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TB Screening
* If "Yes" is selected for any one of the questions below with "*" then show a pop-up message "Refer to the nearest health facility and collect the Sputum sample". Show these beneficiaries to 'Suspected TB cases' section Show these beneficiaries to 'Referral list module in the Home' section
If "Yes" is selected for any one of the questions below with "" then show a pop-up message "Refer to the nearest health facility and collect the Sputum sample". Show these beneficiaries to 'Referral list module in the Home' section
Date	Calendar Date Picker	Is Mandatory	Default value Today's Date Not greater than Today's Date Accept date greater or equal to Date of beneficiary registration should not allow to update in edit or once submitted
Name	Textbox		Auto fill from Beneficiary details Show: First Name + Last Name Read only
Age	Textbox		Auto fill from Beneficiary details Read only
Sex	Textbox		Auto fill from Beneficiary details Read only
Coughing More than 2 weeks *	Spinner	Yes No	Mandatory
Blood in Sputum *	Spinner	Yes No	Mandatory
Fever > 2 weeks *	Spinner	Yes No	Mandatory
Rise of fever in evening*	Spinner	Yes No	Mandatory
Loss of Appetite *	Spinner	Yes No	Mandatory
Loss of Weight *	Spinner	Yes No	Mandatory
Night Sweats *	Spinner	Yes No	Mandatory
History of TB *	Spinner	Yes No	Mandatory
Are you currently taking Anti TB drugs **	Spinner	Is Mandatory Choose: Yes No	Inform to ANM / MPW/ MO for tracing of Family members members
Anyone in Family Currently Suffering from TB **	Spinner	Is Mandatory Choose: Yes No	Inform to ANM / MPW/ MO for tracing of Family members members
Submit	Button

2.2.2.b Suspected TB cases Maintain a separate list of Suspected TB cases based on above assessment check.
This section should contain only Suspected TB cases.

Name of data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
Date	Calendar Date Picker

Is

Mandatory

Default value Today's Date

Not greater than Today's Date

Accept date greater or equal to Date of beneficiary registration

should not allow to update in edit or once submitted

Name

Textbox

Auto fill from Beneficiary details
Show: First Name + Last Name
Read only

Age

Textbox

Auto fill from Beneficiary details
Read only

Sex Is Mandatory
Choose:

Gender	Textbox		Auto fill from Beneficiary details Read only
Is Sputum sample collected?	Spinner

Yes
No

Mandatory
Sputum sample submitted at	Spinner

Choose:

MC

DMC

DH

SC

PHC

PHC

HWC	Enable if "Yes" is selected for 'Is Sputum sample collected?

'

HWC= Health and Wellness Centre, PHC= Primary Health centre, DH= District hospital, MC= Medical College


Nikshay ID	Textbox		Enable if "Yes" is selected for 'Is Sputum sample collected?'
Sputum Test result	Spinner	Choose: Positive Negative	Enable if "Yes" is selected for 'Is Sputum sample collected?' If Test is positive refer to MO Show alert Message: "Refer to MO"
Referred to facility	Spinner	Is Mandatory Choose: Yes No
Facility Referral follow-ups	Textbox
Submit	Button

2.2.3 Module- Non Communicable Disease (NCD) Screening

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Old Version 34

New Version 35

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2.2.3 Module- Non Communicable Disease (NCD) Screening