Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

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. 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.

...

  • 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 three modules/ Cards- All Beneficiaries, TB 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 cards titled, "Digital Chest X-ray", "Sputum Collection"Truenat", "Liquid Culture", "True NATHealth 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.

...

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

·       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)

...

·       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 (Years)

...

  • Mandatory
  • If DOB unknown, approximate age allowed

...

Date of Birth

...

Date Picker

...

  • Populate automatically if entered

...

Gender

...

Dropdown

...

  • Male
  • Female
  • Transgender
  • Prefer not to say

...

  • Mandatory

...

Mobile Number

...

Number

...

  • Mandatory
  • Speech to text feature

...

Village/ Hamlet

...

dropdown

...

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

...

Marital Status

...

radio button

...

  • Unmarried
  • Married
  • Divorced
  • Separated
  • Widow
  • Widower

...

  • Mandatory 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"

...

Are you pregnant

...

 

...

  • Yes
  • No

...

  • Should be enabled if "age" is 15 years and above, "gender" = "female" and if "Marital status"= "Married"
  • Mandatory if enabled

...

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 label name as: 'Husband's' or 'Wife's Name'
  • Accept alphabets only
  • Character limit 50
  • All letter should be in caps
  • 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

·       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)


·       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 (Years)


  • Mandatory
  • If DOB unknown, approximate age allowed

Date of Birth

Date Picker


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

Gender

Dropdown

  • Male
  • Female
  • Transgender
  • Prefer not to say
  • Mandatory

Mobile Number

Number


  • Mandatory
  • Speech to text feature

Whose mobile number

dropdown


 

Marital Status

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)
  • 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"

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 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
  • Optional

Village/ Hamlet

dropdown


  • 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.

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 

 

  • 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 "NAT conducted"

Is Digital Chest X-ray conducted

 

  • Yes
  • No 

 

  • To be auto selected "Yes" if "Is Digital chest x-ray conducted = yes"

Digital Chest X-Ray Test Result 

 

  • Positive
  • Negative
  • Enable only if "Digital Chest X-ray conducted"=“Yes”
  • 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.

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 "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 

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 

 2.2.2.d Tuberculosis Preventive Treatment

Tuberculosis Preventive Treatment (TPT)

  

  • 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 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


 

...

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
  • optional

...

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.

Vital Screen (Skippable section, optional)

Give a box for check mark if the volunteer wants to fill these values. If clicked on it, enable the following fields.

2.2.2 Module- Tuberculosis

2.2.2.a TB Screening 

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

 

...

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 

...

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.

...

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’ 

...

Digital Chest X-Ray Test Result 

...

 

...

  • Clinically Diagnosed TB 
  • TB Not suspected 

...

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

...

AI Cough Assessment conducted

...

 

...

  • 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. 

...

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 

 2.2.2.d Tuberculosis Preventive Treatment

Tuberculosis Preventive Treatment (TPT)

  

  • 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 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 

...

 

...

 

...

 

2.2.3 Module- Non Communicable Disease (NCD) Screening

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