Revised HMIS Tool, Form and Formats 1 to 8 - Medical and Health Hub

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Revised HMIS Tool, Form and Formats 1 to 8

Post By: Medical and Health Hub
Post Date: November 23, 2024

Post Updated Date: 1 year ago

Revised HMIS Tool, Form and Formats 1 to 8

1. Common Tools

S.N.	Tool, Form and Formats	Action
1.	HMIS 1.1- Master Register	View/ Download
2.	HMIS 1.2- Health Service Card	View/ Download
3.	HMIS 1.3- OPD (Outpatient) Register	View/ Download
4.	HMIS 1.4- Referal or Transfer Slip	View/ Download
5.	HMIS 1.5- Loss to Follow Up	View/ Download
6.	HMIS 1.6- Open Tally Sheet	View/ Download
7.	HMIS 1.7- Basic Health Facility Monthly Monitoring Sheet	View/ Download
8.	HMIS 1.8- Hospital Monthly Monitoring Sheet	View/ Download

2. Infant and Child Health

S.N.	Tool, Form and Formats	Action
1.	HMIS 2.1- Child Health Card	View/ Download
2.	HMIS 2.2- Immunization Register	View/ Download
3.	HMIS 2.3- Nutrition Register	View/ Download
4.	HMIS 2.4- Integrated Management of Neonatal & Childhood Illness (IMNCI) Register	View/ Download
5.	HMIS 2.5- IMAM Child Health Card	View/ Download
6.	HMIS 2.6- Integrated Management of Acute Malnutrition (IMAM) Register	View/ Download
7.	HMIS 2.7- Integrated Management of Acute Malnutrition (IMAM) Register (Hospital)	View/ Download
8.	HMIS 2.8- NRH Register	View/ Download

3. Family Health

S.N.	Tool, Form and Formats	Action
1.	HMIS 3.1- Face Sheet	View/ Download
2.	HMIS 3.2- FP Temporary Methods Pills Injectable Service Register	View/ Download
3.	HMIS 3.3- FP Temporary Method IUCD and Implant Service Register	View/ Download
4.	HMIS 3.4- Sterilization Service Register	View/ Download
5.	HMIS 3.5- Maternal and Newborn Health Card	View/ Download
6.	HMIS 3.6- Maternal and Newborn Health Service Register	View/ Download
7.	HMIS 3.7- Safe Abortion Service Register	View/ Download
8.	HMIS 3.7A- Client Personal Profile: Medical Abortion Service	View/ Download
9.	HMIS 3.7B- Client Personal Profile: Manual Vaccum Aspiration Service	View/ Download
10.	HMIS 3.7C- Client Personal Profile: Second Trimester Abortion Service	View/ Download
11.	HMIS 3.7D- Client Personal Profile: Post Abortion Care (PAC) Service	View/ Download
12.	HMIS 3.8- Reproductive Health Morbidity Service Register	View/ Download

4. Community Service

S.N.	Tool, Form and Formats	Action
1.	HMIS 4.1- Outreach Clinic Register	View/ Download
2.	HMIS 4.2- FCHV Service Register	View/ Download
3.	HMIS 4.3- National Vitamin A Programme Register	View/ Download
4.	HMIS 4.4- Health Promotion and Health Education Register	View/ Download

5. Malaria, Leprosy and Kala-azar

S.N.	Tool, Form and Formats	Action
1.	HMIS 5.1- Malaria, Leprosy & Kala-azar Specimen Collection Form	View/ Download
2.	HMIS 5.2- Malaria, Leprosy & Kalazar Laboratory Register	View/ Download
3.	HMIS 5.3- Malaria & Kala-azar Treatment Register	View/ Download
4.	HMIS 5.4- Leprosy Examination & Treatment Card	View/ Download
5.	HMIS 5.5- Leprosy Treatment Register	View/ Download
6.	HMIS 5.6- Rehabilitation Service Register	View/ Download
7.	HMIS 5.7- Rehabilitation Service Card	View/ Download
8.	HMIS 5.8- Leprosy Contact Service Register	View/ Download
9.	HMIS 5.9- Non-Communicable Diseases (NCDs) and Mental Health Register	View/ Download
10.	HMIS 5.10- Senior Citizens Health Service Register	View/ Download

6. Tuberculosis

S.N.	Tool, Form and Formats	Action
1.	HMIS 6.1- Presumptive Tuberculosis (PTB) Register	View/ Download
2.	HMIS 6.2- Laboratory Request and Reporting Form	View/ Download
3.	HMIS 6.3A- Tuberculosis Laboratory Register (Microscopy)	View/ Download
4.	HMIS 6.3B- Tuberculosis Laboratory Register (Xpert MTB/RIF & MTB/XDR)	View/ Download
5.	HMIS 6.3C- Tuberculosis Laboratory Register (LPA)	View/ Download
6.	HMIS 6.3D- Tuberculosis Laboratory Register (DST/Culture)	View/ Download
7.	HMIS 6.4A- Tuberculosis Treatment Management Card (DSTB)	View/ Download
8.	HMIS 6.4B- Tuberculosis Treatment Card (Patient)	View/ Download
9.	HMIS 6.4C- DR Tuberculosis Treatment Management Card	View/ Download
10.	HMIS 6.4D- DR Tuberculosis Treatment Card (Patient)	View/ Download
11.	HMIS 6.5A- TB Treatment Master Register	View/ Download
12.	HMIS 6.5B- DR Tuberculosis Treatment Register	View/ Download
13.	HMIS 6.6- TB Screening and Contact Investigation Form	View/ Download
14.	HMIS 6.7- Contact Investigation and Tuberculosis Preventive Therapy Register	View/ Download
15.	HMIS 6.8- Tuberculosis Preventive Therapy Card	View/ Download
16.	HMIS 6.9- TB Referral Form (Community, Private)	View/ Download
17.	HMIS 6.10- aDSM Adverse Event Recording/Reporting Form	View/ Download

7. HIV/AIDS and STI

S.N.	Tool, Form and Formats	Action
1.	HMIS 7.1- HIV Testing and Counseling Service Register	View/ Download
2.	HMIS 7.2- Sexually Transmitted Infection Treatment Register	View/ Download
3.	HMIS 7.3- PMTCT Service Register	View/ Download
4.	HMIS 7.4- HIV Treatment Care Register	View/ Download
5.	HMIS 7.5- HIV Treatment Care Record	View/ Download
6.	HMIS 7.6- Opoid Substitution Therapy (OST) Register	View/ Download

8. Hospital

S.N.	Tool, Form and Formats	Action
1.	HMIS 8.1- Patient Admission Register	View/ Download
2.	HMIS 8.2- Patient Discharge Register	View/ Download
3.	HMIS 8.3- Emergency Service Register	View/ Download
4.	HMIS 8.4- SNCU/ NICU/ KMCU Register	View/ Download

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