| HMIS form . | Reporting frequency . | Information on form . |
|---|---|---|
| Medical Form Five (MF5) | Daily | Captures patient's personal details and biodata, including: name, outpatient number, age, sex, tribe, village, parish, sub-county, district, telephone contact, next of kin, blood pressure, weight, height, BMI, blood sugar, Z-score, MUAC, diagnosis and treatment notes |
| HMIS Form 105 | Outpatient department, monthly reporting tool | Used to report on: depersonalised outpatient department attendance, referrals and diagnoses, maternal and child health, HIV/AIDS counselling and testing, safe male circumcision, essential medicines and health supplies, outpatient laboratory tests |
| HMIS Form 108 | Inpatient department, monthly reporting tool | Used to report on: depersonalised data of the inpatients, including: census information, referrals, major surgical procedures, minor surgical procedures, utilisation of special services, number of admissions and deaths by diagnosis, maternal conditions |
| HMIS Form 107 HMIS Form 033B | Annual report Surveillance form (weekly reporting) | Captures depersonalised data on: disease surveillance of patients, notifiable diseases/epidemics at outpatient department, maternal health, drug balances |
| HMIS Form 031 | Outpatient register (daily reporting) | Records: patient name, residence, age, sex, next of kin, MUAC, BMI, blood pressure, malaria test, tuberculosis, new diagnosis, drugs and treatment |
| HMIS Form 071 | Antenatal | |
| HMIS Form 106a | Health unit quarterly report | Captures depersonalised data on: HIV/ART services, nutrition quarterly cross-sectional report, tuberculosis/leprosy services, comments by health facility in charge |
| HMIS Form 009 | Nutrition addendum (monthly reporting) | Captures: nutrition addendum details |
| HMIS form . | Reporting frequency . | Information on form . |
|---|---|---|
| Medical Form Five (MF5) | Daily | Captures patient's personal details and biodata, including: name, outpatient number, age, sex, tribe, village, parish, sub-county, district, telephone contact, next of kin, blood pressure, weight, height, BMI, blood sugar, Z-score, MUAC, diagnosis and treatment notes |
| HMIS Form 105 | Outpatient department, monthly reporting tool | Used to report on: depersonalised outpatient department attendance, referrals and diagnoses, maternal and child health, HIV/AIDS counselling and testing, safe male circumcision, essential medicines and health supplies, outpatient laboratory tests |
| HMIS Form 108 | Inpatient department, monthly reporting tool | Used to report on: depersonalised data of the inpatients, including: census information, referrals, major surgical procedures, minor surgical procedures, utilisation of special services, number of admissions and deaths by diagnosis, maternal conditions |
| HMIS Form 107 HMIS Form 033B | Annual report Surveillance form (weekly reporting) | Captures depersonalised data on: disease surveillance of patients, notifiable diseases/epidemics at outpatient department, maternal health, drug balances |
| HMIS Form 031 | Outpatient register (daily reporting) | Records: patient name, residence, age, sex, next of kin, MUAC, BMI, blood pressure, malaria test, tuberculosis, new diagnosis, drugs and treatment |
| HMIS Form 071 | Antenatal | |
| HMIS Form 106a | Health unit quarterly report | Captures depersonalised data on: HIV/ART services, nutrition quarterly cross-sectional report, tuberculosis/leprosy services, comments by health facility in charge |
| HMIS Form 009 | Nutrition addendum (monthly reporting) | Captures: nutrition addendum details |