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Field Name

Input Type

Options / Values

Logic & Validations

Date

Calendar / Date Picker

Date

Mandatory. Default: Today's Date. Not greater than Today's Date. Accept date >= Date of beneficiary registration. Not editable once submitted.

Name

Textbox (read-only)

Auto-filled

Auto-fill from Beneficiary details. Shows First Name + Last Name. Read only.

Age

Textbox (read-only)

Auto-filled

Auto-fill from Beneficiary details. Read only.

Gender

Textbox (read-only)

Auto-filled

Auto-fill from Beneficiary details. Read only.

Nikshay ID

Textbox

Auto-populated

Auto-populated after all mandatory fields per Nikshay application are filled.

Is Digital Chest X-ray conducted

Radio / Auto

Yes  |  No

Enabled for everyone EXCEPT 'Are you pregnant = Yes' and Key Population / Risk Factors = Pregnancy.


Auto-populated by cross-device sync between STOP TB app and digital chest X-ray device.

Digital Chest X-Ray Test Result

Radio / Auto

Positive  |  Negative

Enabled only if 'Is Digital Chest X-ray conducted = Yes'.


Auto-populated by cross-device sync.


If Positive → move case to Confirmed TB cases module AND show patient in Truenat referral list for further testing.

Is Truenat test conducted

Radio / Auto

Yes  |  No

Enabled if 'Are you pregnant = Yes' and , Key Population / Risk Factors = Pregnancy .and "Digital Chest X-Ray Test Result"= "Positive"


Auto-populated by cross-device sync between STOP TB app and Truenat device.

Truenat test result

Radio button / Auto

Positive  |  Negative

Enabled only if 'Is Truenat conducted = Yes'.


Auto-populated by cross-device sync.


If Positive → move case to Confirmed TB cases module.

Recommended for liquid culture test

Radio

Yes  |  No

Enabled only if History of TB = Yes AND Currently on Anti-TB drugs = Yes.

Liquid Culture test result

Radio button

Positive  |  Negative

If Positive → move case to Confirmed TB cases module.


Option to edit/select after form submission as results come after 40-45 days.

Submit

Button

Save diagnostics data.

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