🚙 Check list No: 01, for EPI-Centre general visit report

CHECK LISIT NO:01,FOR EPI-CENTRE GENERAL VISIT REPORT

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

S.NO:	DETAIL	AVAILABLE (YES/NO)	COMPLETE OR INCOMPLETE	IF INCOMPLETE WRITE DATE	REMARKS
01	EPI Centre was Opened (Writer Yes/No in Remarks Column)
02	EPI Centre was (Writer Clean/Dirty in Remarks Column)
03	Who is working at EPI Static Centre (write designation in Remarks Column)
04	No: of Vaccinators Posted at this Centre (Write No: in Remarks Column)
05	No: of Motor Cycles alloted to Vaccinators (Write No: in Remarks Column)
06	No: of Motor Cycles in Working Condition (Write No: in Remarks Column)
07	No: of Motor Cycles Log Books (Write No: in Remarks Column)
08	No: of Present Vaccinators (Write No: in Remarks Column)
09	No: of Absent Vaccinators (write names & date from in Remarks Column)
10	No: of Vaccinators on C/Leave (write names & date from in Remarks Column)
11	No: of Vaccinators on E/Leave (write names & date from in Remarks Column)
12	Daily Vaccination Register
13	Permanant Vaccination Register of Children
14	Permanant Vaccination Register of Women
15	Vaccine Consumption Register
16	Syringes Consumption Register
17	Stock Register
18	Visitors Note Book
19	Daily Tally Sheet Register/File
20	Defaulters Register/File available
21	Other Centres Reffer Lists available
22	Movement Register
23	Antigen wise Graph & Charts
24	Village/Muhalla wise Catchment area Population & Target List
25	Catchment Area Map
26	No:of Saftey Boxes Available
27	No:of Saftey Boxes Available according to Record
28	Last Visit of TSV (Write Date of Visit in Remarks Column)
29	Last Visit of DSV (Write Date of Visit in Remarks Column)
30	Last Visit of EPI-DFP (Write Date of Visit in Remarks Column)
31	No:of LHWs Posted at this H/F (Write No: in Remarks Column)
32	No:of LHWs working in RI (Write No: in Remarks Column)
33	Total Population of EPI Catchment Area (Write Population in Remarks Column)
34	Population of EPI Catchment Area alloted to each Vaccinator (Write Yes / No in Remarks Column)
ABSORVATIONS OF VISITERS

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

SIGNATURE OF VISITOR