PRD for "Nikshay Mitra Application"- Community Screening Application

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.

1.1 Purpose

This application is developed to screen and maximize TB case detection in all age groups through active case finding, contact investigation, and community mobilization. This application helps in patient tracking throughout treatment cascade at community and facility level via Community Influencers and Nikshay Mitras. Ensure prompt referral and linkage of diagnosed individuals from community to health facilities for timely treatment initiation is the purpose of this application.

1.2 Users of the system

1. Volunteers- Community mobilization, screenings, camps etc.
2. Admin / Supervisory- Backend/Dashboard Access

1.3 In Scope Functional Modules


TB Screening modules	Enlisted in the PRD
NCD Screening modules	Enlisted in the PRD
Nikshay integration	External dependency
Integration of AI assessment tool (Cough)	External technical dependency
Lab testing device integration (sputum testing)	External technical dependency
Integration of AI enabled hand- held chest Xray (digital)	External technical dependency
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

AMRIT > STOP TB- > worddavc09fb0260046ac00240c5c62c7f27ed2.png

2. Login Page

Login Page Name should be "NikshayMitra Application".
It must be followed by "NikshayMitra" 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")

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
"NikshayMitra Application" Logo	<Placeholder>
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), "NikshayMitra" 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-

Full Name (User)
Username
Sync Records
Create ABHA ID
Support
Request to delete account
Log out

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

2.2 Home Page- "Home tab"

Should contain four 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 "NCD" card- open the "Non Communicable Disease (NCD) module" (section 2.2.3). On clicking the next screen, it should have 3 cards titled "NCD eligible list", "NCD priority list", and "NCD non-eligible list".
On clicking "Referrals"- The next screen should have 4 cards titled "AI Cough Assessment", "Digital Chest X-ray", "Sputum Collection", "NAAT". 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 (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)
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 Speech to text feature
Mobile Number	Number		Optional Speech to text feature
Village/ Hamlet	dropdown
Marital Status	radio button	Unmarried Married Divorced Separated Widow Widower	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 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	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.

Lists Sections
Different types of lists are created based on the beneficiary registrations. These are defined in the following data fields: "Age" and "CBAC Score".

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 Module- Tuberculosis

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.
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	DS-TB (6 Months) Shorter Regimen (9–12 Months) Longer Regimen (18–24 Months) BPaL Regimen (6 Months) 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-

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)
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) 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 Male Female Children (<15 yrs) 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 Male Female Children (<15 yrs) 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
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