Page History

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Name of data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
Date	Calendar Date Picker	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
Gender	Textbox		Auto fill from Beneficiary details Read only
Symptomatic TB			To be enabled if "Yes" is selected in any "Symptomatic Screening fields"
Is Sputum sample collected?	Spinner	Yes No	Mandatory
Sputum sample submitted at	Spinner	MC DH CHC PHC HWC	Enable if "Yes" is selected for 'Is Sputum sample collected? HWC= Health and Wellness Centre, PHC= Primary Health Centre, CHC= Community Health Centre, DH= District hospital, MC= Medical College
Sputum Test result	Spinner	Positive Negative	Enable if "Yes" is selected for 'Is Sputum sample collected?' If positive, move this case to Confirmed TB cases module.
Asymptomatic TB			To be enabled if "Yes" is selected in any "Asymptomatic Screening fields"
TB Chest X-Ray Test done		Yes No	Enable only for Asymptomatic TB case If “Yes” is selected enable ‘Nikshay Id’
Chest X-Ray Test Result		Clinically Diagnosed TB TB Not suspected	Enable only “Yes” is selected for X-Ray test Enable only for Asymptomatic TB case If "Clinically diagnosed TB" is selected, move this case to Confirmed TB cases module.
Nikshay ID	Textbox		Enable if "Yes" is selected for 'Is Sputum sample collected. Enable if "Yes" is selected for "TB Chest X-ray test done"
Type of suspected TB case	Radio button	New case of TB Previously treated TB case DR-TB case	Mandatory
Reason for suspected TB case	Dropdown	Treatment failure TB Relapse/ Recurring symptoms Contact with DR-TB case Treatment after LFU (Lost to Follow-up) Other	Enable this field only if “Type of TB case” is “Previously treated TB case” or “DR-TB case”
Other	textbox		Mandatory if enabled To be enabled if “Reason for suspected TB case” = “Other”
Has the diagnosis of DR-TB been confirmed?	Radio button	Yes No	Enable this field only if “type of suspected TB case”= “Previously treated TB case” or “DR-TB case” Default value is “No” If “Yes” is selected then move this case to Confirmed TB cases module.
Submit	Button

2.2.2.c Confirmed TB cases

Treatment and follow up of TB confirmed cases.

Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
Regimen Type	Radio button	DS-TB (6 Months) Shorter Regimen (9–12 Months) Longer Regimen (18–24 Months) BPaL Regimen (6 Months) INH Mono (6 Month)	Open module 2.2.2.d (TPT- TB Prevention treatment) module if “DS-TB (6 Months)” is selected Alert to Volunteer to screen all household members/ Contacts if DS-TB case is selected.
Treatment Start Date	Date picker	Mandatory	Should be greater than or equals to TB (Identification and Diagnosis) Visit Date Not greater than Today's Date
Expected Treatment Completion Date	Label	Read only	Auto calculate this date based on below condition form ‘Treatment Start Date’: 1. If ‘Regimen Type’ is “1”, “4”, “5” then add 6 months 2. If ‘Regimen Type’ is “2”, then, Treatment duration is 9–12 months (show 9–12 range dates) 3. If ‘Regimen Type’ is “3”, then, Treatment duration is 18–24 months (show 18–24 range dates)
Follow-up & Adherence
Follow up Date	Date picker	Mandatory	Greater than or equal to Treatment Start Date or greater than Last Follow up Date Minimum date is Treatment Start Date Accept date greater than Last Follow up Date Allow 1 Follow up visit in a month (i.e. monthly 1 Follow up) Not greater than Today's Date
Monthly follow up done	Label	Month-1 to Month-24	Should be incremental based on monthly Follow up
Adherence to Medicines	Radio button	Regular Irregular
Any discomfort	Radio button	Yes No
Treatment Completion
Did the patient complete the full course of treatment?	Radio button	Yes No	Enable these below filed based on below conditions: 1. If ‘Regimen Type’ is “1”, “4”, “5” then enable after 5 Monthly follow up visits 2. If ‘Regimen Type’ is “2”, then enable after 9 Monthly follow up visits 3. If ‘Regimen Type’ is “3”, then enable after 18 Monthly follow up visits
Actual Treatment Completion Date	Date picker		Enable this filed if “Yes” is selected above Greater than Last Follow up Date
TB Treatment outcomes	Dropdown	Cured Failed Lost to Follow-up (LFU) Death	If "Death" is selected, update 'Beneficiary Status' = "Death" in the Beneficiary record, with “Date of Death”, "Place of Death" and "Reason for Death” in the next fields.
Date of Death	Date picker		Enable only if "TB Treatment outcomes" = “Death” and it is Mandatory By default, date is null Not greater than Today’s Date Greater than or equal to Treatment Start Date or greater than Last Follow up Date
Place of Death	Dropdown	Home Subcenter PHC CHC District Hospital Medical College Hospital Private Hospital Other Place	Enable only if "TB Treatment outcomes" = “Death”
Reason for Death	Label Read only	Tuberculosis	Enable only if "TB Treatment outcomes" = “Death”
Reason for non completion of treatment	Textbox		Enable this field if “No” selected for “Did the patient complete full treatment?”
Submit	button
Follow up visit history	Table		Maintain a Follow up visit history of Visit

2.2.2.d Tuberculosis Preventive Treatment

Tuberculosis Preventive Treatment (TPT) sub module

TPT is the preventive treatment given to close contacts of confirmed Drug-Sensitive TB (DS-TB) cases who are at high risk of developing active TB.

If a contact tests positive for active TB at any step (X-Ray or Sputum positive), the system must immediately redirect the volunteer to create a new TB Suspected Case record for that contact — bypassing the TPT flow.

This module should open when in Confirmed TB case module, “Regimen type” = “DS-TB (6 months)”

Make this module editable as after referral of the contact for diagnostic tests, volunteer needs to enter further details once the tests are done.

Household Contact Line listing Screen-

Name of data field	Field Type	Value/ Options	Validation/ logic/ condition
Name of the contact	Text Box
Age of the contact
Gender	Dropdown	Male Female Transgender Prefer not to say	Mandatory Speech to text feature
Mobile Number	Number		Optional Speech to text feature
TPT (TB Preventive Treatment) Screening Status		Not Started Pending Completed	Mandatory Single selection allowed Default option is Pending
Referral Facility for screening		HWC PHC CHC District Hospital	Mandatory. Single selection allowed From here it can directly go to submit option as the contact first needs to get tested and confirmed if he/ she have to take TPT.
Screening done at the referral facility		Yes No	Mandatory
Is it confirmed TB case		Yes No	If yes, move the card to confirmed TB list. If no, continue ahead.
Are you advised to take (TPT)		Yes No	If yes, continue with the next field. If no, then directly go to submit option.
TPT initiated		Yes No	Mandatory Enable next fields if selected Yes.
TPT start date	Date picker	=<Today’s date	Mandatory if enabled Cannot be future date Cannot be before the date of screening
Treatment duration of TPT		1 Month 3 month 6 month
Expected completion date	date	Auto calculated	Auto calculated= TPT start date + regimen duration Non editable
Follow up visit number	Numeric	Auto increment (1-6)	Non editable Automatic calculation by system
Follow up visit date	Date picker	=<Today’s date	Mandatory if enabled Cannot be future date Cannot be before the TPT start date
TPT completion status		Completed Incomplete Lost to follow up Developed active TB during TPT Died during TPT other	Mandatory If selected “Completed” then enable date of completion field If selected “developed active TB during TPT” then redirect ASHA to create new case record for active TB and close the TPT case. If selected “died during TPT” then enable date of death field and cause of death field
Other	Free text
Date of completion	Date picker	=<Today’s date	Mandatory if enabled Cannot be future date
Date of death	Date picker		To be enabled if “TPT completion status” = Died during TPT Mandatory if enabled
Cause of death	Free text		To be enabled if “TPT completion status” = Died during TPT Mandatory if enabled
Submit

2.2.3 Module- Non Communicable Disease (NCD) Screening

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Name of Data Field	Field Type	Value/ Options	Validation/ Logic/ Condition
CBAC Form
Date	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 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
Part A: Risk Assessment
What is your Age? (in Age)	Spinner	Is Mandatory Choose: 30 – 39 40 - 49 50 – 59 60 and Above	Auto-populate Age from 'Beneficiary' registration: Score Logic: "Score" is a variable whose Default Score value is "0". If 30 <= Age <= 39 then display "1"If 40 <= Age <= 49 then display "2"If 50 <= Age <= 59 then display "3"If 60 <= Age then display "4"
Do you smoke or consume smokeless products such as gutka or khaini	Spinner	Is Mandatory Choose: Never Used to consume in the past sometime now Daily	Score Logic: If option selected "Never" then display "0"If option selected "Used to consume in the past sometime now" then display "1"If option selected = "Daily" then display "2"
Do you consume alcohol daily	Spinner	Is Mandatory Choose: Yes No	Score Logic: If "No" then display "0" or If "Yes" then display "1"
Measurement of Waist (in cm)	Spinner	Is Mandatory Condition: Show values in the Spinner based on Gender: For Male: Choose: 90 cm or less 91 - 100 cm More than 100 cm For Female: Choose: 80 cm or less 81 - 90 cm More than 90 cm	Score Logic: If "Gender" = "Female" and "Waist length" <= 80 then display "0"If "Gender" = "Female" and 81 <= "Waist length" <= 90 then display "1"If "Gender" = "Female" and "Waist length" > 90 then display "2"If "Gender" = "Male" and "Waist length" <= 90 then display "0"If "Gender" = "Male" and 91 <= "Waist length" <= 100 then display "1"If "Gender" = "Male" and "Waist length" > 100 then display "2"
Do you under take any physical activity for minimum of 150 minutes in a week	Spinner	Is Mandatory Choose: At least 150 min in a week Less than 150 min in a week	Score Logic: If "At least 150 min in a week" then display "0" or If "Less than 150 min in a week" then display "1"
Do you have any family history (any one of your parents or siblings) of high BP / Diabetes / Heart Disease	Spinner	Is Mandatory Choose: Yes No	Score Logic: If "No" then display "0" or If "Yes" then display "2"
Total Score	Label		Total Score Formula: Sum of all above score. Based on the "Total Score" display a message in pop-up as show below: If score is > 4 "Refer to NCD screening day / VHSND/ HWC for NCD screening (Priority)" If score is < = 4 "Refer to NCD screening day / VHSND/ HWC for NCD screening (Less Priority)"
Part B1: Early Detection Ask if Patient has any of these symptoms
If "Yes" is selected below then display a pop-up message, "Suspected NCD case, please visit nearest HWC or call 104."
* If "Yes" is selected for any one of the questions below with "*" then show a pop-up message "Refer to MO and collect the Sputum sample"
If "Yes" is selected for any one of the questions below with "" then show a pop-up message "Refer to MO or inform ANM/MPW to tracing of all family members"
Shortness of Breath	Spinner	Is Mandatory Choose: Yes No
Coughing More than 2 weeks *	Spinner	Is Mandatory Choose: Yes No
Blood in Sputum *	Spinner	Is Mandatory Choose: Yes No
Fever > 2 weeks *	Spinner	Is Mandatory Choose: Yes No
Loss of Weight *	Spinner	Is Mandatory Choose: Yes No
Night Sweats *	Spinner	Is Mandatory Choose: Yes No
Are you currently taking Anti TB drugs **	Spinner	Is Mandatory Choose: Yes No
Anyone in Family Currently Suffering from TB **	Spinner	Is Mandatory Choose: Yes No
History of TB *	Spinner	Is Mandatory Choose: Yes No
Recurrent of ulceration on Palm or Sole	Spinner	Is Mandatory Choose: Yes No
Recurrent of tingling on Palm or Sole	Spinner	Is Mandatory Choose: Yes No
Cloudy or Blurred Vision	Spinner	Is Mandatory Choose: Yes No
Difficulty in reading	Spinner	Is Mandatory Choose: Yes No
Pain in eyes lasting for more than weeks	Spinner	Is Mandatory Choose: Yes No
Redness in eyes for more than weeks	Spinner	Is Mandatory Choose: Yes No
Difficulty in Hearing	Spinner	Is Mandatory Choose: Yes No
History of Fits	Spinner	Is Mandatory Choose: Yes No
Difficulty in Opening Mouth	Spinner	Is Mandatory Choose: Yes No
Ulcers in Mouth Not Healed in 2 weeks	Spinner	Is Mandatory Choose: Yes No
Growth in Mouth Not Healed in 2 weeks	Spinner	Is Mandatory Choose:
Any white or red Patch in Mouth Not Healed in 2 weeks	Spinner	Is Mandatory Choose: Yes No
Pain while chewing	Spinner	Is Mandatory Choose: Yes No
Any change in Tone of Voice	Spinner	Is Mandatory Choose: Yes No
Any hypo pigmented patches or discolour lesions with loss of sensation	Spinner	Is Mandatory Choose: Yes No
Any thickened skin	Spinner	Is Mandatory Choose: Yes No
Any nodules skin	Spinner	Is Mandatory Choose: Yes No
Any Patch or Discoloration on Skin	Spinner	Is Mandatory Choose: Yes No
Recurrent numbness on palm or sole	Spinner	Is Mandatory Choose: Yes No
Clawing of fingers in hand or feet	Spinner	Is Mandatory Choose: Yes No
Tingling and numbness in hand / or feet	Spinner	Is Mandatory Choose: Yes No
Inability to close eye lid	Spinner	Is Mandatory Choose: Yes No
Difficulty in Holding Objects in hands or Fingers	Spinner	Is Mandatory Choose: Yes No
Weakness in feet that cause difficulty in walking	Spinner	Is Mandatory Choose: Yes No
Part B2: Women Only
Lump in the Breast	Spinner	Is Mandatory Choose: Yes No
Bleeding after Menopause	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Inform ASHA Facilitator."
Blood Stained Discharge from the Nipple	Spinner	Is Mandatory Choose: Yes No
Bleeding after intercourse	Spinner	Is Mandatory Choose: Yes No
Part B3: Elderly Specific
Feeling unsteady while standing or walking	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
Suffering from any physical disability that restrict movement	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
Needing help from others to perform every day activities such as eating, getting dressed, grooming, bathing, walking, or using the toilets	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
Forgetting names of yours, near ones or your own home address	Spinner	Is Mandatory Choose: Yes No	If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "
Part C: Risk factor for COPD
Type of Fuel Used for Cooking	Spinner	Choose: Wood, Crop Residue, Gobar Gas, Coal, Kerosene oil, LPG
Occupational Exposure	Spinner	Choose: Crop residue burning / burning of garbage – leaves/working in industries with smoke, gas and dust exposure such as brick kilns and glass factories etc.
Part D: PHQ2
Over the last two weeks bothered by the following problem?
Little interest or pleasure in doing things?	Spinner	Choose: Not at all several days more than half the days nearly every day	Score Logic: If option selected is "Not at all" then display "0"If option selected is "several days" then display "1"If option selected is "more than half the days" then display "2"If option selected is "nearly every day" then display "3"
Feeling down, depressed or hopeless?	Spinner	Choose: Not at all several days more than half the days nearly every day	Score Logic: If option selected is "Not at all" then display "0"If option selected is "several days" then display "1"If option selected is "more than half the days" then display "2"If option selected is "nearly every day" then display "3"
Total Score	Label		Total Score formula: Sum of all the above score If "Total Score" is more than "3" then display pop up message "Refer the person to MOIC for treatment."

2.2.4 Module - Referrals

This module should contain the list of names/ cases referred to health facilities.

2.3 Home Page- Dashboard

Flip feature between "Home" and "Dashboard".
Put a field for filter with 2 selection options-

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Versions Compared

Old Version 38

New Version 39

Key

2.2.2.d Tuberculosis Preventive Treatment

2.2.3 Module- Non Communicable Disease (NCD) Screening

2.2.4 Module - Referrals

2.3 Home Page- Dashboard