Health Management Information System (HMIS) Guideline 2075

(2nd Edition, Revised)

Register, Card and Reporting Formats

Common Tools

• 1.1 Master Register
• 1.2 Health Service Card
• 1.3 Outpatient Register
• 1.4 Referral/Transfer Slip
• 1.5 Defaulter/Discontinuation Tracking Slip
• 1.6 Tally Sheet

2. Infant and Child Health

• 2.1 Child Health Card
• 2.2 Immunization Register
• 2.3 Children’s Nutrition Register
• 2.4 CBIMNCI Register
• 2.5 IMAM Child Health Card
• 2.6 IMAM Register
• 2.7 IMAM Register- Hospital

3. Family Health

• 3.1 Face Sheet
• 3.2 Pills, Depo Register
• 3.3 IUCD/Implant Service Register
• 3.4 Sterilization Service Register
• 3.5 Maternal and Newborn Health Card
• 3.6 Maternal and Newborn Health Service Register
• 3.7 Safe Abortion Service Register

4. Community Services

• 4.1 ORC Register
• 4.2 FCHV Register
• 4.3 Vitamin A register

5. Malaria, leprosy and Kala-azar

• 5.1 Malaria, leprosy and Kala-azar Specimen Collection Form
• 5.2 Malaria, leprosy and Kala-azar  laboratory Register
• 5.3 Malaria and Kala-azar Treatment Register
• 5.4 Leprosy Examination Treatment card
• 5.5 Leprosy Treatment Register

6. Tuberculosis

• 6.1 Tuberculosis Sample Collection Form
• 6.2 Tuberculosis Laboratory Register
• 6.3 Tuberculosis Treatment Card (Health Facility)
• 6.4 Tuberculosis Treatment Card (Patient)
• 6.5 Tuberculosis Treatment Register
• 6.6 PAL: Smoking cessation Register
• 6.7 DR Tuberculosis Laboratory Register
• 6.8 DR Tuberculosis Treatment Register

7. HIV/AIDS and STI

• 7.1 HIV Testing and Counseling Register
• 7.2 Sexual Transmitted Infection Treatment Register
• 7.3 PMTCT Service Register
• 7.4 HIV Treatment and Care Register
• 7.5 HIV Patient Treatment Card
• 7.6 Opioid Substitution Therapy (OST) Register

8. Hospital

• 8.1 admission Register
• 8.2 Discharge Register
• 8.3 Emergency Service Register

9. Monthly Reporting Forms

• 9.1 FCHV Report Collection
• 9.2 Community Level Health Service Monthly Reporting Form- Immunization & PHCORC
• 9.3 PHCC, HP, SHP, Urban Health Clinic/ Center and Community Health Unit Monthly Reporting Form
• 9.4 Public Hospital Reporting Form
• 9.5 Non-public Health Facility Reporting Form

DOWNLOAD HMIS GUIDELINE PDF FILE

DOWNLOAD HMIS GUIDELINE PDF FILE

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