Document | Information about mother | Information about baby | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Name | Paper/ Electronic) | LOCATION | Name | Date of birth | Age | Address$ | Last menstrual period | Malaria diagnosis (date) | Pregnancy | Delivery | Pregnancy outcome | Birth weight/ length | ||||
 |  |  | First | Middle or initial | Last |  |  |  |  |  |  | Date | Health facility | Type |  |  |
Target client list prenatal visits (TCLP)* | Line list/ Paper | Barangay health station | Not broken into parts | No | Yes | Yes | Yes | No | – | Yes | Yes | No | Yes | Yes | ||
Target client list nutrition and EPI (TCLNE)* | Line list/ Paper | Barangay health station | Not broken into parts | No | No | No | – | – | – | Yes | No | No | Yes | Yes | ||
Malaria surveillance data (PHILMIS) | Line list/ Electronic | Provincial Health Office | Yes | Yes | Yes | Yes | Yes | Yes | – | Yes | Yes | – | – | – | – | – |
Hospital admission logbook@ | Line list/ Electronic | Ospital ng Palawan | Yes | Yes | Yes | Yes | Yes | Yes | – | – | Yes | No | – | Yes | Yes | – |
OB-GYN history form and clinical cover sheet# | Medical chart/ paper | Ospital ng Palawan | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No | – | Yes | – | Yes | Yes | No |