Document Version

Description of changes made

Created/Updated by

Reviewed by

1.0

BRD HWC MOBILE APPLICATION REQIOREMENTS

DEEPSHIKHA & SHRESHTHA

Parameter

Value

Build version

State

Feature Code

Not applicable at this point, can quote JIRA IDs later

Customer (if done for any particular stakeholder)

CR

CR number

Related Defect IDs (if any)

UI Field Name

Field Type

Options

Validations

HWC Logo

<Placeholder>

Please Select your Language

Radio Button

• English
  
• Kannada
  
  
  
  
  

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

Username

Free Text

• There must be User name icon on the right corner of the Field
  
• User Name has 2 Workflows,
  
  1.If CHO Login the user must be allowed with CHO , Lab Technician, Pharmacist access to respective forms
  2.If PHC Staff Logs in (Registrar,Nurse, Doctor, Labtechnician,Pharmacist)
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  

• It must be 20 Digit Characters.
  
• It must be configurable to add numericals and alphanumerical values
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="3739db73-b617-407b-b60c-f99752dfc910"><ac:plain-text-body><![CDATA* [(One Time Activity-The Username must be stored in Master data under "Settings button" for the First time, and on subsequent logins it must compare the Entered Username with the Master data] \]></ac:plain-text-body></ac:structured-macro>
  
  
  
  
  
  
  
  
  
  
  
  
  

Remember Me

Checkbox

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

Next

Button

• User can either Authenticate with Fingerprint OR Use Next Button and Enter the Password in HWC Page(i.e Next page)
  
• On Clicking Next , user must be navigated to "HWC" page
  

Biometric Authentication
Login Using biometric credential
Scan your Finger Print

Finger Print sensor Button

• On placing the registered Finger for Finger print it navigates to the HWC Page
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="db6d5ef7-bab8-4d4d-b473-5d1db563937d"><ac:plain-text-body><![CDATA* [(One time Activity) -Registering the Fingerprint Under settings button \]></ac:plain-text-body></ac:structured-macro>
  Must Display "Please place your Finger on the fingerprint sensor to proceed" non editable Text
  
• Initially by default select one finger in the drop-down, after successful capture;
  
• Then, auto select one by one above finger from the drop-down, after successful capture; i.e. after one finger is done, auto select another finger from the drop-down;
  
• Drop down values are Right Thumb ,Left Thumb , Right Finger ,Left Finger
  
• and show 'Next Finder' button to proceed
  
• Once all four fingers are captured successfully, then submit
  
• button to 'Submit' Note: if already fingerprints are submitted for any User, do not allow to submit again, and show an alert message "fingerprints are already available".But allow to submit again, when it is deactivated by Admin
  
• If the Finger print do not match the Display as "No Match" with Fingerprint symbol in "Red" and a Popup as "Authentication failed"along with small HWC Logo on the left corner of the pop up

Powered by Piramal Foundation

Text

• This must be displayed below the "Next" Button in the centre

UI Field Name

Field Type

Options

Validations

State

 Drop Down

• Auto-Populate
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  

• (This must be configurable and must allow to add different states in Future)
  
• (One Time Activity)- User must be registered with the State that he selected while enrolling himself for the first time under "Settings"
  1.Compare the Lat and Log , if lat and log is not matching, Show an Alert "Your Attendance is Marked as Absent as you are not at the Facility , Do you want to continue Logina) "Yes "- Continue Loginb) "No"- Retry 2. It Should Authenticate the finger Print of the user , If the current fingerprints matches the Master Fingerprints the show "Authentication Successful", If the fingerprints do not match then show"Retry"

District/Town/City

Drop Down

• Auto-Populate
  
  
  
  
  
  
  
  
  
  
  
  

• (This must be configurable and must allow to add different District/Town/City in Future)
  
• (One Time Activity)- User must be registered with the State that he selected while enrolling himself for the first time under "Settings"
  

Taluk/Tehsil

Drop Down

• Auto-Populate
  
  
  
  
  
  
  
  
  
  
  

• (This must be configurable and must allow to add different Taluk/Tehsil in Future)
  
• (One Time Activity)- User must be registered with the Taluk/Tehsil that he selected while enrolling himself for the first time under "Settings"

Street/Panchayat/Village

Drop Down

• Auto-Populate
  
  
  
  
  
  
  

• (This must be configurable and must allow to add different Taluk/Tehsil in Future)
  
• (One Time Activity)- User must be registered with the Taluk/Tehsil

Get GPS Location

Button

• On clicking it must fetch the Current Lat and Long
  
• (One Time Activity) Register the Master lat and Long of user under Settings
  
• Compare the current with Master, if lat and log is not matching, Show an Alert"Your Attendance is Marked as Absent as you are not at the Facility , Do you want to continue Logina) "Yes "- Continue Loginb) "No"- Retry

Master Latitude

Text

Auto- Populate

• This must capture current Latitude of the Location

Master Longitude

Text

Auto- Populate

• This must capture current Latitude of the Location

Submit

Button

• On clicking Submit Button it must navigate to HWC Page

UI Field Name

Field Type

Options

Validations

HWC (Page)

Text

• It must be displaced on the Top of the page in left corner

Facility

Radio Button

• Facility Workflow must encorporate 12 CPHC services
  
• On selecting Facility "Password" and "Login" Field must appear

Password

Text

• It must allow Numeric, Alphanumeric and Special character with "view icon" on the right corner of the Field

Login

Button

• It must Navigate to the "Home" screen

Outreach

Radio Button

• It must open to "Camera", "Outreach" ,"Password"," Proceed to Home" Field

Camera

• On Clicking "Take Photo Button" App must turn the "Camera On"& must have capability of "Face Detection"and click the Live photo of the User and must have "Liveness Detection"capacity to prevent fraudulent attempts using static photos2.Time Stamp- It must capture Current Date in Long date Format e.g, "June 4, 2023"and Time in AM/PM format" e.g "10:30 AM and store it in Backend

Outreach

Drop Down

• Home visit
  
• NCD Camp
  
• Anganwadi Visit
  
• School Visit
  
• VHSND
  
• VHSNC
  
• Yoga Camp
  
• Training
  
• Meeting at PHC
  
• Meeting at District

• On Clicking "Home Visit" it must navigate to "Home" page
  
  
  
  
  
  
  
  
  

Proceed to Home

Button

It must navigate to the "Home" page

UI Field Name

Field Type

Options

Validations

 Hamburger Icon

 Side Drawer

• On clicking it must Auto-populate the "Photo", "Name", "Username" "User Id" of the User.
  
• Followed by "Create ABHA Number",
  
• Followed by "Outreach Activity"
  
• Followed by "Help"
  
• Followed by "Logout"
  
  
  

Create ABHA Number

Button

• On clicking it, "Enter Aadhaar Number" Text must Display with "Home" Icon(That navigates to Home Screen) and the "Timer"(that shows the time in minutes since the user in logged in) on the Top row
  
• Followed by "Aadhaar" Dropdown Field with 1."Aadhaar ID" 2."Fingerprint" as Drop down Values in the 2^nd row
  
• Followed by "With OTP" and "Without OTP"Radio Buttons in 3^rd row
  
  (A)1.On selecting "With OTP", Enter Aadhaar Number is the Text Displayed.
  2."Aadhaar Number" is Text field ,it must allow the 12 digit Numerical values only without space.
  3.Check Box with Consent for creation of ABHA Number
  4.Generate OTP
  (B)1.On selecting "Without OTP",
  " Aadhaar Number" is Text field ,it must allow the 12 digit Numerical values only without space.
  2."Full Name" Field must allow Numericals , alphanumericals ,special characters ,space
  3. "DOB" Field must be a date Picker Calender
  4." Male"& "Female" Radio Button
  5."State" Field is a dropdown field including all Indian States
  6 ." District" Field must Filter with repect to the State selected

Outreach Activity

Button

It must Navigate to Previous Activity Page

Help

Button

• In Construction

Logout

Button

• 1.Login-Logout Capture- Login Logout Time must be captured every single time the user attempts , 2 Types of Logoutsa)System Logout System will Force logout post working Hours if User misses to Logout, b)User Logout- Capture current Lat and Long , If Logout happens away from the Facility Show an Alert"Your Attendance is Marked as Absent as you are not at the Facility" , Do you want to continue Logina) "Yes "- Continue Loginb) "No"- Retry 2.Login and Logout should able to work offline and online, andEvery Login and Logout should capture GPS Coordinates

Version number

Text

• It must display at the end of the Side Drawer page

UI Field Name

Field Type

Options

Validations

CPHC

Text

• This must display on top

Refresh Icon

<Placeholder>

• It must refresh the screen

Sync icon

<Placeholder>

It opens the table with Sync , Unsync, Pending Sync icon for the below rows:

• Patient
  
• Nurse
  
• Doctor
  
• Lab Technician
  
• Pharmacist
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  

• It must show Status of record whether Sync or Uncyn or Pending for all the roles
  
• It opens the table with header"Form Name" "Sync Icon" , "UnSync" Icon "Pending" Icon on 1^st row
  
• "Patient""Sync Icon" , "UnSync" Icon "Pending" Icon on 2^nd row
  
• "Nurse",""Sync Icon" , "UnSync" Icon "Pending" Icon on 3^nd row
  
• "Doctor",""Sync Icon" , "UnSync" Icon "Pending" Icon on 4^th row
  
• "Lab Technician" ""Sync Icon" , "UnSync" Icon "Pending" Icon on 5^th row
  
• "Pharmacist"""Sync Icon" , "UnSync" Icon "Pending" Icon on 6^th row
  
  
  

Kannada Language Translation icon

<Placeholder>

• This must convert all the Fields to Kannada language

Face Recognition Face recognition technique in Registration page

<Placeholder>

• uses technology and biometrics — typically through AI — to identify human faces. It maps facial features from a photograph and then compares the information with a database of known faces to find a match for rapid recognition for follow up visits

UI Field Name

Field Type

Options

Validations

Tap to Search

Text

Auto-Complete feature

It has Speech to Text feature

• It has Speech to Text feature
  
• It can retrive the data by Beneficiary "Name", "Phone number", "Beneficiary Id".

<Placeholder> Patients

Placeholder is the number

• This must Autopopulate the total number of patients registered by the user from start date to current date of the Application
  
• Eg : 100 Patients

<Beneficiary card>

It has below Field on Card
1.Name
2.Beneficiary ID
3.Phone No.
4.Village Name
5.Visit Date
6.Age
7.Gender

• This should follow Newest on Top alignment of the Beneficiary Card
  
• This is Beneficiary Card were Beneficiary details must Autopopulate post submission of the Beneficiary
  

Name

Text

Beneficiary Name must be Auto-populated and displayed over card

• Allow Numerical, Alphanumerical values , Special characters and Spaces

Beneficiary ID

Text

• Once the Pateint is registered , Generate the Beneficiary ID and display on the Beneficiary Card

Phone number

Text

• The 10 digit mobile number registered must display over the card

Village Name

Text

• Registered village nume must be displayed on the call

Visit Date

Text

• It must display the date on which the Patient consultation occurred
  

Age

Text

• It must dislplay the age in years ,days ,that was entered during Patient Registration

Gender

Text

• It must display the Gender of the patient entered during Patient registration

ABHA

Button

• It should be green Button
  
• On clicking ABHA button it must follow the "Create ABHA Number" Work flow

eSanjeevani

Button

• It should be green Button
  
• It Should be integrated with "eSanjeevini"
  
• eSanjeevini is Teleconsultation app ,which allows the User to consult the Healthcare providers for achieving the Continnum of care for the beneficiaries

Sync icon

<Placeholder>

• This allows to view the Sync status of the Beneficiary Data.
  

Registration

Button

• On Clicking ,A Pop appears
  
  "Note!
  Please search for Beneficiary before registration" with two Navigation Button
  1."Search" – This Navigated to the "Tap to Search field"
  2."Proceed with Registration"- This navigates to "Patient Registration" Page

<User Specific> Icon

Button

• There are 2 Workflows based on the User logins
  
• CHO Workflow: He has access to Registrar, Nurse, Doctor , Lab Technician, Pharmacist
  
• PHC Workflow-Registrar will follow Registrar workflow , Nurse will follow Nurse Workflow, Doctor will follow Doctor Workflow,Lab technician will follow Lab technician workflow and Pharmacist will follow Pharmacist workflow
  
• Role based Icons available to follow their respective workflows.
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  

• Based upon the User login , the role based Icon must Auto-populate
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="057e20c5-a156-43b2-bcc5-14315daf4833"><ac:plain-text-body><![CDATA* [Use Case1.-The User is a CHO then role based Icon to populate woud be Registrar ,Nurse Lab technician , Pharmacist , on clicking the Respective icons ,app must traverse through the Role specific Workflow \]></ac:plain-text-body></ac:structured-macro>
  
  We can have seamless flow for CHO without clicking separately on Nurse, doc, LT, Pharmacist. If CHO having all the role access then need not to click separately on CHO, Lab Technician & Pharmacist instead seamless flow from registration till drug dispension.Process Team Input
  
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="d5cd9769-f832-44a0-8861-8e266704aec6"><ac:plain-text-body><![CDATA-The user is a Registrar – he must only be enabled with Registrar Role(It should be configurable to accommodate other roles based upon the requirement) \]></ac:plain-text-body></ac:structured-macro>
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="889dbba8-ddb4-4aea-8c35-9cd7d62e8163"><ac:plain-text-body><![CDATA- The user is a Nurse– he must only be enabled with Nurse Role(It should be configurable to accommodate other roles based upon the requirement) \]></ac:plain-text-body></ac:structured-macro>
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="bc84a3de-2bf4-4f6e-b963-58d0ca120af3"><ac:plain-text-body><![CDATA- The user is a Doctor– he must only be enabled with Doctor Role(It should be configurable to accommodate other roles based upon the requirement) \]></ac:plain-text-body></ac:structured-macro>
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="9858b34e-6fa4-453e-873a-eb60854600c5"><ac:plain-text-body><![CDATA- The user is a Lab Techinician– he must only be enabled with Lab Technician Role(It should be configurable to accommodate other roles based upon the requirement) \]></ac:plain-text-body></ac:structured-macro>
  <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="e079d7e4-80b2-4ef4-a4aa-e5bbf034c4c0"><ac:plain-text-body><![CDATA[* [Use Case6:- The user is a Pharmacist– he must only be enabled with Pharmacist Role(It should be configurable to accommodate other roles based upon the requirement)
  

]]></ac:plain-text-body></ac:structured-macro>

UI Field Name

Field Type

Options

Validations

Select

Drop down

The Dropdown Values are

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

• This must allow to fetch the Patient foot fall based on the drop down values selected
  
  
  
  
  
  
  
  
  
  

OPD
Male- <Number>
Female-<Number>
Others-<Number>

Text

• Card must be Yellow in color
  
  
  

• It must Auto-populate the total OPD Foot fall of the selected Dropdown Option

eSanjeevani Count
<Number>

Text

• Card must be Yellow in color
  

• It must Auto-populate the total eSanjeevini Foot fall of the selected Dropdown Option

NCD Count
< Number >

Text

• Card must be Yellow in color
  

• It must Auto-populate the total NCD Count Foot fall of the selected Dropdown Option

ANC Count
< Number >

Text

• Card must be Yellow in colour
  

• It must Auto-populate the total ANC Count Foot fall of the selected Dropdown Option

PNC Count
< Number >

Text

• Card must be Yellow in colour
  

• It must Auto-populate the total PNC Count Foot fall of the selected Dropdown Option

Family Count
< Number >

Text

• Card must be Yellow in colour
  

• It must Auto-populate the total Family Count Foot fall of the selected Dropdown Option

Immunization Count
< Number >

Text

• Card must be Yellow in colour
  

• It must Auto-populate the total Immunization Count Foot fall of the selected Dropdown Option

HBNC Count
< Number >

Text

• Card must be Yellow in colour
  

• It must Auto-populate the total Family Count Foot fall of the selected Dropdown Option

HBYC Count
< Number >

Text

• Card must be Yellow in colour
  

• It must Auto-populate the total Family Count Foot fall of the selected Dropdown Option

UI Field Name

Field Type

Options

Validations

Patient Registration

Text

Header

Photo< >

Image

• On clicking Tap to take photo it must enable the camera to click the photo of the Beneficiary
  
• This should have the ability to retrive the patients data associated with the photo already registered (under Construction)
  
• This should have Face detection feature
  
  
  

Village

Dropdown

• Mandatory
  
  
  
  

• This must auto fech the dropdown values (Villages)with which the user is aligned.

First Name

Text

• Mandatory
  
• Speech to Text Feature
  
  
  
  
  
  

• Allow Numerical Alphanumerical values , Special characters and spaces
  
  
  
  

Last Name/Surname

Text

• Speech to Text Feature
  
  
  
  
  
  

• Allow Numerical Alphanumerical values , Special characters and spaces
  
  
  
• This must have Speech to Text Feature .

Father's Name

Text

• Speech to Text Feature
  
  
  
  
  
  
  

• Allow Numerical Alphanumerical values , Special characters and spaces
  
  
  
  

Phone number

Text

• Speech to Text Feature
  
  
  
  
  
  
  
  
  

• Allow Numerical values only
  
• This should be a 10 digit Mobile number starting with 6,8,9 number
  
• This not allow the repetition of the number

Age

Date Picker

• Mandatory
  
  
  
  
  
  
  
  
  
  
  

• Scroll feature for Years ,Months Days and select
  
• Once Age is entered then it must calculate the "Date of birth" from Today's date minus "X" days from current date.and Autopopulate on "Date of Birth" Field

Date of Birth

Date Picker
(Calender)

• Mandatory
  
  
  
  
  
  
  
  
  
  
  
  

• Calender date picker
  
• On selecting the date of Birth it must calculate the age in Years From current to Date of Birth
  
• And this must auto populate the age in Age Field
  
  
  
  

Gender

Drop down

• Mandatory
  
  The drop down values are as below:
  
• Male
  
• Female
  
• Transgender
  
• Not Disclosed

Marital Status

Dropdown

• Mandatory
  
  The drop down values are as below:
  
• Married
  
• Unmarried
  
• Divorced
  
• Separated

On selecting women beneficiary as married then one filed should get popped-up as "`Spouse Name"
Note: Applicable only for married women not for Men.

Pregnancy Status

Dropdown

• Mandatory
  
  The drop down values are as below:
  
• Pregnant women
  
• Eligible couple
  
• Lactating women

This field should get appear only for women whose age is more than 15 years.

Cancel

Button

• On clicking this, it must navigate to the Home Page

Submit

Button

• 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 fileds over the Beneficiary card
  
• This Beneficiary Card must be visible in registrar & Nurse Role
  
• This Beneficiary Card should be editable by registrar.

*Edit*Edit option after Registration details of beneficiary is submitted.

Pencil Button(click to edit)

• On clicking this, it must navigate to the Page filled by registrar to edit and at the end "OK" button.
  
• On clicking "OK" it must display the Pop up msg "Patient details edited successfully"
  

UI Field Name

Field Type

Options

• Validations

Visit Details

Text

• Non Editable

 Home Icon

 Text

• This must allow user to navigate to the Home page without saving the record

Category

Radio Button

The Drop down values are:

• OutPatient care
  
• Other CPHC services
  
  
  
  
  
  
  
  
  

• Based on the Drop down values selected,it must open the respective Worflows
  
• This must display the subcategories based upon "Age" and "Gender" of the Beneficiary
  
• Refer 1st 2^nd Tabular column for better insite

Reason for Visit

Radio Button

The Drop down values are:

• New Chief Complaint
  
• Follow Up
  
  
  
  

• Based on the drop down values selected, it must open the respective workflow
  
• Refer 3^rd Tabular Column for better insite

Chief Complaints

Drop Down

Mandatory

• It must fetch the results from Snowmed , and must have Auto-complete feature

Duration

Incremental Scroll

• Mandatory
  
  
  
  
  
  
  
  
  
  
  
  

• It must allow to enter 1, 2,3 numbers only
  
• By clicking on "+ " Button the Number should increase
  
• By Clicking on "- " it should decrease the number
  
• On entering Duration , it must enable the "Add "Button
  

Duration Unit

Drop Down

The Drop down values are:

• Day(s)
  
• Weeks(s)
  
• Months(s)
  
• Years(s)

• Under drop down Values,"Day(s)" must be Auto selected,
  
• It must be editable
  
  
  

Description

Text

• Speech to Text Feature
  
  
  
  
  
  

• It must allow Numericals, Alpha numericals, Special Characters, Spaces
  
  
  

Reset

Button

• It must reset "Chief Complaint","Duration Unit","Description " Fields

Add

Button

• It must again display the Fields "Chief Complaints","Duration
  
  Duration Unit" , "Description" ,Reset","Cancel & "Add"Button
  
• Add attempts are not restrictive , User can use the feature based on the need
  

Cancel

Button

• It must Navigate to Home Page with saving the data
  

Next

Button

• On clicking , it must save the data and navigate to Vitals Page
  
• If the Chief complaint is not entered then it should not navigate to Vitals page , and should display a Pop Up msg
  "Please select chief complaint"

UI Field Name

Field Type

Options

Validations

Temperature(F)

Text

• Mandatory only if Chief complaint is Fever.
  
  
  When we are selecting fever then temperature is mandatory likewise If Hypertension is marked as chief complaint, then BP should be mandatory under the Vitals section. We may relook at what the chief complaint-wise mandatory vitals would be.Process Team Input
  
  
  
  
  
  
  
  
  
  
  
  
  
  

• Decimals should be allowed
  
• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• Temperature must range between
  
  95-115 F
  
• It must allow only 2 and 3 digit numbers
  
• It should display to enter values if Fever is Chief complaint

BP(mmhg)Systolic

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• No Decimals
  
• It must allow only 2 and 3 digit numbers
  
• It should Display "Please enter Value Between 50-300" in red letters below the field
  

BP(mmhg)Diastolic

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• No Decimals
  
• It must allow only 2 and 3 digit numbers
  
• It should Display "Please enter Value Between 30-200" in red letters below the field
  

Pulse rate (min)

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• No Decimals
  
• It must allow only 2 and 3 digit numbers

SPO2

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• Allow Decimals
  
• It must allow only 2 and 3 digit numbers
  
• It should Display "Please enter Value Between 30-100" in red letters below the field

Respiratory Rate(per min)

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• No Decimals
  
• It must allow only 2 and 3 digit numbers
  
• It should Display "Please enter Value Between 10-40" in red letters below the field

RBS Result (mg/dl)

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• No Decimals
  
• It must allow only 2 and 3 digit numbers
  
• It should Display "Invalid RBS " if doesn't satisfy the above criteria

Anthropometry

Text

• Non-Editable

Height(cm)

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• Allow Decimals
  
• It must allow only 2 and 3 digit numbers
  
• It should Display "Invalid Height" if doesn't satisfy the above criteria

Weight(Kg)

Text

• Numericals must be allowed
  
• Do not allow Alphanumericals,Special Characters ,Spaces
  
• Allow Decimals
  
• It must allow only 2 and 3 digit numbers
  
• It should Display "Invalid Weight" if doesn't satisfy the above criteria

BMI

Text

• Auto Calculate BMI based on Height and weight formula
  
• BMI Value between 25 and 29.9 would be classified as overweight with Red Highlight &
  
• BMI over 30 would be classified as having obesity with Red Heighlight .
  
• BMI Below 25 is Normal Highlight in Green

Cancel

Button

• On clicking ,it must navigate to Home Page

Submit to Doctor

Button

• On Clicking , it must save the beneficiary data
  
• It must display the beneficiary card with required data to Registrar, Nurse &Doctor role

UI Field Name

Field Type

Options

• Validations

Chief Complaint

  Text

Mandatory

• This field must Fetch "new Chief complaint and display

Duration

  Text

Mandatory

• This field must Fetch "Duration" and display
  
  
  

Duration Unit

  Text

Mandatory

• This field must Fetch "Duration Unit" and display
  

Test Name

Drop Down(Multiselect) with "Clear all" and "Ok" Fields at the bottom of the drop down list

• Hemoglobin
  
• Complete Blood count
  
• Total Leucoyte count
  
• Differential Leucocute Count
  
• Platelet count
  
• Malaria Rapid Test
  
• Dengue Rapid Test
  
• Stool for occult Blood
  
• RPR/VDRL Test for Syphillis
  
• HIV test(Antibody ½ and HIV ½
  
• Hepatitis B Surface Antigen Test
  
• HCV Antibody Test(Anti HCV
  
• Erythrocyte Sedimentation Rate
  
• Reticulocyte Count
  
• Absolute Eosinophil Count
  
• Quantative Test for G6PD Enzyme Deficiency
  
• Prothrombin Time(PT)
  
• Activated Partial Thromboplastine time
  
• 24-Hours Unirary Protein
  
• Urine for Microalbumin
  
• Urine for Creatinine and Albumin to Creatinine Ratio(ACR)
  
• Stool for Ova and Cyst
  
• Sputum for AFB
  
• Typhoid Test(IgM)
  
• Pap Smear
  
• Urine Culture and Antimicrobia Sensitivity
  
• TB -Mantoux
  
• Smear for Filaria
  
• rK3 for Kala Azar
  
• Erythrocyte Sedimentation Rate (ESR)Peripheral Blood film
  
• Bleeding Time(BT)
  
• Clotting Time (CT)
  
• Blood Group and Rh Type
  
• Sickling Test for Sickle Cell Anemia
  
• Quantative Test for G6PD
  
• Test for Chickangunya
  
• Blood Sugar
  
• Glucose Tolerance Test(GTT)
  
• S.Bilirubin(T)
  
• S.Bilirubin
  
• Serum creatinine
  
• Blood Urea
  
• Uric Acid
  
• Hemoglobin
  
• Blood Sugar
  
• Malaria
  
• S. total Protein
  
• S.Albumin and AG Ratio
  
• Dengue Rapid Test
  
• S.Triglycerides
  
• S.VLDL
  
• S.HDL
  
• S.LDL
  
• Serum Sodium
  
• S.Potassium
  
• Serum Calcium
  
• Gram Staining for Clinical Specimen
  
• Throat Swab for Diptheria
  
• Visual Inspection Acetic Acid(VIA)
  
• Smear for RTI/STD
  
• CRP
  
• RA Factor

• On Clicking the Drop down values and submit the case ,the Investigation details will then navigated to Lab Technician role
  
• On clicking "Clear all" the selected field will Unselect
  
• On clicking "OK " the Investigations will saved and navigated to the Lab technician role
  
  
  
  
  
  
  
  
  

Provisional/
Final Diagnosis

Text

• Mandatory
  
  
  
  
  
  
  
  
  

• It has "Reset Button" to reset the Final Diagnosis Field
  
• It has "Add Button" to Add the Final Diagnosis Field
  
• It has "Close Button" to clear the Final Diagnosis Field

External Investigation

Text

• User can add the additional Investigations that falls apart of the Test Names listed above

Select Template Name To Fill

Drop Down

User Specific Dropdown Values

• It shows the Drop down values that is saved by the user ,using "Save this Template"Field
  

Prescription

Text

• Header
  
• This has From/Medcine/Dosage, Frequency, Duration, Unit,Instruction
  
• This prescription section ends with , Reset ,Add, Close Buttons

From/Medcine/Dosage

Auto-complete, Dropdown

• It must have auto-complete Feature,it must Autopopulate the Med, Form&Dosage e.g. Tab Paracetamol 500mg, Syp Paracetamol 5ml
  

Frequency

Drop Down

The Dropdown values are as below

• 1-0-0
  
• 0-1-0
  
• 0-0-1
  
• 1-1-0
  
• 1-0-1
  
• 0-1-1
  
• 1-1-1
  
• 1-1-1-1
  
• SOS(Needs to be implemented)
  

Duration

-Text+

 The incremental Text Value are below

• 1
  
• 2
  
• 3
  
• 4
  
• 5
  
• 6
  
  
  

• On Clicking "+" the numbers for selecting must display in increasing order, On Clicking "- "the numbers for selecting must display in decreasing order
  
  
  

Unit

Drop Down

Day(s)
Month(s)
Week(s)

• Day must auto- Populate, it can be editable if required

Instruction

 Drop down

 The Drop down values are below

• After Food
  
• Before Food
  

Enter Template Name

Text

• It must allow Numericals ,Alphanumerical, Special characters and Spaces
  
• The user needs to add Fill the Prescription Section and Enter a Template Name and Click on Save Templete Button
  
• This is user specific , and hence the user can now enter the saved Template name to retrive the prescription section

Save this Template

Button

• By clicking this button , the Template gets saved

Delete Template

Button

• By clicking this button , the Template gets Deleted

Councilling/ Advice

Dropdown

Drop Down Values are below:

• Healthy Lifestyle &Lifestyle Modification
  
• Adherence to Treatment Regimen
  
• Health &Nutrition
  
• Rest & Physical Activity
  
• Personal Hyegiene
  
• Menstrual Hyegiene
  
• Safe Sexual Practices
  
• Avoidance of Substance Abuse
  
• Complication Readiness(Warning Symptoms)
  
• Personal Proactive Measures
  
• Home Isolation
  
• Hand Wash
  
• Cough Etiquette(Respiratory Hygiene)
  
• Follow up Instructions
  
• Preventive Measures
  
• Other

Refer

Header

This Section Consists of Refer, Reason for referral

Refer

Drop down

Drop down values are

• PHC
  
• CHC
  
• District Hospital

Submit

Button

Visual Acuty Test

Select none

CHC

 Refer- Card

FRU

Other

Refer

Drop Down

RH

SDH

UPHC

PHC

Save & Submit

Button

Log out-Card 

Logout

Button

1.Login-Logout Capture- Login Logout Time must be captured every single time the user attempts , 2 Types of Logoutsa)System Logout System will Force logout post working Hours if User misses to Logout, b)User Logout- Cature current Lat and Long , If Logout happens away from the Facility Show an Alert"Your Attendance is Marked as Absent as you are not at the Facility" , Do you want to continue Logina) "Yes "- Continue Loginb) "No"- Retry 2.Login and Logout should able to work offline and online, and should capture GPS CoordinatesEvery Login and Logout should capture GPS Coordinates

My Dashboard

Text

Header

Today's

Button

On Clicking this , it must Auto-fetch the Count for each card

Monthly Report

Dropdown

DropDown values must be all the Months of this Current Year

OPD -Work Flow
 

OPD Total

Text

1. Total Number to be autocalculated based on registrations

Male

Text

Auto- calculate based on the registrations

Female

Text

Auto- calculate based on the registrations

e-Sanjeevini

Text

Auto- calculate based on the registrations

NCD

Text

Auto- calculate based on the registrations

ANC

Text

Auto- calculate based on the registrations

PNC

Text

Auto- calculate based on the registrations

Family Planning

Text

Auto- calculate based on the registrations

Immunization

Text

Auto- calculate based on the registrations

HBNC

Text

Auto- calculate based on the registrations

HBYC

Text

Auto- calculate based on the registrations

Assessment Indicators

Button

It will take to 15 Indicators Page, This button must be displayed only for CHO

View Batch

View Batch

LMP Date

Calender

• Accept date less than 5 weeks from Date of Registration.
  
• Accept date not less than 10 months from Today's Date.
  
• Not greater than Today's Date

Registered within 12 Weeks of Pregnancy

Text Box

Yes
No

• Display yes, if the date of registration is within 12 weeks of LMP
  
• Display No, if the date of registration is more than 12 weeks of LMP

Weeks of Pregnancy at the time of Registration

Text Box

• Auto Calculated based on the LMP date and date of registration

EDD Date

Text Box

• Auto Calculated based on the LMP date
  
• LMP Date + 280 days

Does the pregnant woman have any past illness?

Radio Button

• Options as
  
  Yes / No{} J-
  
• Default value is null

• Default Value: To be null if no data is entered.
  
• Open "Past Illness" drop down list on selection of Yes.

Past Illness

Drop Down List

• Choose from A. TB B. DIABETES
  
  C. HYPERTENSION D. HEART DISEASE E. EPILEPTIC (CONVULSIONS) F. STI/RTI G. HIV +ve H. HEPATITIS B
  I. ASTHMA
  ANY OTHER (SPECIFY) – Z
  J. None

• None – default Selection
  
• Open "Other Past Illness" Text Box on selection of Any Other (Specify) option and is mandatory.

Other Past Illness

Edit Text Box

• Accept Alphabets only, Character limit 50

Blood Group of Pregnant Woman

Drop Down

A+ve
B+ve
AB+ve
O+ve
A-ve
B-ve
AB-ve
O-ve
Not done

If "Not Done" is selected Auto fill Blood Group in Investigation

Is this first pregnancy of woman?

Radio Group

• Option as
  Yes / No

• If No, populate from EC Section "Total No. of Children Born – Male & Female". (Not working as expected) & hear we have only 5 in drop down list, where we have 9 in EC Reg)
  
• Open "Total No. of Pregnancy (previous)" data field on selection of No option and mandatory.

Total No. of Pregnancy (previous)

Spinner

• Options as
  
  -0-5- 0-15
  
• Default value should be 0

• Populated from EC Section "Total No. of Children Born – Male & Female".(Not populating from EC)
  
• Open "Last Pregnancy" data fields (29), if value is 1 or more than 1.
  
• Open "Last to Last Pregnancy" data fields (68), if value is 2 or more than 2.

G _ P_ A _ L _ S

Increment Scroll Box

1-15 numbers

• Increment Scroll box between "G" and "P"& "P" and "A" &"A" and "L" with 1-15 numbers

Last Pregnancy

Text Box

• This data field must appears if "Total No. of Pregnancy (previous)" is mentioned as 1 or more than 1.
  
• "Outcome" data field is Mandatory.

Was there any complication in Last Pregnancy?

Radio Group

• Options as
  
  Yes –1
  No – l2
  Default value – null L

• This data field must appears if "Total No. of Pregnancy (previous)" is mentioned as 1 or more than 1.
  
• Open "Complications" Drop down List on selection of Yes option and is mandatory.
  
• Default Value: to be null if no data is entered

Complications in previous pregnancies

Drop Down

• CONVULSIONS – A
  
• APH – B
  
• PREGNANCY INDUCED HYPERTENSION (PIH) – C
  
• REPEATED ABORTION – D
  
• STILLBIRTH – E
  
• CONGENITAL ANOMALY – F
  
• CAESAREAN SECTION – G
  
• BLOOD TRANSFUSION – H
  
• TWINS – I
  
• OBSTRUCTED LABOUR – J
  
• PPH – K
  
• ANY OTHER (SPECIFY) – Z
  
• None

• "None" must be Default selection
  
• Open "Other Complication" Text Box on selection of Any Other (Specify) option and is mandatory.

Other Complication

Text Box

• Accept alphabets only
  
• Character limit 50

Outcome

Drop Down List

• Choose from Live Birth - 1 Abortion- 2
  
  Stillbirth – 3
  Default should be 0

• If "Total No. of Pregnancy (previous)" is 1 or more than 1, then this data field becomes Mandatory.

Last to Last Pregnancy

Label

• This data field must appears if "Total No. of Pregnancy (previous)" is mentioned as 2 or more than 2.
  
• "Outcome" data field is Mandatory.

Was there any complication in Last to Last Pregnancy?

Radio Button

• Options as
  
  Yes – 1
  No – L2
  Default value is L

• This data field must appears if "Total No. of Pregnancy (previous)" is mentioned as 2 or more than 2.
  
• Open "Complications" Drop down List on selection of Yes option and is mandatory.
  
• Default Value: to be null if no data is entered

Complication

Drop Down List

• CONVULSIONS – A
  
• APH – B
  
• PREGNANCY INDUCED HYPERTENSION (PIH) – C
  
• REPEATED ABORTION – D
  
• STILLBIRTH – E
  
• CONGENITAL ANOMALY – F
  
• CAESAREAN SECTION – G
  
• BLOOD TRANSFUSION – H
  
• TWINS – I
  
• OBSTRUCTED LABOUR – J
  
• PPH – K
  
• ANY OTHER (SPECIFY) – Z
  
• Default – Lnull

• Open "Other Complication" Text Box on selection of Any Other (Specify) option and is mandatory.

Other Complication

Text Box

• Accept alphabets only
  
• Character limit 50

Outcome

Drop Down List

• Choose from Live Birth- 1 Abortion- 2 Stillbirth- 3
  
• Default 0

• If "Last to Last Pregnancy" is 2 or more than 2, then this data field becomes Mandatory.

Expected Facility for Delivery

Spinner

• Choose from
  
  District Hospital - 5 Community Health Centre – 2
  Primary Health Centre – 1
  Sub Centre – 24 Other Public Facility – 19
  Accredited Private Hospital – 24
  Other Private Hospital – 21
  Home- 22
  Sub District Hospital – 4
  Medical College Hospital – 17
  Default value – 0

Place Name

Spinner List / Edit Text Box

• Populated from drop down list / Accept alphabets, numeric and special characters.
  
• Character limit 50

• If DH/CHC/PHC/SC/Sub District Hospital/Medical College Hospital is chosen in "Facility for Delivery" then drop list appears based on the mapped facilities.
  
• If any option, other than the above mentioned options is chosen then text box appears.

VDRL/RPR Test Done

Drop Down List

• Choose from
  
  Yes – true
  Not Done – false
  Default value null

• Open "VDRL/RPR Date" and "VDRL/RPR Result" data fields on selection of done option and is mandatory.
  
• Default Value: to be null if no data is entered.

VDRL/RPR Date

Date Picker

• Choose the date from the calendar
  
• Format: dd-mm-yyyy
  
• Default value null

• Accept date equal to or greater than Date of Registration.
  
• Accept date up to EDD
  
• Not greater than Today's Date.

VDRL/RPR Result

Spinner

• Choose from
  
  +ve - P/ -ve – N
  Default value- : to be null

HIV Screening Test

Radio Group

• Choose from
  Done – True /Not Done - False

• Open "Date of HIV Test conducted" and "HIV Screening Test Result" data fields on selection of Done option and is mandatory.
  
• Default Value: to be null if no data is entered

Date of HIV Test conducted

Date Picker

• Choose the date from the calendar
  
• Format: dd-mm-yyyy
  
• Default Value - null

• Accept date equal to or greater than Date of Registration.
  
• Accept date up to EDD
  
• Not greater than Today's Date

HIV Screening Test Result

Radio Group

• Choose
  
  -ve - N / Refer to ICTC – R
  Default Value - null

Weight of PW (Kg) at time Registration

Number Picker

• Accept numeric (integer) value only
  
• Accept values from 30 to 200

Height of PW

Number Picker

• Accept numeric (integer) value only
  
• Accept values from 50 to 200

• Default value 0

BMI

Text Box

• Auto calculated if "Weight of PW" and "Height of PW" given.

Picture of PW

Camera

• It should capture the picture of PW

ASHA Name 

Spinner 

• Select Single Name of ASHA 
   

• List to be populated from the Health provider Master / Village profile entry 

PNC Period 

Spinner 

• Choose from 
  1st Day 3rd Day 7th Day 14th Day 21st Day 28th Day 42nd Day 

PNC Date 

Calendar 

• Choose the date from the calendar  
  
• Format: dd-mm-yyyy 

• 1st Day - Accept date equal to Delivery Date or up to 1^st  days from Delivery Date. 
  
• 3rd Day – should be strictly given on 3^rd day after delivery 
  
• 7th Day – Should be given between Delivery + 7 (-3 and +3 ) in days 
  
• 14th Day - Should be given between Delivery + 14 (-3 and +3) in days. 
  
•  21st Day - Should be given between Delivery + 21 (-3 and +3 ) in days. 
  
•  28th Day - Should be given between Delivery + 28 (-3 and +3 ) in days  
  
• 42nd Day Should be given between Delivery + 42 (-3 and +3 ) in days Not greater than Today's Date 
  
• Not less than Date of Delivery 
  
• Date should be 1990-01-01 if Mother death is true 

No. of IFA Tablets given 

Custom Number Picker 

• Default value Null 0 

• Accept numeric (integer)  value only 
  
• Accept value greater than 0 
  
• Accept value up to 400 

Any Method of Contraception 

Radio Button 

• Options as  
  Yes / No 

• Open "PPC Method" data field on selection of Yes option. 

Method of Contraception 

Spinner 

• Choose from  A. POST PARTUM IUCD (PPIUCD WITHIN 48HRS OF DELIVERY) B. CONDOM C. MALE STERILIZATION D. POST PARTUM STERILIZATION (PPS WITHIN 7 DAYS OF DELIVERY) E. ANY OTHER (SPECIFY) 

• Default Value: to be null  
  
• If no data is entered. Open "Other Method" Text Box on selection of Any Other (Specify) option and is mandatory.  

Other PPC Method 

Edit Text Box 

• Accept alphabets, numeric and special character.  
  
• Character limit 50 

Any mother danger sign? 

Radio Group 

• Options as  
  Yes / No – Y 

• Open "Mother Danger Sign" drop down list on selection of Yes 

Mother Danger Sign 

Drop Down List 

• Choose from  A. PPH B. FEVER C. SEPSIS D. SEVERE ABDOMINAL PAIN E. SEVERE HEADACHE OR BLURRED VISION F. DIFFICULT BREATHING G. ANY OTHER (SPECIFY)  
  
• Z. Any Other  H. NONE 

• Open "Other Danger Sign" Text Box on selection of Any Other (Specify) option and is mandatory.  
  
• Default Value: to be null if no data is entered. 

Other Danger Sign 

Edit Text Box 

• Accept alphabets only  
  
• Character limit up to 50 

Referral Facility 

Spinner 

• Choose from 
  Primary Health Centre - 1/Community Health Centre - 2/District Hospital - 5/Other Private Hospital - 21/Any Other (Specify) -99 

Place Name 

Spinner / Text Box 

• Populated from drop down list / Accept alphabets, numeric and special characters. 
  
• Character limit 50 

• If PHC / CHC / DH is chosen in "Referral Facility" then drop list appears based on the mapped facilities. 
  
• If any option other than the above mentioned options is chosen then text box appears. 

Mother Death 

Radio Button 

• Options as  
  Yes -True / No -False 

• Open "Mother Death Date", "Mother Death Reason" and "Place of Death" data fields on selection of Yes option and are mandatory. 
  
• Disable "PNC Period", "PNC Date", "IFA Tablets given to Mother", "PPC Method" and "Referral Facility" data fields on selection of Yes option. 
  
• Pnc_type should be 99 

Date of Death 

Date Picker 

• Choose the date from the calendar  
  
• Format: dd-mm-yyyy 

• Not greater than Today's Date 
  
• Not less than Delivery Date 

Probable Cause of Mother Death 

Spinner 

• Choose from 
  
  SELECT ALL  
  A. ECLAMPSIA  
  B. HAEMORRHAGE (PPH) 
  C. ANAEMIA 
  D. HIGH FEVER  
  E. ANY OTHER (SPECIFY) 
  Z. Any Other 

• Open "Other Death Cause" Text Box on selection of Any Other (Specify) option and is mandatory. 

Other Death Cause 

Edit Text Box 

• Accept alphabets only  
  
• Character limit 50 

Place of Death 

Radio Group 

• Options as  
  Home - 1 / Hospital - 2 / Transit -{}– 3 

Remarks 

Text Box 

• Accept alphabets, numeric and special characters 
  
• Character limit 250 

S
No

Name of Data Field

Field Type

Value/ Options

Validation/ Logic/ Condition

CBAC Form

Date

Calend
ar
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

Textbo x

Auto fill from Beneficiary details
Show: First Name + Last Name
Read only

Age

Textbo x

Auto fill from Beneficiary details Read only

Sex

Textbo x

Auto fill from Beneficiary details Read only

Part A: Risk Assessment

1

What is your Age? (in Age)

Spinner

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"

2

Do you smoke or consume smokeless products such as gutka or khaini

Spinner

Is Mandatory Choose:

• Never
  
• Used to consume in

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"

the past sometime
now
▪ Daily

3

Do you consume alcohol daily

Spinner

Is Mandatory Choose: ▪ Yes
▪ No

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

4

Measurement of
Waist (in cm)

Spinner

Is Mandatory Condition:
Show values in the Spinner 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"

5

Do you undertake any physical activity for
minimum of 150 minutes in a week

Spinner

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"

6

Do you have any family history (any one of your parents or siblings) of high BP / Diabetes / Heart
Disease

Spinner

Is Mandatory Choose:

• Yes
  
• No

Score Logic:
If "No" then display "0" or If "Yes" then display "2"

7

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"

1

History of TB *

Spinner

Is Mandatory Choose:

• Yes
  
• No

2

Coughing More than 2 weeks *

Spinner

Is Mandatory Choose: ▪ Yes
▪ No

3

Blood in Sputum *

Spinner

Is Mandatory Choose:

• Yes
  
• No

4

Fever > 2 weeks *

Spinner

Is Mandatory Choose:

• Yes
  
• No

5

Loss of Weight *

Spinner

Is Mandatory Choose:

• Yes
  
• No

6

Night Sweats *

Spinner

Is Mandatory Choose:

• Yes
  
• No

7

Anyone in Family Currently Suffering from TB **

Spinner

Is Mandatory Choose:

• Yes
  
• No

8

Are you currently taking Anti TB drugs **

Spinner

Is Mandatory Choose:

• Yes
  
• No

9

Recurrent of ulceration on Palm or Sole

Spinner

Is Mandatory Choose:

• Yes
  
• No

10

Recurrent of tingling on Palm or Sole

Spinner

Is Mandatory Choose:

• Yes
  
• No

11

Cloudy or Blurred Vision

Spinner

Is Mandatory Choose:

• Yes
  
• No

12

Difficulty in reading

Spinner

Is Mandatory Choose:

• Yes
  
• No

13

Pain in eyes lasting for more than weeks

Spinner

Is Mandatory Choose:

• Yes
  
• No

14

Redness in eyes for more than weeks

Spinner

Is Mandatory Choose:

• Yes
  
• No

15

Difficulty in
Hearing

Spinner

Is Mandatory Choose:

• Yes
  
• No

16

Shortness of Breath

Spinner

Is Mandatory Choose:
▪ Yes
▪No

17

History of Fits

Spinner

Is Mandatory Choose:

• Yes
  
• No

18

Difficulty in
Opening Mouth

Spinner

Is Mandatory Choose:

• Yes
  
• No

19

Ulcers in Mouth Not Healed in 2 weeks

Spinner

Is Mandatory Choose:

• Yes
  
• No

20

Any Change in the tone of your voice

Radio Button

Is Mandatory Choose:

• Yes
  
• No
  

21

Growth in Mouth Not Healed in 2 weeks

Spinner

Is Mandatory Choose:

22

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

Spinner

Is Mandatory Choose:

• Yes
  
• No

23

Pain while chewing

Spinner

Is Mandatory Choose:
▪Yes
▪ No

24

Any hypo pigmented patches or discolour lesions with loss of sensation

Spinner

Is Mandatory Choose:

• Yes
  
• No

25

Any thickened skin

Spinner

Is Mandatory Choose:

• Yes
  
• No

26

Any nodules skin

Spinner

Is Mandatory Choose:

• Yes
  
• No

27

Any Patch or
Discoloration on
Skin

Spinner

Is Mandatory Choose:

• Yes
  
• No

28

Recurrent numbness on palm or sole

Spinner

Is Mandatory Choose:

• Yes
  
• No

29

Clawing of fingers in hand or feet

Spinner

Is Mandatory Choose:

• Yes
  
• No

30

Tingling and numbness in hand
/ or feet

Spinner

Is Mandatory Choose:

• Yes
  
• No

31

Inability to close eye lid

Spinner

Is Mandatory Choose:

• Yes
  
• No

32

Difficulty in
Holding Objects in hands or Fingers

Spinner

Is Mandatory Choose:

• Yes
  
• No

33

Weakness in feet that cause
difficulty in walking

Spinner

Is Mandatory Choose:

• Yes
  
• No

Part B2: Women Only

1

Lump in the Breast

Spinner

Is Mandatory Choose:

• Yes
  
• No

• Yes
  
• No

2

Blood Stained
Discharge from the
Nipple

Spinner

Is Mandatory Choose:

• Yes
  
• No

3

Change in shape and size of breast

Spinner

Is Mandatory Choose:

• Yes
  
• No Not present in Sakhi

4

Bleeding between periods

Spinner

Is Mandatory Choose:

• Yes
  
• No

5

Bleeding after
Menopause

Spinner

Is Mandatory Choose:

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

6

Bleeding after intercourse

Spinner

Is Mandatory Choose:

• Yes
  
• No

7

Foul smelling vaginal discharge

Spinner

Is Mandatory Choose:

• Yes
  
• No

Part B3: Elderly Specific Not present in HWC Mobile App

1

Feeling unsteady while standing or walking

Spinner

Is Mandatory Choose:

• Yes
  
• No

If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "

2

Suffering from any physical disability
that restrict
movement

Spinner

Is Mandatory Choose:
▪ Yes
▪ No

If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "

3

Needing help from others to perform every day activities such as eating, getting dressed, grooming, bathing, walking, or using the toilets

Spinner

Is Mandatory Choose:
▪Yes
▪ No

If option selected is "Yes" then display "Send the patient to MOIC of nearest health center for treatment "

4

Forgetting names of yours, near ones or your own home address

Spinner

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

1

Type of Fuel Used for Cooking

Spinner

Choose:

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

2

Occupational Exposure

Spinner
r

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?

1

Little interest or pleasure in doing things?

Spinner

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"

2

Feeling down, depressed or hopeless?

Spinner

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"

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."

S No

Early Detection of Tuberculosis (TB)
Ask if Patient has any of these symptoms

* 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".
Show these beneficiaries to 'Suspected TB cases' section

** 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"

1

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

2

Name

Textbox

Auto fill from Beneficiary details
Show: First Name + Last Name
Read only

3

Age

Textbox

Auto fill from Beneficiary details Read only

4

Sex

Textbox

Auto fill from Beneficiary details Read only

5

Coughing More than 2 weeks *

Spinner

Is
Mandatory Choose:

• Yes
  
• No

6

Blood in Sputum *

Spinner

Is
Mandatory Choose:

• Yes
  
• No

7

Fever > 2 weeks *

Spinner

Is
Mandatory Choose: ▪ Yes
▪ No

8

Loss of Weight *

Spinner

Is
Mandatory Choose: ▪ Yes
▪ No

9

Night Sweats *

Spinner

Is
Mandatory Choose:

• Yes
  
• No

10

History of TB *

Spinner

Is
Mandatory Choose:

• Yes
  
• No

11

Are you currently taking Anti TB drugs **

Spinner

Is
Mandatory Choose:

• Yes
  
• No

Inform to ANM / MPW/ MO for tracing of Family members

12

Anyone in Family Currently Suffering from TB **

Spinner

Is
Mandatory Choose:

• Yes
  
• No

Inform to ANM / MPW/ MO for tracing of Family members

13

Submit

Button

▪

S.
No

Name of data
Field

Field Type

Value/ Options

Validation/ Logic/ Condition

1

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

2

Name

Textbox

Auto fill from Beneficiary details
Show: First Name + Last Name
Read only

3

Age

Textbox

Auto fill from Beneficiary details Read only

4

Sex

Textbox

Auto fill from Beneficiary details Read only

5

Is Sputum sample collected?

Spinner

Is Mandatory Choose:

• Yes
  
• No

6

Sputum sample submitted at

Spinner

Choose:

• DMC
  
• SC
  
• PHC

Enable if "Yes" is selected for 'Is Sputum sample collected?'

7

Nikshay ID

Textbox

Enable if "Yes" is selected for 'Is Sputum sample collected?'

8

Sputum Test result

Spinner

Choose:

• Positive
  
• Negative

Enable if "Yes" is selected for 'Is Sputum sample collected?'

If Test is positive refer to MO
Show alert Message: "Refer to MO"

9

Referred to facility

Spinner

Is Mandatory Choose:
▪Yes
▪ No

10

Facility Referral follow-ups

Textbox

11

Submit

Button