NewNew Screening History Monitor

Edit Child Screening

Priscilla dozoe

Demographics

Child's Name*

Parent / Guardian Name

Guardian Phone Number

Age (years)

Age (months)

Sex

NHIS Status

NHIS Number

Vitals

Weight (kg)

Height (cm)

BMI (auto)

14.3Normalz -0.72

Pulse (bpm)

Temperature (°C)

Hb (g/dL)

Clinical

Complaint

Complaint Duration

Examination Findings

Treatment Plan