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PRD for "STOP TB Application"- Community Screening Application


Document Revision History

Date

Version Number

Author

Approved By

Document change reference



Dr VanshikaMadhavInitial draft
23.4.2026
Dr VanshikaMadhavBeneficiary Registration, TB screening, Vitals after feedback and several updates done
24.4.2026
Dr VanshikaMadhavMock ups and flow diagram


Dr VanshikaMadhavTPT screening module in progress

1. Document Overview

This document defines the functional requirements for the TB Screening mobile application developed under the TB Mukt Janjati Abhiyan: A community-driven TB elimination initiative targeting tribal populations across India. The application is purpose-built for field use by community volunteers in tribal areas where connectivity, literacy, and device familiarity may be limited.
The application should be simple to use, comprehensive and must work in low/no-connectivity environments.

...



TB Screening modulesEnlisted in the PRD
Nikshay integrationExternal dependency
Integration of AI enabled hand- held chest Xray (digital)External technical dependency
Lab testing device integration (sputum testing)- TrueNatTruenatExternal technical dependency

Hypertension and Random Blood Sugar testing (NCDGeneral NCD Screening module (Vital check-up)

Enlisted in the PRD

General OPD module

Enlisted in the PRD

Dashboard indicators

Enlisted in the PRD. Can be added more as per the requirement.

 Pre Camp Work Plan Preparation Module

Subjected to requirement



1.4 Workflow


Image RemovedImage Added

2. Login Page

  • Login Page Name should be "STOP TB" Application.
  • It must be followed by "STOP TB" Logo.
  • It must have both Online and Offline capabilities. ("Offline capabilities feature to exchange data between Mobile devices in a closed environment in real-time without internet")For online- Mobile number OTP based with 5 min expiry. For offline- 4-digit PIN which can be set during the first login.
  • It must have Multilingual Feature with English, Hindi and other Indian languages enabled, and must be configurable to accommodate all the Indian languages as and when required in future.


UI Field Name 

Field Type 

Options 

Validations 

"STOP TB" Application Logo 

<Placeholder> 

 

 Image Modified

Please Select your Language 

Radio Button 

  • English 
  • Hindi 

 
 
 
 
 
 

  • The fields and labels must populate in the language selected by the user 
     
     
     

Username 

Textbox 



Password

Textbox



Remember Me 

Checkbox 

 

  • When 'Remember Me' checkbox is selected, next time directly allow user to login just by authenticating with fingerprint 

Powered by Piramal Foundation 

Text 

 

  • Display on the bottom of the screen


2.1 Landing page

  • This page must have a hamburger icon (side drawer), "STOP TB" text, sync button, and "Language Translation" button on the Top row.
  • There should be a hamburger icon on the left side, which on clicking should have following details-

...

  • Landing page should have 2 tabs- "Home" and "Dashboard".
  • In home tab floating "Registration" button on the right bottom corner.

Image Added


2.2 Home Page- "Home tab" 

  • Should contain four three modules/ Cards- All Beneficiaries, TB screening, NCD screening, Referrals written on these cards. 
  • On clicking "All Beneficiaries" card- open the "Beneficiary module" form documented below (section 2.2.1) for registering the beneficiary by giving the floating "Registration" button in the right corner.
  • On clicking "TB" card- open the "Tuberculosis module" (section 2.2.2). On clicking the next screen, it should have 3 cards titled "TB Screening", "Suspected TB cases" and ""Confirmed TB cases". 
  • On clicking "Referrals"- The next screen should have 4 cards titled"AI Cough Assessment", "Digital Chest X-ray", "Sputum CollectionTruenat", "NAAT". These cards Liquid Culture", "Health and Wellness Centre". These cards will enlist patients for a particular type of testing.  

2.2.1 Module - Beneficiary Registration

  • On clicking Registration button the user will be navigated to Beneficiary Registration Page
  • Show a pop up for Consent form "I have been explained, the purpose for which the information and findings is being collected from me, in a language I understand and I give my consent to collect the information and findings on my personal health profile."
  • This page has "All Beneficiaries" Text displayed on top with "Home" Icon on the right corner to Navigate to Home page in the 1st row
  • The card below should be visible after the registration of beneficiary.
  • If the beneficiary does not have ABHA ID, give one clickable button on the ABHA ID area of the card to initiate ABHA ID generation.
  • Beneficiaries who are pregnant will be shown directly in "Truenat". All beneficiaries who are not pregnant are shown in "Digital Chest X-ray" and if any abnormality is detected on chest x-ray then that beneficiary is further referred for Truenat testing. All beneficiaries who have high blood pressure and high random blood sugar will be shown in "Health and Wellness Centre" card.


Image AddedImage AddedImage AddedImage Added

2.2.1 Module - Beneficiary Registration

  • On clicking Registration button the user will be navigated to Beneficiary Registration Page
  • Show a pop up for Consent form "I have been explained, the purpose for which the information and findings is being collected from me, in a language I understand and I give my consent to collect the information and findings on my personal health profile."
  • This page has "All Beneficiaries" Text displayed on top with "Home" Icon on the right corner to Navigate to Home page in the 1st row
  • The card below should be visible after the registration of beneficiary.
  • If the beneficiary does not have ABHA ID, give one clickable button on the ABHA ID area of the card to initiate ABHA ID generation.


Photo of the beneficiary

Name

Beneficiary ID


Age (Years)

Village Name-


Phone Number

ABHA ID (ABHA registration)- Clickable


Field Name

Field Type

Value/ Options

Validation/ Logic

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

First Name

Text


  • Mandatory
  • Speech to text feature

Last Name



  • Optional
  • Speech to text feature

Beneficiary Status

Radio Button

·       Alive

·       Death

·       Enable only in the “Edit” Beneficiary screen

Photo of the beneficiary

Name

Beneficiary ID

Age (Years)

Village Name-

Phone Number

ABHA ID (ABHA registration)- Clickable

Field Name

Field Type

Value/ Options

Validation/ Logic

Date of registration

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

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

First Name

Text

  • Mandatory
  • Speech to text feature

Last Name

  • Optional
  • Speech to text feature

Beneficiary Status

Radio Button

·       Alive

·       Death

·       Enable only in the “Edit” Beneficiary screen

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

·       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)·       Show only if above

Time of Death

Time picker

·       Default value is

“Death”

“Alive”

·      

Optional

Reason for Death

(Type of Death)

·       Maternal Death

·       Natural Death

·       Accident

·       Infectious Disease

·       Animal Bite Death

·       Suicide

·       Undetermined

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

  • 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

·       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)


·       Maternal Death

·       Natural Death

·       Accident

·       Infectious Disease

·       Animal Bite Death

·       Suicide

·       Undetermined

·      

Place of Death

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

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. 
  • 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 (Years)


  • Mandatory
  • If DOB unknown, approximate age allowed

Date of Birth

Date Picker


  • Populate automatically if entered

Gender

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

Gender

Dropdown

Dropdown

  • Male
  • Female
  • Transgender
  • Prefer not to say
  • Mandatory
Speech to text feature

Mobile Number

Number

Optional


  • Mandatory
  • Speech to text feature
Village/ Hamlet

Whose mobile number

dropdown


 

Marital Status

radio button

dropdown

  • Unmarried
  • Married
  • Divorced
  • Separated
  • Widow
  • Widower
  • Conditionally Mandatory if gender= female, age>= 15 years and single selection allowed
  • Not Applicable for Newborn/ Child/ Adolescent (Age 0 to less than 15 Years)
editable
  • optional
    • Based on the 'Gender' values in this dropdown list should change as follows:
    • In case of 'Gender' = "Female" show "Widow" and hide "Widower"
    • In case of 'Gender' = "Male" show "Widower" and hide "Widow"

    Husband's/ Wife's Name

    Textbox

  • Input method: Speech to Text feature
  • Optional
  • Based on the Gender

    Are you Pregnant

     radio button

    • Yes
    • No
    • Enabled if "Marital status"= "Married"
    • Mandatory if enabled
    • If ""Are you pregnant"= "Yes", then referral to Truenat and not digital chest x-ray.

    Husband's/ Wife's Name

    Textbox


    • Input method: Speech to Text feature
    • Optional
    • Should be enabled if "Marital status"= Married
    • Based on the Gender show
    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


    • Input method: Speech to Text feature
    • Optional
    • Accept alphabets only
    • Character limit 50
    • All letter should be in caps

    Mother's Name

    Textbox


    • Input method: Speech to Text feature
    • Optional
    • Accept alphabets only
    • Character limit 50
    • All letter should be in caps

    Community

    radio button

    • General
    • SC
    • ST
    • OBC
    • OC
    • Not Given


    • should be editable
    • optional

    Religion

    radio button

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


    • should be editable
    • optional

    Economic Status

    radio button

    • APL
    • BPL
    • Don't know
    • optional

    Type of Residential area

    radio button

    • Rural
    • Urban
    • Tribal
    • Tea Garden
    • Other
    • optional

    Other Type of Residential area

    Textbox


    • Enable if other is selected above
    • Allow Alphanumeric Character and special Characters
    • Character limit 100

    Occupation

    free text


    • Default value is unknown
    Cancel
    • Optional
    Button

    Village/ Hamlet

    Yes

    dropdown

  • No
  • If


    • Single selection allowed
    • This must auto fetch the dropdown values (Villages) with which the user is aligned.

    Sub Centre

    dropdown

     
    •  Single selection

    Capture Geolocation



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

    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.

    Capture Geolocation

    Capture current location details (latitude, longitude, address)

    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 "TB Screening" Screen

    2.2.2 Module- Tuberculosis

    2.2.2.a TB Screening 

    In this section show all beneficiaries irrespective of any age group and gender. 

    This module should open in continuation after beneficiary registration.

     

    * If "Yes" is selected for any one of the questions below with "*" ; "Refer for "digital chest x-ray" or "Collecting the sputum sample".

    ** If "Yes" is selected for any one of the questions below with "**" ; "Advise tracing and screening of all family members".

    TB Screening

     

     

     

    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 

    Coughing More than 2 weeks * 

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    Blood in Sputum * 

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    Fever > 2 weeks * 

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    Rise of fever in evening*

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    Loss of Appetite*

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    Loss of Weight * 

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    Night Sweats * 

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    History of TB *

    radio button 

    •  Yes 
    • No 
    •  Mandatory

    Are you currently taking Anti TB drugs  **

    radio button 

    • Yes 
    • No 
    •  Mandatory

    Anyone in Family Currently Suffering from TB **

    radio button 

    • Yes 
    • No 
    •  Mandatory

    Submit 

    Button 

     

     Continue next to "General Examination"

     

    General Examination


    Image Added

    Fields

    Validation

    Anthropometric (Optional)

     

    Weight (Kgs) 

    - 

    Height (cms) 

    - 

    BMI=Weight/(Height/100) ²  

    Should be auto calculated if height and weight details are entered

    Vitals (Optional)

     

    Temperature (Degree Fahrenheit) 

    • Also give free textbox for manual entry.
    • Give predefined options (Normal range= 97-99 F)

    a) 97.5

    b) 98.5

    c) 99.5

    d)>= 100

    If option d)>= 100 is chosen, show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

    Pulse Rate (beats per minute) 

    • Also give free textbox for manual entry.

    Give predefined options (Normal range= 60-90 BPM)

    a) less than 60

    b) 60-70

    c) 70-80

    d) More than 90

    If "less than 60" or "more than 90" option is chosen, show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

    Systolic Blood Pressure (mmHg)

    •  Give space to write measurement
    • If >=140 mmHg (High BP) or <90 mmHg (low BP) show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

     Diastolic Blood Pressure (mmHg)

    • Give space to write measurement
    • If >=90 mmHg (High BP) or <60 mmHg (low BP) show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

    Random Blood sugar (mg/dl)

    • Give space to write measurement
    • If >=100 mm/dl show alert "Refer to Health and Wellness Centre" and show such beneficiaries in "Referral" card in Home

     

    Skip Button

     

    Submit Button

     Continue next to "Diagnostics" Screen

    Diagnostics

    Image Added


    Diagnostics 




    Is Digital chest x-ray conducted


    • Yes
    • No
    • To be enabled for everyone except "Are you pregnant" = "Yes"

    Digital Chest X-Ray Test Result 

     

    • Positive
    • Negative
    • Enable only if "Is Digital Chest X-ray conducted"=“Yes”
    • If "Positive" is selected, move this case to Confirmed TB cases module and also enable sputum test fields for further testing.

    Is Sputum sample collected


    • Yes
    • No
    • To be enabled in the following conditions-
    1. If "History of TB" = "Yes"
    2. If "Are you pregnant= yes"
    3. If "Are you currently taking Anti TB drugs" = "yes"

    Recommended for Truenat test


    • Yes
    • No
    • To be enabled if "Are you pregnant= yes" 

    Truenat test result

     radio button 

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

    Recommended for liquid culture test


    • Yes
    • No
    • To be enabled only if "History of TB" = "Yes", "Currently on Anti-TB drugs" = "Yes"

    Liquid Culture test result

     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


    2.2.2.b Suspected TB cases  
    This section should contain all beneficiaries in the following scenario-

    Scenario 1- If not a single symptom is presented in a beneficiary but chest x-ray is positive, show the case here.

    Scenario 2- If any symptom or symptoms reported "yes" then show the case here even if chest x-ray/ Truenat is negative.

     

    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 

     

    • All Beneficiaries List- All beneficiaries Should be visible in "All beneficiaries" and "TB Screening" modules.
    • NCD Eligible List: All Beneficiaries both Male and Female whose age > = 30 years and excluding Pregnant Women; with CBAC Form access. 
    • NCD Priority List: Beneficiary age > = 30 years and CBAC assessment score is greater than 4
    • NCD Non-Eligible List: Beneficiary age > = 30 years and CBAC assessment score is less or equals to 4

    ...

    2.2.2.a TB Screening 

    In this section show all beneficiaries irrespective of any age group and gender. 

     

    ...

    TB Screening

    ...

     

    ...

     

    ...

     

    ...

    * If "Yes" is selected for any one of the questions below with "*" auto select "yes" for "Referral Required."

    Show these beneficiaries to 'Suspected TB cases' section

    Show these beneficiaries to 'Referral list module in the Home' section as per the test selected ("AI Cough Assessment", "Digital Chest X-ray", "Sputum Collection", "NAAT")

    ...

     

    ...

     

    ...

     

    ...

    ** If "Yes" is selected for any one of the questions below with "**" auto select "yes" for "Referral Required."

    Show these beneficiaries to 'Suspected TB cases' section

    Show these beneficiaries to 'Referral list module in the Home' section as per the test selected ("AI Cough Assessment", "Digital Chest X-ray", "Sputum Collection", "NAAT")

    Screen all the family members and contacts of the beneficiary

    ...

     

    ...

     

    ...

     

    ...

    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 

    ...

    Symptomatic Screening

    ...

     

    ...

    Coughing More than 2 weeks * 

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    Blood in Sputum * 

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    Fever > 2 weeks * 

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    Rise of fever in evening*

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    Loss of Appetite*

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    Loss of Weight * 

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    Night Sweats * 

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    History of TB * 

    ...

    radio button 

    ...

    •  Yes 
    • No 

    ...

    •  Mandatory

    ...

    Are you currently taking Anti TB drugs ** 

    ...

    radio button 

    ...

    • Yes 
    • No 

    ...

    •  Mandatory

    ...

    Anyone in Family Currently Suffering from TB ** 

    ...

    radio button 

    ...

    • Yes 
    • No 

    ...

    •  Mandatory

    ...

    Asymptomatic Screening

    ...

     

    ...

     

    ...

     

    ...

    Age more than 60 

    ...

    radio button 

    ...

    • Yes 
    • No 

    ...

    • Mandatory
    • Should automatically get selected based on age from the beneficiary registration.

    ...

    Diabetic 

    ...

    radio button 

    ...

    • Yes 
    • No 

    ...

    • Mandatory

    ...

    Tobacco user 

    ...

    radio button 

    ...

    • Yes 
    • No 

    ...

    • Mandatory

    ...

    Contact with TB patient on treatment 

    ...

    radio button 

    ...

    • Yes 
    • No 

    ...

    • Mandatory

    ...

    Referral Required

    ...

    radio button 

    ...

    • Yes 
    • No 

    ...

    • "Yes" Should be auto selected if any of the "*" or "**" field is "yes"
    • If "Yes" is selected, show these beneficiaries in Suspected TB module

    ...

    Referral for

    ...

    • AI Cough Assessment",
    • "Digital Chest X-ray",
    • "Sputum Collection",
    • "NAAT

    ...

    • Multiple option selection possible.
    • Mandatory if "Referral required"= "Yes"

    ...

    Capture Geolocation

    ...

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

    ...

    Submit 

    ...

    Button 

    ...

     

    ...

     

     

    2.2.2.b Suspected TB cases  
    This section should contain all beneficiaries 
    If "referral required "= "Yes"

     

    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 

    Is Sputum sample collected? 

    radio button 

    • Yes 
    • No 
    • To be enabled if "Referral for" = "Sputum Collection"
    •  Mandatory if enabled
    • If “Yes” is selected enable ‘Nikshay Id’ 

    Sputum sample submitted at 

    radio button 

    • 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 

    radio button 

    • Positive 
    • Negative 
    • .
    • Enable if "Yes" is selected for
    • 'Is Sputum sample collected?' If positive, move this case to Confirmed TB cases module.
    • "Digital Chest X-ray conducted"
    • Enable if "Yes" is selected for "NAT conducted"

    Is Digital Chest X-ray conducted

     

    • Yes
    • No 

     

    • To be
    • enabled if "Referral for" = "Digital Chest X-ray"If “Yes” is selected enable ‘Nikshay Id’ 
    • auto selected "Yes" if "Is Digital chest x-ray conducted = yes"

    Digital Chest X-Ray Test Result 

     

      Clinically Diagnosed TB 
    • Positive
      TB Not suspected 
    • Negative
    • Enable only if "Digital Chest X-ray conducted"=“Yes”
    • If "Clinically diagnosed TB" is
    • Auto select the result if "Digital Chest X-Ray Test Result" is already captured in the diagnostics screen.
    • Also give option to do manual selection
    • If "Positive" is selected, move this case to Confirmed TB cases module and also enable sputum test fields for further testing.

    AI Cough Assessment conductedSputum Test

     

  • Yes
  • No  
    • To be enabled
    • if "Referral for" = "AI Cough Assessment"

    AI Cough Assessment result

     

    • Positive 
    • Negative 
    • Enable if "Yes" is selected for 'AI Cough Assessment conducted?' 
    • If positive, move this case to Confirmed TB cases module.

    NAAT conducted

     

    • Yes
    • No 
    • To be enabled if "Referral for" = "NAAT"

    NAAT result

     

    • Positive 
    • Negative 
    • Enable if "Yes" is selected for "NAAT conducted?" 
    • If positive, 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 "Digital Chest X-ray conducted"
    • Enable if "Yes" is selected for "AI Cough Assessment conducted"
    • Enable if "Yes" is selected for "NAAT conducted"

    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.

    Capture Geolocation

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

    Submit 

    Button 

     

     

     

    2.2.2.c Confirmed TB cases

    Treatment and follow up of TB confirmed cases. 

    • in the following conditions-

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

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

    c) If "Are you pregnant= yes"

    d) If "Are you currently taking Anti TB drugs" = "yes"

    Is Sputum sample collected? 

    radio button 

    • Yes 
    • No 
    • To be auto selected "Yes" if "Is Sputum sample collected= yes"

    Sputum Sample submitted at

    dropdown

    • DMC
    • DH
    • CHC
    • PHC
    • SC
    •  Optional

    Is Truenat conducted

    radio button 

    • Yes
    • No 
    • To be auto selected "Yes" if "Is Truenat conducted = yes" and "Sputum Sample Collected" = "Yes" or if "Digital Chest X-Ray Test Result" = "Positive"

    Truenat test result

     radio button 

    • Positive
    • Negative
    • Enable only if "Is Truenat conducted"=“Yes”
    • Option to edit/ select after submission of the form
    • Auto select the result if "Truenat test result" is already captured in the diagnostics screen.
    • Also give option to do manual selection
    • If "Positive" is selected, move this case to Confirmed TB cases module.

    Is Liquid culture conducted

    radio button 

    • Yes
    • No 
    • To be auto selected "Yes" if "Is liquid culture conducted = yes" and "Sputum Sample Collected" = "Yes"
    • To be enabled only if "History of TB" = "Yes", "Currently on Anti-TB drugs" = "Yes"

    Liquid Culture test result

     radio button 

    • Positive
    • Negative
    • Auto select the result if "Liquid Culture test result" is already captured in the diagnostics screen.
    • Also give option to do manual selection
    • 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 

     

     

     

    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 

    1. DS-TB (6 Months)
    2. Shorter Regimen (9–12 Months)
    3. Longer Regimen (18–24 Months)
    4. BPaL Regimen (6 Months)
    5. 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 

    Name of Data Field 

    Field Type 

    Value/ Options 

    Validation/ Logic/ Condition 

    Regimen Type 

    Radio button 

    1. DS-TB (6 Months)
    2. Shorter Regimen (9–12 Months)
    3. Longer Regimen (18–24 Months)
    4. BPaL Regimen (6 Months)
    5. 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?” 

    Capture Geolocation



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

    Submit  

    button 

     

     

    Follow up visit history  

    Table 

     

    Maintain a Follow up visit history of Visit 

    ...

    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 volunteer 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 

    Capture Geolocation



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

    Submit 

     

     

     

    ...

    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-
    1. Time Period- based on "today and previous months" This filter should show all the data cards in the dashboard pertaining to the time period selected. (eg: today, Jan, Feb etc)
    2. Village Name- Dropdown options to be populated with names of village/ hamlets



    Field Name

    Field Type

    Options

    Validation

    Filter/ Selection option

    Dropdown

    The Dropdown Values are

    • Today
    • January
    • February
    • March
    • April
    • May
    • June
    • July
    • August
    • September
    • October
    • November
    • December

    If this filter is selected, then show all the values of the dashboard indicators pertaining to the time period selected.

    Filter/ Selection option

    Dropdown

    Village/ Hamlet names to be put here

    If this filter is selected, then show all the values of the dashboard indicators pertaining to the particular village selected.

    Total TB screenings

    Total Positives/ Negatives 

    Male- Positives/ Negatives 
    Female- Positives/ Negatives 
    Children (<15 yrs)- Positives/ Negatives 
    Others


    Card must be yellow in colour

    It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    Total TB suspected cases

    Total Positives/ Negatives 

    Male- Positives/ Negatives 
    Female- Positives/ Negatives 
    Children (<15 yrs)- Positives/ Negatives 
    Others


    Card must be yellow in colour

    It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    Total TB confirmed cases

    Total Positives/ Negatives 

    Male- Positives/ Negatives 
    Female- Positives/ Negatives 
    Children (<15 yrs)- Positives/ Negatives 
    Others


    Card must be yellow in colour

    It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    Total Digital Chest X-Rays conducted

    Total Positives/ Negatives

    Male- Positive/ Negative
    Female- Positive/ Negative
    Children (5-15 years)- Positives/ Negatives
    Others

    Age>= 60 years- Positives/ Negatives


     

     It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    Total Sputum collection conducted

    Total- Positives/ Negatives

    Male- Positives/ Negatives
    Female- Positives/ Negatives
    Children (<15 yrs)- Positives/ Negatives
    Others

    Age>= 60 years- Positives/ Negatives


     

     It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    Total Truenat tests conducted

    Male- Positives/ Negatives
    Female- Positives/ Negatives
    Children (<15 yrs)- Positives/ Negatives
    Others

    Age>= 60 years- Positives/ Negatives


     

    ...

    Note: The common questions in CBAC Part B1 and TB screening form, if either of the form is filled and submitted first, then responses in the other form should be automatically selected.

    Community Based Assessment Checklist (CBAC) Form 

    NCD (Non-Communicable Diseases) Eligible List: 
    Show all Beneficiary both Male and Female whose age > = 30 years and excluding Pregnant Women. 
    And this CBAC Form is applicable to screen these Beneficiaries. 
    This CBAC Form, assessment check should be done yearly once, Maintain the history of submitted CBAC Form for viewing, year wise 

    ...

    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) 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

    Score Logic: 
    If "No" then display "0" or If "Yes" then display "1" 

    ...

    Measurement of Waist (in cm) 

    ...

    radio button 

    ...

    Is Mandatory 
    Condition: 
    Show values in the radio button 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 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Coughing More than 2 weeks * 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Blood in Sputum * 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Fever > 2 weeks * 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Loss of Weight * 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Night Sweats * 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Are you currently taking Anti TB drugs ** 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Anyone in Family Currently Suffering from TB ** 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    History of TB * 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Recurrent of ulceration on Palm or Sole 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Recurrent of tingling on Palm or Sole 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Cloudy or Blurred Vision 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Difficulty in reading 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Pain in eyes lasting for more than weeks 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Redness in eyes for more than weeks 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Difficulty in Hearing 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    History of Fits 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Difficulty in Opening Mouth 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Ulcers in Mouth Not Healed in 2 weeks 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Growth in Mouth Not Healed in 2 weeks 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    ...

     

    ...

    Any white or red Patch in Mouth Not Healed in 2 weeks 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Pain while chewing 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Any change in Tone of Voice 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Any hypo pigmented patches or discolour lesions with loss of sensation 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Any thickened skin 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Any nodules skin 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Any Patch or Discoloration on Skin 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Recurrent numbness on palm or sole 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Clawing of fingers in hand or feet 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Tingling and numbness in hand / or feet 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Inability to close eye lid 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Difficulty in Holding Objects in hands or Fingers 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Weakness in feet that cause difficulty in walking 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

     

    Part B2: Women Only 

    ...

     

    ...

     

    ...

     

    ...

    Lump in the Breast 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Bleeding after Menopause 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

    If option selected is "Yes" then display "Inform ASHA Facilitator." 

    ...

    Blood Stained Discharge from the Nipple 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

    Bleeding after intercourse 

    ...

    radio button 

    ...

    Is Mandatory 
    Choose: 

    • Yes 
    • No 

    ...

     

    ...

     

    Part B3: Elderly Specific 
      

    ...

     

    ...

     

    ...

     

    ...

    Feeling unsteady while standing or walking 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    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 

    ...

    radio button 

    ...

    Choose: 
     
    Wood, Crop Residue, Gobar Gas, Coal, Kerosene oil, LPG 

    ...

     

    ...

    Occupational Exposure 

    ...

     radio button 

    ...

    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? 

    ...

    radio button 

    ...

    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? 

    ...

    radio button 

    ...

    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." 

    ...

    Capture Geolocation

    ...

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

    ...

    Submit

    ...

     

    ...

     

    ...

     

    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-
    1. Time Period- based on "today and previous months" This filter should show all the data cards in the dashboard pertaining to the time period selected. (eg: today, Jan, Feb etc)
    2. Village Name- Dropdown options to be populated with names of village/ hamlets
    • Module cards should be placed below the filter selection option.

    Field Name

    Field Type

    Options

    Validation

    Filter/ Selection option

    Dropdown

    The Dropdown Values are

    • Today
    • January
    • February
    • March
    • April
    • May
    • June
    • July
    • August
    • September
    • October
    • November
    • December

    If this filter is selected, then show all the values of the dashboard indicators pertaining to the time period selected.

    Filter/ Selection option

    Dropdown

    Village/ Hamlet names to be put here

    If this filter is selected, then show all the values of the dashboard indicators pertaining to the particular village selected.

    Total TB screenings
    Male
    Female
    Children (<15 yrs)
    OthersCard must be yellow in colour

    It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    Total

    TB suspected cases

    sputum samples sent for liquid culture

    Male- Positives/ Negatives
    Female- Positives/ Negatives
    Children (<15 yrs)- Positives/ Negatives
    Others

    Card must be yellow in colour
    Male

    Age>= 60 years- Positives/ Negatives


     

    It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    Total

    TB confirmed cases

    cases referred to Health and Wellness Centres

    Male 


    Female
    Children (<15 yrs)
    Others

    Card must be yellow in colour

    It

    Age>= 60 years


     

     It must auto populate based on the filter selected.

    Total number should be shown in bold with sex aggregated data- male, female, Children, others

    NIKSHAY IDs


    Card must be yellow in colour

    Total number of NIKSHAY IDs made in the selected time period or Village

    ABHA IDs


    Card must be yellow in colour

    Total number of ABHA IDs made in the selected time period or Village