Page History

Field Name

Input Type

Options / Values

Logic & Validations

Date of Registration

• Should be auto selected and updated when the volunteer logs in the application to do the screening.

Beneficiary ID (AMRIT ID)

• Unique ID auto generated by the system

Photo

Camera

Optional

• Should have face detection/ Facial recognition
• Camera should identify & capture human face but not any objects
• Show an Alert if Photo is not captured, just as reminder but Not Mandatory

• Alert: "Do you like to Take Photo", Yes or No If "Yes", open Camera; If "No", go to next

I want to add a person from*

Radio

·       Public Sector

• Private Sector

This field is not visible in the form/ screen. Will be handled in the backend.       

·       Mandatory

·       Single select

• Default: Public Sector selected. 

Type of Case Finding*

Radio

·       Passive (Routine programme)

• Active (Active Case Finding)

·This field is not visible in the form/ screen. Will be handled in the backend.          

·       Mandatory

·       Single select

• Default: Passive selected.

First Name*

Text Input

·       Free text

·       Mandatory

·       Only English letters

• No numbers/special characters.

Middle & Last Name*

Text Input

• Free text

·       Mandatory

·       Only English letters

• No numbers/special characters.

Beneficiary Status

Radio Button

·       Alive

·       Death

·       Enable only in the “Edit” Beneficiary screen

·       Auto-populate, if ‘Death’ is reported from any module

·       Default value is “Alive”

·       If “Death” is selected, enable below four fields and mark it mandatory-

1. Date of Death

2. Time of Death

3. Reason for Death

• 4. Place of Death or Other Place of Death

Date of Death

Date picker

·       Enable if “Beneficiary status”= “Death”

·       Mandatory if enabled

·       By default, date is null

·       Not greater than Today’s Date

·       Accept ‘Date of Death’ after date of registration

• ·       Auto-populate, if ‘Death’ is reported from any module (eg: Tuberculosis)

Time of Death

Time picker

·       Show only if above value is “Death”

• ·       Optional

Reason for Death

(Type of Death)

• Tuberculosis
• Maternal Death

·       Natural Death

·       Accident

·       Infectious Disease

·       Animal Bite Death

·       Suicide

·       Undetermined

·       Enable if “Beneficiary status”= “Death”

·       Mandatory if enabled

• Show only above value is “Death” and it is Mandatory

• If Gender is Female, and Age is 15-49 Years, show “Maternal Death” in dropdown list otherwise hide

Place of Death

• Home
• Subcenter
• PHC
• CHC
• District Hospital
• Medical College Hospital
• Private Hospital
• In Transit
• Other Place of Death

·       Enable if “Beneficiary status”= “Death”

·       Mandatory if enabled

• If ‘Place of Death’ is selected as “Other Place of Death” then enable below field “Other Place of Death” and is mandatory. 

Other Place of Death

Textbox

• Enable if “Beneficiary status”= “Death”

•  Mandatory if enabled

Age*

Number Input

1–99

·       Required.

·       Numeric. Min 1 Max 99 in years

• Either Age or DOB required.

Date of Birth

Date Picker

• Populate automatically if entered

• Auto Calculate 'Date of Birth' based on the Age entered

Gender*

Radio

·       Male

·       Female

·       Transgender

·       Mandatory

• Single select

Mobile number not available

Checkbox

• If this check box is selected, disable mobile number field.

Primary Phone*

Number

• Mandatory
• In case mobile number is not available, consider this number (9999999999) as mobile number (Will be handeled by default in the backend)

• Exactly 10 digits.

Whose mobile number

dropdown

·       Self

·       Husband

·       Mother

·       Father

·       Family Head

• Other

•  Default select "Self" option.

Address*

Text

• Free text

• Required. Max 2000 chars. Only English letters.
• Default value to be considered as "Village" name

State*

Dropdown

• Required. Drives District. 
• Default value selected from location screen

District*

Dropdown

• Required.
• Cascades from State.

• Default value selected from location screen

Block*

Dropdown

• Required.
• Cascades from district.
• Default value selected from location screen

Village*

Dropdown

• Required. 
• Cascaded from block
• Default value selected from location screen or selection to change the village is given

TU

Health Facility*

Dropdown·      

• Required.

• Cascades from District.

·       Cascaded

• Default value selected from location screen

Health FacilityVillage*

Dropdown

• Required.
Must select
• Cascades from District.
Cascaded
• Default value selected from location screen

Caste*

Radio

·       SC

·       ST

·       Other

·       Mandatory

• Single select

Religion

radio button

• Hindu
• Muslim
• Christian
• Sikhism
• Buddhism
• Jainism
• Parsi
• Other
• Not disclosed

• should be editable

• optional

Area*

Radio

·       Tribal-NPVTG

·       Tribal-PVTG

·       Rural

·       Urban

·       Urban Slum

·       Unknown

·       Mandatory

Default Unknown.

Marital Status*

Radio

·       Single

·       Married

·       Unknown

·       Mandatory

·       Default Unknown.

Are you Pregnant*

 radio button

• Yes
• No

• Enabled if "Marital status"= "Married" and “Gender”= “Female”
• Mandatory
• If ""Are you pregnant"= "Yes", then referral to NAAT and not digital chest x-ray.

Husband's/ Wife's Name

Textbox

·       Optional

• Should be enabled if "Marital status"= Married
• Based on the Gender show label name as: 'Husband's' or 'Wife's Name'
• Accept alphabets only
• Character limit 50

All letter should be in caps

Father's Name

Textbox

·        

• Optional
• Accept alphabets only
• Character limit 50

• All letter should be in caps

Mother's Name

Textbox

·        

• Optional
• Accept alphabets only
• Character limit 50

• All letter should be in caps

Occupation*

Dropdown

·       Unknown

·       Student

·       Unemployed

·       Homemaker

·       Farmer

·       Laborer / Daily Wage Worker

·       Self-employed / Business

·       Government Employee

·       Private Employee

·       Health Care Worker

·       Retired / Pensioner

·       Other

·       Mandatory

·       Default Unknown.

Socioeconomic Status*

Radio

·       APL

·       BPL

·       Unknown

·       Mandatory

• Default Unknown.

Cancel

Button

• Yes

·       No

• If cancel is selected, a pop up message "Are you Sure?" with options "Yes" and "No" will come.
• If selected "yes" navigate back to home page

·       If selected "no" then do not erase the patient health data and let the page remain open so it can be submitted by volunteer as sometime by mistake cancel button is clicked.

Submit

• On clicking this, it must display the Pop up msg "Patient Registered successfully"
• This must store the data of the patient and display the required fields over the Beneficiary card.

 Continue next to "Anthropometry" Screen