📠Monthly vaccination reporting form

EPI PAKISTAN - VACCINATION REPORTING SYSTEM

MONTHLY VACCINATION REPORTING FORM (UNION COUNCIL / HEALTH FACILITY)

Data Entry

Reports

Analytics

Admin

Guest User

Basic Information

Month Select Month January February March April May June July August September October November December

Year

District

Taluka

Union Council

Health Facility

H/F Code

Session Information

FIXED VACCINATION SESSION						OUT REACH SESSION						HEALTH HOUSE SESSION						MOBILE SESSION
PLANNED			HELD			PLANNED			HELD			PLANNED			HELD			PLANNED			HELD

Target Information

POPULATION			Y.TARGET (0-11.M)			M.TARGET (0-11.M)		Y.TARGET (12-23.M)			M.TARGET (12-23.M)		Y.TARGET (P.L)		M.TARGET (P.L)		Y.TARGET (CBAs)		NO:OF LHWs		LHWs INVOLVED

Vaccination Data

ANTIGEN	OPENING BALANCE (DOSES)	RECEIVED (DOSES)	DOSE	NO. OF CHILDREN VACCINATED (0-11 MONTHS)												NO. OF CHILDREN VACCINATED (12-23 MONTHS)												G.TOTAL	CLOSING BALANCE	UN-USABLE DOSES
				FIXED				OUT REACH		MOBILE		LHWs		TOTAL DEFAULTERS	DEFAULTERS COVERED	FIXED				OUT REACH		MOBILE		LHWs		TOTAL DEFAULTERS	DEFAULTERS COVERED
				IN SIDE UC		OUT SIDE UC						HEALTH HOUSE				IN SIDE UC		OUT SIDE UC						HEALTH HOUSE
				M	F	M	F	M	F	M	F	M	F			M	F	M	F	M	F	M	F	M	F
BCG			-
BCG			-
BCG			-
BCG			-

EPI Pakistan - Vaccination Reporting System v1.0

© 2023 Ministry of Health, Government of Pakistan. All rights reserved.

DESIGNED & CREATED BY: RAZA MUHAMMAD DANDAN, EX-DISTRICT SUPERINTENDENT OF VACCINATION (EPI) SUKKUR