Condition: In ANC visit, if 'Is pregnant woman delivered' is "Yes", open these details.

S No

Name of Data Field

Field Type

Value/ Options

Validation/ Logic/ Condition

Date of Delivery

Date Picker
  • Choose the date from the calendar
  • Format: dd-mm-yyyy
  • Accept date 21 weeks from LMP Date
  • Accept date greater or equal to Date of Last ANC Date.
  • Accept date equal to or up to 25 days from EDD.
  • Not greater than Today's Date

Time of Delivery

Time Picker
  • Accept numeric (integer) values only.
  • Format: hh-mm
  • Default value is null

 

Place of Delivery

Spinner
  • Choose from

    District Hospital – 5
    Community Health Centre – 2
    Primary Health Centre – 1
    Sub Centre – 24
    Other Public Facility – 19
    Accredited Private Hospital – 20
    Other Private Hospital – 21
    Home – 22
    Sub District Hospital – 4
    Medical College Hospital 17
    In Transit – 23

 

Type of Delivery

Drop Down List

Choose:

  • Normal
  • Caesarean
  • Assisted

 

Complications during Delivery?

Radio Button
  • Options as
    Yes / No

 

Delivery Complication

Spinner
  • PPH
  • RETAINED PLACENTA
  • OBSTRUCTED DELIVERY
  • PROLAPSED CORD
  • TWINS PREGNANCY
  • CONVULSIONS
  • DEATH
  • ANY OTHER (SPECIFY)
  • DON'T KNOW
  • Default value is select.
  • If Death is chosen, then open "Other Delivery Complication" Text Box on selection of Any Other (Specify) option and is mandatory
  • Open "Probable Death Cause" Text Box on selection of Death option and is mandatory.
  • If "Death" is selected, then move this record 'MDSR' section

7

Probable Cause of Death

Spinner

Choose:

  • Eclampcia
  • Haemorrahge
  • Obstructed Labour
  • Prolonged Labour
  • Other
  • High Fever
  • If "Other" is selected, then Open "Other Death Cause" Text Box and is mandatory.

8

Other Death Cause

Text Box
  • Accept only alphabets and special character.
  • Character limit 50

 

9

Other Delivery Complication

Text Box
  • Accept only alphabets and special character.
  • Character limit 50

 

10

Outcomes of Delivery

Custom Number Picker
  • Accept numeric (integer) value only.
  • Values from 0 – 6.
  • Delivery Outcome is equal to sum of Live Births and Still Births.

11

Live Birth

Custom Number Picker
  • Accept numeric (integer) value only
  • Value from 0-6
  • Accept value less than or equal to "Outcomes of Delivery"

12

Still Birth

Custom Number Picker
  • Accept numeric (integer) value only
  • Value from 0-6
  • Accept value less than or equal to "Outcomes of Delivery"

13

Date of Discharge

Date Picker
  • Choose the date from the calendar
  • Format: dd-mm-yyyy
  • Not greater than Today's Date.
  • Not less than Date of Delivery.

14

Discharge Time

Time Picker
  • Accept numeric (integer) values only.
  • Format: hh-mm
  • Default value - null

 

15

Is the Pregnant Woman a JSY Beneficiary?

Radio Button

Choose:
Yes / No

 



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