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F2 Monthly Malaria Report Form

This document is a monthly malaria report form used to collect data on malaria cases from health facilities. It collects information on the number of malaria tests conducted, the number of positive and negative malaria tests, the number of clinical diagnoses, and the total number of positive malaria cases for a given month. It also collects identifying information about the reporting health facility and is reviewed at both the rural health unit and provincial health office levels.

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Cha Tuban Diana
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2K views1 page

F2 Monthly Malaria Report Form

This document is a monthly malaria report form used to collect data on malaria cases from health facilities. It collects information on the number of malaria tests conducted, the number of positive and negative malaria tests, the number of clinical diagnoses, and the total number of positive malaria cases for a given month. It also collects identifying information about the reporting health facility and is reviewed at both the rural health unit and provincial health office levels.

Uploaded by

Cha Tuban Diana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Monthly Malaria Report Form

Philippine Malaria Information System (PhilMIS)

F2

Monthly Malaria Report Form (MMRF)


REPORT NO. (To be filled-up by Data Encoder)

MONTH AND YEAR


NAME OF FACILITY
PROVINCE
MUNICIPALITY
BARANGAY
DATE SUBMITTED
SUBMITTED TO

NAME OF PATIENT

SLIDE /RDT NO.

DIAGNOSIS

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NO. OF POSITIVE SLIDE:

NO. OF PATIENT TESTED


NEGATIVE FOR MALARIA

NO. OF RDT DONE :

WITHIN 24 HOURS:

NO. OF SLIDES EXAMINED :

NO. OF POSITIVE RDT:


NO. OF CLINICAL DIAGNOSIS:
TOTAL NO. OF POSITIVE CASES:
PREPARED BY:
DESIGNATION:
RECEIVED IN THE RHU BY :

REVIEWED IN THE RHU BY :

POSITION:

POSITION:

DATE RECEIVED:

DATE REVIEWED:

RECEIVED IN THE PHO BY:


(IF APPLICABLE)

REVIEWED IN THE PHO BY:


(IF APPLICABLE)

POSITION:
DATE RECEIVED:

POSITION:
DATE REVIEWED:

REMARK(S)

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