Birth (CPAB) 0 0 0 Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0

Infant age 6 months seen 0 0 0 Pneumonia cases 0-59 months old 0 0 0

Infant exclusively breastfeed until 6th month 0 0 0 Pneumonia cases 0-59 mos old completed tx 0 0 0

ROTA

PCV

CHILD CARE

Hepa B1

PENTA

OPV

MCV

FebruaryMonth of

Page 15: FHIS Version 2014

M-Form Page 2

Male Female Total CHILD CARE Male Female Total

Infant Given : Infant given complimentary food from 6-8 months 0 0 0

BCG 0 0 0 Infant for newborn screening: referred 0 0 0

w/ in 24

Hrs0 0 0 done 0 0 0

> 24 Hrs 0 0 0 Infant 6-11 months old received Vitamin A 0 0 0

1 0 0 0 Children 12-59 months old received Vitamin A 0 0 0

2 0 0 0 Infant 6-11 months old received Iron 0 0 0

3 0 0 0 Children 12-59 months old received Iron 0 0 0

1 0 0 0 Infant 6-11 months old received MNP 0 0 0

2 0 0 0 Children 12-59 months old received MNP 0 0 0

3 0 0 0 Sick Children 6-11 months old Seen 0 0 0

MCV 1

(AMV)0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 2

(MMR)0 0 0

Sick Children 12-59 months seen0 0 0

1 0 0 0 Children 12-59 months old given de-worming tabs 0 0 0

2 0 0 0 Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0

3 0 0 0 Infant 2-5 mos. w/ LBW received full dose iron 0 0 0

1 0 0 0 Anemic Children 6-11 mos. old seen 0 0 0

2 0 0 0 Anemic Children 6-11 mos. received full dose iron 0 0 0

3 0 0 0 Anemic Children 12-59 mos. Old seen 0 0 0

Fully Immunized Child (0-11 mos) FIC 0 0 0 Anemic Children 12-59 mos. received full dose iron 0 0 0

Completely immunized Child (12-23 mos.) 0 0 0 Diarrhea cases 0-59 mos. Old seen 0 0 0

Total Live Births 0 0 0 Diarrhea cases 0-59 mos. Received ORS 0 0 0

Child Protected at Birth (CPAB) 0 0 0 Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0

Infant age 6 months seen 0 0 0 Pneumonia cases 0-59 months old 0 0 0

Infant exclusively breastfeed until 6th month 0 0 0 Pneumonia cases 0-59 mos old completed tx 0 0 0

PCV

Month of March

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

Page 16: FHIS Version 2014

M-Form Page 2

Male Female Total CHILD CARE Male Female Total

Infant Given : Infant given complimentary food from 6-8 months 0 0 0

BCG 0 0 0 Infant for newborn screening: referred 0 0 0

w/ in 24

Hrs0 0 0 done 0 0 0

> 24 Hrs 0 0 0 Infant 6-11 months old received Vitamin A 0 0 0

1 0 0 0 Children 12-59 months old received Vitamin A 0 0 0

2 0 0 0 Infant 6-11 months old received Iron 0 0 0

3 0 0 0 Children 12-59 months old received Iron 0 0 0

1 0 0 0 Infant 6-11 months old received MNP 0 0 0

2 0 0 0 Children 12-59 months old received MNP 0 0 0

3 0 0 0 Sick Children 6-11 months old Seen 0 0 0

MCV 1

(AMV)0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 2

(MMR)0 0 0

Sick Children 12-59 months seen0 0 0

1 0 0 0 Children 12-59 months old given de-worming tabs 0 0 0

2 0 0 0 Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0

3 0 0 0 Infant 2-5 mos. w/ LBW received full dose iron 0 0 0

1 0 0 0 Anemic Children 6-11 mos. old seen 0 0 0

2 0 0 0 Anemic Children 6-11 mos. received full dose iron 0 0 0

3 0 0 0 Anemic Children 12-59 mos. Old seen 0 0 0

Fully Immunized Child (0-11 mos) FIC 0 0 0 Anemic Children 12-59 mos. received full dose iron 0 0 0

Completely immunized Child (12-23 mos.) 0 0 0 Diarrhea cases 0-59 mos. Old seen 0 0 0

Total Live Births 0 0 0 Diarrhea cases 0-59 mos. Received ORS 0 0 0

Child Protected at Birth (CPAB) 0 0 0 Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0

Infant age 6 months seen 0 0 0 Pneumonia cases 0-59 months old 0 0 0

Infant exclusively breastfeed until 6th month 0 0 0 Pneumonia cases 0-59 mos old completed tx 0 0 0

Month of April

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

Page 17: FHIS Version 2014

M-Form Page 2

Male Female Total

Infant Given :

BCG 0 0 0

w/ in 24

Hrs0 0 0

> 24 Hrs 0 0 0

1 0 0 0

2 0 0 0

3 0 0 0

1 0 0 0

2 0 0 0

3 0 0 0

MCV 1

(AMV)0 0 0

MCV 2

(MMR)0 0 0

1 0 0 0

2 0 0 0

3 0 0 0

1 0 0 0

2 0 0 0

3 0 0 0

Fully Immunized Child (0-11 mos) FIC 0 0 0

Completely immunized Child (12-23 mos.) 0 0 0

Total Live Births 0 0 0

Child Protected at Birth (CPAB) 0 0 0

Infant age 6 months seen 0 0 0

Infant exclusively breastfeed until 6th month 0 0 0

MCV

ROTA

PCV

Month of May

CHILD CARE

Hepa B1

PENTA

OPV

Page 18: FHIS Version 2014

M-Form Page 2

CHILD CARE Male Female Total Male Female Total

Infant given complimentary food from 6-8 months 0 0 0 Infant Given :

Infant for newborn screening: referred 0 0 0 BCG 0 0 0

done 0 0 0w/ in 24

Hrs0 0 0

Infant 6-11 months old received Vitamin A 0 0 0 > 24 Hrs 0 0 0

Children 12-59 months old received Vitamin A 0 0 0 1 0 0 0

Infant 6-11 months old received Iron 0 0 0 2 0 0 0

Children 12-59 months old received Iron 0 0 0 3 0 0 0

Infant 6-11 months old received MNP 0 0 0 1 0 0 0

Children 12-59 months old received MNP 0 0 0 2 0 0 0

Sick Children 6-11 months old Seen 0 0 0 3 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 1

(AMV)0 0 0

Sick Children 12-59 months seen0 0 0

MCV 2

(MMR)0 0 0

Children 12-59 months old given de-worming tabs 0 0 0 1 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0 2 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0 3 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0 1 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0 2 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0 3 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0 Fully Immunized Child (0-11 mos) FIC 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0 Completely immunized Child (12-23 mos.) 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0 Total Live Births 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0 Child Protected at Birth (CPAB) 0 0 0

Pneumonia cases 0-59 months old 0 0 0 Infant age 6 months seen 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0 Infant exclusively breastfeed until 6th month 0 0 0

Month of June

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

Page 19: FHIS Version 2014

M-Form Page 2

CHILD CARE Male Female Total Male Female Total

Infant given complimentary food from 6-8 months 0 0 0 Infant Given :

Infant for newborn screening: referred 0 0 0 BCG 0 0 0

done 0 0 0w/ in 24

Hrs0 0 0

Infant 6-11 months old received Vitamin A 0 0 0 > 24 Hrs 0 0 0

Children 12-59 months old received Vitamin A 0 0 0 1 0 0 0

Infant 6-11 months old received Iron 0 0 0 2 0 0 0

Children 12-59 months old received Iron 0 0 0 3 0 0 0

Infant 6-11 months old received MNP 0 0 0 1 0 0 0

Children 12-59 months old received MNP 0 0 0 2 0 0 0

Sick Children 6-11 months old Seen 0 0 0 3 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 1

(AMV)0 0 0

Sick Children 12-59 months seen0 0 0

MCV 2

(MMR)0 0 0

Children 12-59 months old given de-worming tabs 0 0 0 1 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0 2 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0 3 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0 1 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0 2 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0 3 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0 Fully Immunized Child (0-11 mos) FIC 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0 Completely immunized Child (12-23 mos.) 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0 Total Live Births 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0 Child Protected at Birth (CPAB) 0 0 0

Pneumonia cases 0-59 months old 0 0 0 Infant age 6 months seen 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0 Infant exclusively breastfeed until 6th month 0 0 0

Month of July

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

Page 20: FHIS Version 2014

M-Form Page 2

CHILD CARE Male Female Total Male Female Total

Infant given complimentary food from 6-8 months 0 0 0 Infant Given :

Infant for newborn screening: referred 0 0 0 BCG 0 0 0

done 0 0 0w/ in 24

Hrs0 0 0

Infant 6-11 months old received Vitamin A 0 0 0 > 24 Hrs 0 0 0

Children 12-59 months old received Vitamin A 0 0 0 1 0 0 0

Infant 6-11 months old received Iron 0 0 0 2 0 0 0

Children 12-59 months old received Iron 0 0 0 3 0 0 0

Infant 6-11 months old received MNP 0 0 0 1 0 0 0

Children 12-59 months old received MNP 0 0 0 2 0 0 0

Sick Children 6-11 months old Seen 0 0 0 3 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 1

(AMV)0 0 0

Sick Children 12-59 months seen0 0 0

MCV 2

(MMR)0 0 0

Children 12-59 months old given de-worming tabs 0 0 0 1 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0 2 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0 3 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0 1 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0 2 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0 3 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0 Fully Immunized Child (0-11 mos) FIC 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0 Completely immunized Child (12-23 mos.) 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0 Total Live Births 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0 Child Protected at Birth (CPAB) 0 0 0

Pneumonia cases 0-59 months old 0 0 0 Infant age 6 months seen 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0 Infant exclusively breastfeed until 6th month 0 0 0

Month of August

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

Page 21: FHIS Version 2014

M-Form Page 2

CHILD CARE Male Female Total Male Female Total

Infant given complimentary food from 6-8 months 0 0 0 Infant Given :

Infant for newborn screening: referred 0 0 0 BCG 0 0 0

done 0 0 0w/ in 24

Hrs0 0 0

Infant 6-11 months old received Vitamin A 0 0 0 > 24 Hrs 0 0 0

Children 12-59 months old received Vitamin A 0 0 0 1 0 0 0

Infant 6-11 months old received Iron 0 0 0 2 0 0 0

Children 12-59 months old received Iron 0 0 0 3 0 0 0

Infant 6-11 months old received MNP 0 0 0 1 0 0 0

Children 12-59 months old received MNP 0 0 0 2 0 0 0

Sick Children 6-11 months old Seen 0 0 0 3 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 1

(AMV)0 0 0

Sick Children 12-59 months seen0 0 0

MCV 2

(MMR)0 0 0

Children 12-59 months old given de-worming tabs 0 0 0 1 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0 2 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0 3 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0 1 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0 2 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0 3 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0 Fully Immunized Child (0-11 mos) FIC 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0 Completely immunized Child (12-23 mos.) 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0 Total Live Births 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0 Child Protected at Birth (CPAB) 0 0 0

Pneumonia cases 0-59 months old 0 0 0 Infant age 6 months seen 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0 Infant exclusively breastfeed until 6th month 0 0 0

MCV

ROTA

PCV

Month of September

CHILD CARE

Hepa B1

PENTA

OPV

Page 22: FHIS Version 2014

M-Form Page 2

CHILD CARE Male Female Total Male Female Total

Infant given complimentary food from 6-8 months 0 0 0 Infant Given :

Infant for newborn screening: referred 0 0 0 BCG 0 0 0

done 0 0 0w/ in 24

Hrs0 0 0

Infant 6-11 months old received Vitamin A 0 0 0 > 24 Hrs 0 0 0

Children 12-59 months old received Vitamin A 0 0 0 1 0 0 0

Infant 6-11 months old received Iron 0 0 0 2 0 0 0

Children 12-59 months old received Iron 0 0 0 3 0 0 0

Infant 6-11 months old received MNP 0 0 0 1 0 0 0

Children 12-59 months old received MNP 0 0 0 2 0 0 0

Sick Children 6-11 months old Seen 0 0 0 3 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 1

(AMV)0 0 0

Sick Children 12-59 months seen0 0 0

MCV 2

(MMR)0 0 0

Children 12-59 months old given de-worming tabs 0 0 0 1 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0 2 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0 3 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0 1 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0 2 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0 3 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0 Fully Immunized Child (0-11 mos) FIC 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0 Completely immunized Child (12-23 mos.) 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0 Total Live Births 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0 Child Protected at Birth (CPAB) 0 0 0

Pneumonia cases 0-59 months old 0 0 0 Infant age 6 months seen 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0 Infant exclusively breastfeed until 6th month 0 0 0

Month of October

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

Page 23: FHIS Version 2014

M-Form Page 2

CHILD CARE Male Female Total Male Female Total

Infant given complimentary food from 6-8 months 0 0 0 Infant Given :

Infant for newborn screening: referred 0 0 0 BCG 0 0 0

done 0 0 0w/ in 24

Hrs0 0 0

Infant 6-11 months old received Vitamin A 0 0 0 > 24 Hrs 0 0 0

Children 12-59 months old received Vitamin A 0 0 0 1 0 0 0

Infant 6-11 months old received Iron 0 0 0 2 0 0 0

Children 12-59 months old received Iron 0 0 0 3 0 0 0

Infant 6-11 months old received MNP 0 0 0 1 0 0 0

Children 12-59 months old received MNP 0 0 0 2 0 0 0

Sick Children 6-11 months old Seen 0 0 0 3 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 1

(AMV)0 0 0

Sick Children 12-59 months seen0 0 0

MCV 2

(MMR)0 0 0

Children 12-59 months old given de-worming tabs 0 0 0 1 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0 2 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0 3 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0 1 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0 2 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0 3 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0 Fully Immunized Child (0-11 mos) FIC 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0 Completely immunized Child (12-23 mos.) 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0 Total Live Births 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0 Child Protected at Birth (CPAB) 0 0 0

Pneumonia cases 0-59 months old 0 0 0 Infant age 6 months seen 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0 Infant exclusively breastfeed until 6th month 0 0 0

Month of November

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

Page 24: FHIS Version 2014

M-Form Page 2

CHILD CARE Male Female Total Male Female Total

Infant given complimentary food from 6-8 months 0 0 0 Infant Given :

Infant for newborn screening: referred 0 0 0 BCG 0 0 0

done 0 0 0w/ in 24

Hrs0 0 0

Infant 6-11 months old received Vitamin A 0 0 0 > 24 Hrs 0 0 0

Children 12-59 months old received Vitamin A 0 0 0 1 0 0 0

Infant 6-11 months old received Iron 0 0 0 2 0 0 0

Children 12-59 months old received Iron 0 0 0 3 0 0 0

Infant 6-11 months old received MNP 0 0 0 1 0 0 0

Children 12-59 months old received MNP 0 0 0 2 0 0 0

Sick Children 6-11 months old Seen 0 0 0 3 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

MCV 1

(AMV)0 0 0

Sick Children 12-59 months seen0 0 0

MCV 2

(MMR)0 0 0

Children 12-59 months old given de-worming tabs 0 0 0 1 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0 2 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0 3 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0 1 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0 2 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0 3 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0 Fully Immunized Child (0-11 mos) FIC 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0 Completely immunized Child (12-23 mos.) 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0 Total Live Births 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0 Child Protected at Birth (CPAB) 0 0 0

Pneumonia cases 0-59 months old 0 0 0 Infant age 6 months seen 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0 Infant exclusively breastfeed until 6th month 0 0 0

Month of December

CHILD CARE

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

Page 25: FHIS Version 2014

CHILD CARE Male Female Total

Infant given complimentary food from 6-8 months 0 0 0

Infant for newborn screening: referred 0 0 0

done 0 0 0

Infant 6-11 months old received Vitamin A 0 0 0

Children 12-59 months old received Vitamin A 0 0 0

Infant 6-11 months old received Iron 0 0 0

Children 12-59 months old received Iron 0 0 0

Infant 6-11 months old received MNP 0 0 0

Children 12-59 months old received MNP 0 0 0

Sick Children 6-11 months old Seen 0 0 0

Sick Children 6-11 months old received Vitamin A0 0 0

Sick Children 12-59 months seen0 0 0

Children 12-59 months old given de-worming tabs 0 0 0

Infant 2-5 mos. w/ Low Birth Weight seen 0 0 0

Infant 2-5 mos. w/ LBW received full dose iron 0 0 0

Anemic Children 6-11 mos. old seen 0 0 0

Anemic Children 6-11 mos. received full dose iron 0 0 0

Anemic Children 12-59 mos. Old seen 0 0 0

Anemic Children 12-59 mos. received full dose iron 0 0 0

Diarrhea cases 0-59 mos. Old seen 0 0 0

Diarrhea cases 0-59 mos. Received ORS 0 0 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0 0 0

Pneumonia cases 0-59 months old 0 0 0

Pneumonia cases 0-59 mos old completed tx 0 0 0

Page 26: FHIS Version 2014

A B C D E F G H I J K L M

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

Bilolo

Capunitan

Camachile

Page 27: FHIS Version 2014

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

Monthly

January

February

March

April

May

Bantan

Daan Pare

Page 28: FHIS Version 2014

June

July

August

September

October

November

December

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Arellano

San Vicente

Page 29: FHIS Version 2014

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

MonthlyJanuary

Balut

Wakas

Daan Bago

Page 30: FHIS Version 2014

FebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

Sta. Elena

Villa Angeles

Page 31: FHIS Version 2014

November

December

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

A B C D E F G H I J K L M

Annual

Quarterly

Monthly

January 0 0 0 0 0 0 0 0 0 0 0 0 0

February 0 0 0 0 0 0 0 0 0 0 0 0 0

March 0 0 0 0 0 0 0 0 0 0 0 0 0

April 0 0 0 0 0 0 0 0 0 0 0 0 0

May 0 0 0 0 0 0 0 0 0 0 0 0 0

June 0 0 0 0 0 0 0 0 0 0 0 0 0

July 0 0 0 0 0 0 0 0 0 0 0 0 0

August 0 0 0 0 0 0 0 0 0 0 0 0 0

September 0 0 0 0 0 0 0 0 0 0 0 0 0

October 0 0 0 0 0 0 0 0 0 0 0 0 0

November 0 0 0 0 0 0 0 0 0 0 0 0 0

December 0 0 0 0 0 0 0 0 0 0 0 0 0

Total 0 0 0 0 0 0 0 0 0 0 0 0 0

ORION

Page 32: FHIS Version 2014

N O A B C D E F G H I

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

Bilolo General Lim

Capunitan Balagtas

Camachile Sto. Domingo

Page 33: FHIS Version 2014

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

Monthly

January

February

March

April

May

Bantan Calungusan

Daan Pare Daan Bilolo

Page 34: FHIS Version 2014

June

July

August

September

October

November

December

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

Monthly

January

February

March

April

May

June

July

August

September

October

November

December

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Arellano Bagumbayan

San Vicente Sabatan

Page 35: FHIS Version 2014

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

MonthlyJanuary

Wawa

Balut Puting Buhangin

Wakas Lusungan

Daan Bago

Page 36: FHIS Version 2014

FebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

0 0 Total 0 0 0 0 0 0 0 0 0

N O A B C D E F G H I

Annual

Quarterly

MonthlyJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

0 0 Total 0 0 0 0 0 0 0 0 0

N O

Sta. Elena

Villa Angeles Lati

Page 37: FHIS Version 2014

0 0

N O

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

ORION

Page 38: FHIS Version 2014

J K L M N O

0 0

J K L M N O

0 0 0 0 0 0

J K L M N O

General Lim

Balagtas

Sto. Domingo

Page 39: FHIS Version 2014

0 0 0 0 0 0

J K L M N O

0 0 0 0 0 0

J K L M N O

Calungusan

Daan Bilolo

Page 40: FHIS Version 2014

0 0 0 0 0 0

J K L M N O

0 0

J K L M N O

Bagumbayan

Sabatan

Page 41: FHIS Version 2014

0 0 0 0 0 0

J K L M N O

0 0 0 0 0 0

J K L M N O

0 0 0 0 0 0

J K L M N O

Wawa

Puting Buhangin

Lusungan

Page 42: FHIS Version 2014

0 0 0 0 0 0

J K L M N O

0 0 0 0 0 0

Lati

Page 43: FHIS Version 2014
Page 44: FHIS Version 2014

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

MCV

ROTA

PCV

JanuaryIndicators

BCG

Hepa B1

PENTA

OPV

Bilolo General Lim

Page 45: FHIS Version 2014

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

IndicatorsBCG

February Bilolo General Lim

Page 46: FHIS Version 2014

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

IndicatorsBCG

March Bilolo General Lim

Page 47: FHIS Version 2014

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

IndicatorsBCG

April Bilolo General Lim

Page 48: FHIS Version 2014

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

IndicatorsBCG

May Bilolo General Lim

Page 49: FHIS Version 2014

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

IndicatorsBCG

June Bilolo General Lim

Page 50: FHIS Version 2014

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

IndicatorsBCG

July Bilolo General Lim

Page 51: FHIS Version 2014

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

IndicatorsBCG

August Bilolo General Lim

Page 52: FHIS Version 2014

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

Hepa B1

PENTA

OPV

MCV

ROTA

IndicatorsBCG

September Bilolo General Lim

PCV

Page 53: FHIS Version 2014

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

Hepa B1

PENTA

OPV

IndicatorsBCG

October Bilolo General Lim

ROTA

PCV

Page 54: FHIS Version 2014

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total Male

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

Hepa B1

PENTA

IndicatorsBCG

November Bilolo General Lim

OPV

MCV

ROTA

PCV

Page 55: FHIS Version 2014

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Pneumonia cases 0-59 mos old completed tx 0

Male Female Total MaleIndicators

December Bilolo General Lim

PENTA

OPV

MCV

ROTA

PCV

Page 56: FHIS Version 2014

0

w/ in 24 Hrs 0

> 24 Hrs 0

1 0

2 0

3 0

1 0

2 0

3 0

MCV 1 (AMV) 0

MCV 2 (MMR) 0

1 0

2 0

3 0

1 0

2 0

3 0

Fully Immunized Child (0-11 mos) FIC 0

Completely immunized Child (12-23 mos.) 0

Total Live Births 0

Child Protected at Birth (CPAB) 0

Infant age 6 months seen 0

Infant exclusively breastfeed until 6th month 0

Infant given complimentary food from 6-8 months 0

Infant for newborn screening: referred 0

done 0

Infant 6-11 months old received Vitamin A 0

Children 12-59 months old received Vitamin A 0

Infant 6-11 months old received Iron 0

Children 12-59 months old received Iron 0

Infant 6-11 months old received MNP 0

Children 12-59 months old received MNP 0

Sick Children 6-11 months old Seen 0

Sick Children 6-11 months old received Vitamin A 0

Sick Children 12-59 months seen 0

Children 12-59 months old given de-worming tabs 0

Infant 2-5 mos. w/ Low Birth Weight seen 0

Infant 2-5 mos. w/ LBW received full dose iron 0

Anemic Children 6-11 mos. old seen 0

Anemic Children 6-11 mos. received full dose iron 0

Anemic Children 12-59 mos. Old seen 0

Anemic Children 12-59 mos. received full dose iron 0

Diarrhea cases 0-59 mos. Old seen 0

Diarrhea cases 0-59 mos. Received ORS 0

Diarrhea 0-59 mos received ORS/ORT w/ zinc 0

Pneumonia cases 0-59 months old 0

Hepa B1

PENTA

OPV

MCV

ROTA

PCV

BCG

Page 57: FHIS Version 2014

Pneumonia cases 0-59 mos old completed tx 0

Page 58: FHIS Version 2014

Female Total Male Female Total Male Female Total Male

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

General Lim Capunitan Balagtas Camachile

Page 59: FHIS Version 2014

0 0 0

0 0 0

0 0 0

Female Total Male Female Total Male Female Total Male

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

General Lim Capunitan Balagtas Camachile

Page 60: FHIS Version 2014

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

Female Total Male Female Total Male Female Total Male

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

General Lim Capunitan Balagtas Camachile

Page 61: FHIS Version 2014

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

Female Total Male Female Total Male Female Total Male

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

General Lim Capunitan Balagtas Camachile

Page 62: FHIS Version 2014

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

Female Total Male Female Total Male Female Total Male

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

General Lim Capunitan Balagtas Camachile

Page 63: FHIS Version 2014

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

Female Total Male Female Total Male Female Total Male

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

General Lim Capunitan Balagtas Camachile

Page 64: FHIS Version 2014

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

Female Total Male Female Total Male Female Total Male

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

General Lim Capunitan Balagtas Camachile

Page 65: FHIS Version 2014

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

0 0 0

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Female Total Male Female Total

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0 0 0 27

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0 0 0 23

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0 0 0 19

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0 0 0 15

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0 0 0 11

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0 0 0 0

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Page 169: FHIS Version 2014

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Page 170: FHIS Version 2014

January

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Page 171: FHIS Version 2014

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Page 172: FHIS Version 2014

June

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Bilolo General Lim

Page 173: FHIS Version 2014

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Page 174: FHIS Version 2014

L 0 0 0 0 0

November

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Page 175: FHIS Version 2014

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Page 176: FHIS Version 2014

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Page 177: FHIS Version 2014

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Page 178: FHIS Version 2014

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Page 179: FHIS Version 2014

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Page 180: FHIS Version 2014

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Page 181: FHIS Version 2014

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Page 182: FHIS Version 2014

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Page 183: FHIS Version 2014

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Page 184: FHIS Version 2014

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Page 185: FHIS Version 2014

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Page 186: FHIS Version 2014

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Page 187: FHIS Version 2014

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Page 188: FHIS Version 2014

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Page 189: FHIS Version 2014

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Page 190: FHIS Version 2014

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Page 191: FHIS Version 2014

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Page 192: FHIS Version 2014

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Page 193: FHIS Version 2014

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Page 194: FHIS Version 2014

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Page 195: FHIS Version 2014

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Page 196: FHIS Version 2014

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Page 197: FHIS Version 2014

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Page 198: FHIS Version 2014

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Page 199: FHIS Version 2014

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Page 200: FHIS Version 2014

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Page 201: FHIS Version 2014

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Page 202: FHIS Version 2014

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Page 203: FHIS Version 2014

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Page 204: FHIS Version 2014

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Page 205: FHIS Version 2014

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Page 206: FHIS Version 2014

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Page 207: FHIS Version 2014

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Page 208: FHIS Version 2014

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Page 209: FHIS Version 2014

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Page 210: FHIS Version 2014

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New

Acceptor

(Present

Month)

Bagumbayan

Current User

(Begin

Month)

ACCEPTORS

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 211: FHIS Version 2014

0

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Month)

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Month)

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New

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Month)

OthersNew

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Month)

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 212: FHIS Version 2014

New

(Previous

Month)

OthersNew

(Previous

Month)

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Month)

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Month)

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(Present

Month)

Current User

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Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 213: FHIS Version 2014

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Current User

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ACCEPTORS

Drop OutCurrent User

(End of

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Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 214: FHIS Version 2014

0 0 0 0 0

New

(Previous

Month)

OthersNew

(Previous

Month)

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(Present

Month)

Current User

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Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Sabatan Arellano Bagumbayan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 215: FHIS Version 2014

OthersNew

(Previous

Month)

Others

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0 0

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Month)

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OthersNew

(Previous

Month)

Others

0 0

0 0

0 0

Bagumbayan

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Balut

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 216: FHIS Version 2014

0 0

0 0

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0 0

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Month)

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Month)

Others

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0 0

0 0

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0 0

0 0

0 0

0 0

0 0

0 0

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Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 217: FHIS Version 2014

OthersNew

(Previous

Month)

Others

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OthersNew

(Previous

Month)

Others

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0 0 0 0

Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 218: FHIS Version 2014

0 0 0 0

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Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 219: FHIS Version 2014

0 0 0 0

OthersNew

(Previous

Month)

Others

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Month)

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Bagumbayan Balut

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Bagumbayan Balut

Page 220: FHIS Version 2014

New

(Previous

Month)

OthersNew

(Previous

Month)

0

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Month)

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Month)

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New

(Previous

Month)

OthersNew

(Previous

Month)

0

0

0

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Current User

(End of

Month)

Balut

New

Acceptor

(Present

Month)

Puting Buhangin

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Daan Bago

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop Out

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

Page 221: FHIS Version 2014

0

0

0

0

0

0

0

0

0

New

(Previous

Month)

OthersNew

(Previous

Month)

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New

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Month)

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Current User

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Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop Out

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 222: FHIS Version 2014

New

(Previous

Month)

OthersNew

(Previous

Month)

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New

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Month)

OthersNew

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Month)

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New

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Month)

OthersNew

(Previous

Month)

0 0 0 0 0

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ACCEPTORS

Drop OutCurrent User

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Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Page 223: FHIS Version 2014

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Drop OutCurrent User

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Page 224: FHIS Version 2014

0 0 0 0 0

New

(Previous

Month)

OthersNew

(Previous

Month)

0

0

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Drop OutCurrent User

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Balut Puting Buhangin Daan Bago

Page 225: FHIS Version 2014

OthersNew

(Previous

Month)

Others

0 0

0 0

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OthersNew

(Previous

Month)

Others

0 0

0 0

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ACCEPTORS

Drop Out

Daan Bago

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Wawa

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Daan Bago Wawa

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Daan Bago Wawa

Current User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 226: FHIS Version 2014

0 0

0 0

0 0

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OthersNew

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Month)

Others

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0 0

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ACCEPTORS

Drop OutCurrent User

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Daan Bago Wawa

Drop OutCurrent User

(End of

Month)

Daan Bago Wawa

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 227: FHIS Version 2014

OthersNew

(Previous

Month)

Others

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OthersNew

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Others

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Drop OutCurrent User

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New

Acceptor

(Present

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Daan Bago Wawa

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Daan Bago Wawa

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Daan Bago Wawa

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 228: FHIS Version 2014

0 0 0 0

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ACCEPTORS

Drop OutCurrent User

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Month)

New

Acceptor

(Present

Month)

Daan Bago Wawa

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Daan Bago Wawa

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 229: FHIS Version 2014

0 0 0 0

OthersNew

(Previous

Month)

Others

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ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Daan Bago Wawa

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Daan Bago Wawa

Page 230: FHIS Version 2014

New

(Previous

Month)

OthersNew

(Previous

Month)

0

0

0

0

0

0

0

0

0

0

0

0

New

(Previous

Month)

OthersNew

(Previous

Month)

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0 0 0 0 0

New

(Previous

Month)

OthersNew

(Previous

Month)

0

0

0

Wawa

New

Acceptor

(Present

Month)

Wakas

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Lusungan

Current User

(Begin

Month)

ACCEPTORS

Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 231: FHIS Version 2014

0

0

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Month)

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Month)

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OthersNew

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Month)

0

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Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 232: FHIS Version 2014

New

(Previous

Month)

OthersNew

(Previous

Month)

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Month)

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(Previous

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Month)

0 0 0 0 0

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Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 233: FHIS Version 2014

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Wawa Wakas Lusungan

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(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

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(End of

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Wawa Wakas Lusungan

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 234: FHIS Version 2014

0 0 0 0 0

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Month)

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Wawa Wakas Lusungan

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(Present

Month)

Current User

(Begin

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ACCEPTORS

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Wawa Wakas Lusungan

Page 235: FHIS Version 2014

OthersNew

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Month)

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Drop OutCurrent User

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Villa Angeles

Current User

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Acceptor

(Present

Month)

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New

Acceptor

(Present

Month)

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ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Page 236: FHIS Version 2014

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New

Acceptor

(Present

Month)

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Month)

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Acceptor

(Present

Month)

Page 237: FHIS Version 2014

OthersNew

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Month)

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Month)

Villa Angeles

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Villa AngelesLusungan

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

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ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

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ACCEPTORS

Drop OutCurrent User

(End of

Month)

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Acceptor

(Present

Month)

Page 238: FHIS Version 2014

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ACCEPTORS

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Villa AngelesLusungan

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New

Acceptor

(Present

Month)

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Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Page 239: FHIS Version 2014

0 0 0 0

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Month)

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ACCEPTORS

Drop OutCurrent User

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Current User

(Begin

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ACCEPTORS

Drop OutCurrent User

(End of

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Villa AngelesLusungan

ACCEPTORS

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ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

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(End of

Month)

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Acceptor

(Present

Month)

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Page 240: FHIS Version 2014

New

(Previous

Month)

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(Previous

Month)

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New

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OthersNew

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Month)

0

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Drop OutCurrent User

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles

New

Acceptor

(Present

Month)

Villa Angeles Lati Sta. Elena

Lati Sta. Elena

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Page 241: FHIS Version 2014

0

0

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Month)

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Month)

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Drop OutCurrent User

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Acceptor

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Month)

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Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Page 242: FHIS Version 2014

New

(Previous

Month)

OthersNew

(Previous

Month)

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Page 243: FHIS Version 2014

0 0 0 0 0

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Month)

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ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Drop OutCurrent User

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Page 244: FHIS Version 2014

0 0 0 0 0

New

(Previous

Month)

OthersNew

(Previous

Month)

0

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New

Acceptor

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Month)

Current User

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Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORSNew

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Villa Angeles Lati Sta. Elena

Page 245: FHIS Version 2014

OthersNew

(Previous

Month)

Others

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Drop OutCurrent User

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Drop OutCurrent User

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Current User

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Sta. Elena ORION

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Sta. Elena ORION

Sta. Elena

Drop Out

ORION

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

ACCEPTORS

Drop OutCurrent User

(End of

Month)

Page 246: FHIS Version 2014

0 0 0 0 0 0

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Drop OutCurrent User

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Drop OutCurrent User

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ACCEPTORS

Drop OutCurrent User

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ACCEPTORS

Drop OutCurrent User

(End of

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New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Sta. Elena ORION

Page 247: FHIS Version 2014

OthersNew

(Previous

Month)

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Drop OutCurrent User

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ACCEPTORS

Drop OutCurrent User

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New

Acceptor

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ACCEPTORS

Drop OutCurrent User

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ACCEPTORS

Drop OutCurrent User

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Acceptor

(Present

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ACCEPTORS

Drop OutCurrent User

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ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Sta. Elena ORION

Page 248: FHIS Version 2014

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Drop OutCurrent User

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Drop OutCurrent User

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ACCEPTORS

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ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Sta. Elena ORION

Page 249: FHIS Version 2014

0 0 0 0 0 0

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ACCEPTORS

Drop OutCurrent User

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ACCEPTORS

Drop OutCurrent User

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New

Acceptor

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Month)

Current User

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ACCEPTORS

Drop OutCurrent User

(End of

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Sta. Elena ORION

ACCEPTORS

Drop OutCurrent User

(End of

Month)

New

Acceptor

(Present

Month)

Current User

(Begin

Month)

Sta. Elena ORION

Page 250: FHIS Version 2014

0

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New

Acceptor

(Present

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New

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ORION

ORION

ORION

New

Acceptor

(Present

Month)

Page 251: FHIS Version 2014

0

0

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ORION

ORION

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New

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ORION

New

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ORION

ORION

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New

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ORION

ORION