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Kobotool

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Polio Refusal Investigation (Sample) Investigator name Town -- select -- Islam Nangar Etehad town Sample Town Did child receive OPV in last campaign? Yes No Don't know Reason for refusal (if 'no') Child details (repeat group) + Add child GPS location Get GPS No location Upload photo (optional) Save Draft Load Draft Export CSV Submit
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🚙 Check list No: 05, for EPI house to house field visit summary

CHECK LIST NO: 05, FOR EPI HOUSE TO HOUSE FIELD VISIT SUMMARY NAME OF VISITOR DESIGNATION DATE OF VISIT TIME OF VISIT NAME OF VILLAGE/MUHALLA/STREET NAME OF UNION COUNCIL NAME OF (EPI) CENTRE NAME OF VACCINATOR (THIS AREA) NO:OF HOUSES VISITED NO:OF CHILDREN CHECKED NO:OF CHILDREN BCG SCAR WAS VISIBLE % OF BCG SCARS NO:OF FULLY IMMUNIZED CHILDREN % OF FULLY IMMUNIZED CHILDREN NO:OF PARTIALY VACCINATED % OF (PI) CHILDREN NO:OF DEFAULTERS FOUND % OF DEFAULTERS CHILDREN NO:OF UNVACCINATED CHILDREN FOUND % OF UNVACCINATED CHILDREN NO:OF V.CARDS AVAILABLE % OF V.CARDS AVAILABLE NO:OF V.CARDS NOT AVAILABLE % OF NOT AVAILABLE V.CARDS OBSERVATIONS: DESIGNED BY:-RAZA MUHAMMAD,DANDAN,EX-DSV (EPI) SIGNATURE OF VISITOR 🧮 Calculate % 📊 Export...
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Location: Pakistan
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