S. No |
Name of data Field |
Field Type |
Value/ Options |
Validation/ Logic/ Condition |
1 |
Date of Registration |
Calendar
Date Picker |
- Is Mandatory
- Choose the date from the calendar
- Format: dd-mm-yyyy
- Default value Today's Date
|
- Not greater than Today's Date
- Accept date greater or equal to Date of beneficiary registration
- Don't allow date not less than 280 days from Today's Date
- Do not allow to update in edit or once submitted
|
2 |
RCH ID No. of Woman |
Text Box |
Default as 0 |
- 12-digit unique number
- Accept numeric (integer) value only
- Character limit up to 12
|
3 |
MCP Card No |
Text Box |
Default as 0 |
- 12-digit unique number
- Accept numeric (integer) value only
- Character limit up to 12
|
4 |
Name of Pregnant Women |
|
|
Auto-populate |
5 |
Name of Husband |
|
|
Auto-populate |
6 |
Current Age of Woman |
|
|
Auto-populate
|
7 |
LMP Date |
Calendar |
Is Mandatory |
- Accept date not less than 10 months 280 days from Today's Date
- Not greater than Today's Date
- And this LMP Date is editable
- For Edit LMP: any one of the conditions is applicable
- Allow to edit till 26 Weeks of Pregnancy
- Or till ANC-2 is not submitted
- Whichever is first
|
8 |
Weeks of Pregnancy at the time of PW Registration |
Text Box |
|
- Auto Calculated based on the LMP date and date of PW registration and convert to weeks
- Read only
|
9 |
EDD |
Text Box |
|
- Auto Calculated based on the LMP date
- Formula: LMP Date + 280 days
|
10 |
Blood Group |
Spinner |
Choose:
- A +ve
- B +ve
- AB +ve
- O +ve
- A -ve
- B -ve
- AB -ve
- O -ve
|
|
11 |
Weight of PW (Kg) |
Number Picker |
|
- Accept numeric (integer) value only
- Accept values from 30 to 200
- Weight of PW (Kg) at time of PW Registration
|
12 |
Hight of PW (Cm) |
Number Picker |
|
- Accept numeric (integer) value only
- Accept values from 50 to 200
- Hight of PW (cm) at time of PW Registration
|
13 |
VDRL/RPR Test result |
Spinner |
Choose:
- Reactive
- Non-Reactive
- Test Not Done
|
|
14 |
Date of VDRL/RPR Test done |
Calendar |
- Choose the date from the calendar
- Date Format: dd-mm-yyyy
|
- Accept date equal to or greater than Date of PW Registration.
- Accept Date of PW registration minus one year
- Not greater than Today's Date
- Disable if "Test Not Done"
|
15 |
HIV Test result |
Spinner |
Choose:
- Reactive
- Non-Reactive
- Test Not Done
|
|
16 |
Date of HIV Test done |
Calendar |
- Choose the date from the calendar
- Date Format: dd-mm-yyyy
|
- Accept date equal to or greater than Date of PW Registration.
- Not greater than Today's Date
- Disable if "Test Not Done"
- Accept Date of PW registration minus one year
|
17 |
HBsAg Test result |
Spinner |
Choose:
- Positive
- Negative
- Test Not Done
|
|
18 |
Date of HBsAg Test done |
Calendar |
- Choose the date from the calendar
- Date Format: dd-mm-yyyy
|
- Accept date equal to or greater than Date of PW Registration.
- Not greater than Today's Date
- Disable if "Test Not Done"
- Accept Date of PW registration minus one year
|
19 |
Past Illness |
Multi select checkbox list |
Is Mandatory
Choose:
None TB Diabetes Hypertension Heart Disease Epileptic STI/RTI Hepatites-B Asthama Any Other |
- Default value is "None"
- If any other is selected "None" should unselect.
|
20 |
Any other |
Textbox |
- Accept alphabets only
- Character limit 50
|
- Enable if other is selected above
- Is Mandatory if other is selected above
|
21 |
Is this your 1st pregnancy? |
Spinner |
Mandatory Choose: Yes No |
- If "Yes" is selected, then disable below all fields from S. No. 22
- If "No" is selected, then enable below all fields from S. No. 22
|
22 |
Total no. of previous Pregnancy |
Number Picker |
|
- Accept numeric
- Accepts values from 0 to 15
|
23 |
Any complications in Last Pregnancy |
Spinner |
Choose:
- None
- Convulsions
- APH
- Pregnancy Induced Hypertension (PIH)
- Repeated Abortion
- Stillbirth
- Congenital Anomaly
- Caesarean Section
- Blood Transfusion
- Twins
- Obstructed Labour
- PPH
- Any Other
|
- Enable if "No" is selected in "Is this your 1st pregnancy?"
- Default value is "None"
- If "Any other" is selected enable below field 'Any other Complication' and is mandatory
|
24 |
Any other Complication |
Text Box |
- Accept alphabets only
- Character limit 50
|
|
25 |
Is Identified as HRP cases? |
Radio button |
Choose:
|
If "Yes" is selected, enable below field "Who had identified HRP?" and is Mandatory
- If "Yes" then
- Add the Woman name in the "HRP List"
- Display the name in the PMSMA list
- Highlight the Pregnant Women in Red colour in the Pregnant Women List
- Then flag as HRP Case and show in scheduler till Delivery
|
26 |
Who had identified as HRP? |
Spinner |
Is conditionally Mandatory
Choose:
- ANM
- CHO
- PHC – MO
- Specialist at Higher Facility
|
- Enable only if "Yes" is selected above,
- If "Yes" is selected above, then it is Mandatory
|