Page History

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 

Nikshay ID 

Textbox 

• Enable if "Yes" is selected for 'Is Sputum sample collected.
• Enable if "Yes" is selected for "Digital Chest X-ray conducted"
• Enable if "Yes" is selected for "NAAT conducted"

Is Digital Chest X-ray conducted

• Yes
• No 

• To be enabled if "Referred for" = "Digital Chest X-ray"

Digital Chest X-Ray Test Result 

• Positive

• Negative

• Enable only if "Digital Chest X-ray conducted"=“Yes”
• If "Positive" is selected, move this case to Confirmed TB cases module.

Sputum Test

• To be enabled in the following conditions-

a) If "Digital Chest X-Ray Test Result"= "Positive"

b) If "History of TB" = "Yes"

c) If "Age=< 5 years"

d) If "Are you pregnant= yes"

Is Sputum sample collected? 

radio button 

• Yes 
• No 

• Single selection
• Mandatory

Sputum Sample submitted at

dropdown

• Medical College
• DH
• CHC
• PHC
• SC
• Lab

Is TrueNAT conducted

radio button 

• Yes
• No 

• To be enabled if "Referred for" = "TrueNAT" and "Sputum Sample Collected" = "Yes"

True NAT test result

 radio button 

• Positive
• Negative

• Enable only if "TrueNAT conducted"=“Yes”
• Option to edit/ select after submission of the form
• If "Positive" is selected, move this case to Confirmed TB cases module.

Is Liquid culture conducted

radio button 

• Yes
• No 

• To be enabled only if "History of TB" = "Yes", "Currently on Anti-TB drugs" = "Yes" "and "Sputum Sample Collected" = "Yes"

Liquid Culture

 radio button 

• Positive
• Negative

• If "Positive" is selected, move this case to Confirmed TB cases module.
• Option to edit/ select after submission of the form
  

Capture Geolocation

• Capture current location details (latitude, longitude, address)

Submit 

Button