🚙 Check list No: 03, for EPI-Centre coverage % report

CHECK LISIT NO:03,FOR EPI-CENTRE COVERAGE % REPORT

NAME OF VISITOR	DESIGNATION	DATE OF VISIT	TIME OF VISIT
NAME OF EPI CENTRE	UNION COUNCIL	TALUKA	DISTRICT
NAME OF VACCINATOR(1)	NAME OF VACCINATOR(2)	NAME OF VACCINATOR(3)	NAME OF VACCINATOR(4)

S.NO:	ANTIGEN	TARGET (LAST YEAR)	NO:OF CHILDREN VACCINATED (LAST YEAR)	COVERAGE (%) (LAST YEAR)	TARGET UP TO THE MONTH (THIS YEAR)	CHILDREN VACCINATED UP TO THE MONTH (THIS YEAR)	COVERAGE (%) UP TO THE MONTH (THIS YEAR)	REMAINING TARGET OF THIS MONTH	REMARKS
01	BCG
02	HEP-B (BD)
03	bOPV-0
04	bOPV-I
05	ROTA-I
06	PENTA-I
07	PCV13-I
08	bOPV-II
09	ROTA-II
10	PENTA-II
11	PCV13-II
12	bOPV-III
13	PENTA-III
14	PCV13-III
15	IPV-I
16	MR-I
17	IPV-II
18	TCV
19	MR-II
20	PL, TD-I
20	PL, TD-II
ABSORVATIONS OF VISITERS
Note

DESIGNED BY:-RAZA MUHAMMAD,DANDAN,EX-DSV (EPI)

SIGNATURE OF VISITOR