CBHI Form No.

2-A

 

 

 

 

 

 

 

 

 

 

Monthly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                 MONTHLY REPORT ON INSTITUTIONAL CASES AND DEATHS IN THE STATE / UT DUE TO

 

 

COMMUNICABLE DISEASES NOT COVERED UNDER ANY NATONAL HEALTH PROGRAMME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF THE STATE / UT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REPORTING MONTH & YEAR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total No. of Health/Medical

 

 

 

No. of Health/Medical Care Institutions Reported During the Month  

 

 

 

 

Care Institutions in the State/UT$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sl. No.

Name of Disease as per standard definition of case

ICD - 10

Code

Patients Reported/Treated During the Month

Total Deaths

 

Out-Patient

(OPD) Cases

In-Patient

(IPD)

Cases

Referred Amongst

Out-Patients

(OPD)

IPD Cases Reported

Direct

Total Cases

During the Reporting Month

 

M

F

M

F

M

F

M

F

Total

M

F

Total

 

1

2

3

4

5

6

7

8

9

10

(4+8)

11

(5+9)

12

   (10+11)

13

14

15

 

1

Cholera(Lab.  confirmed)

A00

 

 

 

 

 

 

 

 

  

 

 

 

 

2

Acute Diarrhoeal Diseases**

(including Gastro Enteritis Etc.)

A09

 

 

 

 

 

 

 

 

 

 

 

 

 

3

Diphtheria

A36

 

 

 

 

 

 

 

 

 

 

 

 

 

4

Tetanus other than Neonatal

A35

 

 

 

 

 

 

 

 

 

 

 

 

 

5

Neonatal Tetanus

A33

 

 

 

 

 

 

 

 

 

 

 

 

 

6

Whooping Cough

A37

 

 

 

 

 

 

 

 

 

 

 

 

 

7

Measles

B05

 

 

 

 

 

 

 

 

 

 

 

 

 

8

Acute Respiratory Infection(ARI)

(including Influenza and excluding Pneumonia)

J22

 

 

 

 

 

 

 

 

 

 

 

 

 

9

Pneumonia

J18

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Enteric Fever

A01

 

 

 

 

 

 

 

 

 

 

 

 

 

11

Viral Hepatitis - A

B15.9

 

 

 

 

 

 

 

 

 

 

 

 

 

12

Viral Hepatitis - B

B16.9

 

 

 

 

 

 

 

 

 

 

 

 

 

13

Viral Hepatitis - C,D, E

B17.8

 

 

 

 

 

 

 

 

 

 

 

 

 

14

Meningococcal Meningitis

A39.0

 

 

 

 

 

 

 

 

 

 

 

 

 

15

Rabies ***

A82

 

 

 

 

 

 

 

 

 

 

 

 

 

16

Syphilis

A50-A53

 

 

 

 

 

 

 

 

 

 

 

 

 

17

Gonococcal Infection

A54

 

 

 

 

 

 

 

 

 

 

 

 

 

18

Others(Specify) :-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18.1

Swine Flue (H1 N1)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18.2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18.3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M-Male,    F - Female,   T-Total

 

 

 

 

 

 

 

 

NOTES:

 

 

 

 

 

 

 

 

 

 

 

 

 

$

All the health/medical institutions i.e. Hospitals, Dispensaries, Clinics, PHCs, CHCs, Sanatoria etc. to be covered.

 

 

The cases and deaths due to various diseases other than those treated in Medical/ Health Institutions, whenever reported / recorded should also be included in this report.

 

 

 

**

Acute diarrhoeal disease should include all Gastro Enteritis Cases i.e. cases with three or more loose watery

motions in a day, irrespective of aetiology / causation, except Cholera to be reported separately.

 

 

 

***

Only confirmed cases of Rabies i.e. Hydrophobia, should be included and not the simple dog-bite/animal bite cases

 

 

 Data on vaccine preventable disease should tally with Universal Immunization Program (UIP) data being furnished by

State EPI (Extended Program of Immunisation) officer to Min. of Health & FW/GOI.

 

 

 

This Monthly Report should be communicated Online http://www.cbhidghs.nic.in/   to CBHI positively by 20th of the succeeding            

month. In case it is not at all possible for Online data transmission, then send through e-mail- javascript:main.compose('new','t=dircbhi@nb.nic.in')  OR Fax 011 –23061529/

 

23063175  to CBHI by 20th of succeeding month, positively.

 

 

 

 

To

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Director
Central Bureau of Health Intelligence(CBHI), Dte.GHS/GOI, Room No. 401 - A Wing,
Nirman Bhavan, New Delhi – 110108.

Website/Online http://www.cbhidghs.nic.in/
E-Mail: javascript:main.compose('new','t=dircbhi@nb.nic.in')
Tel/ Fax: 91-011-23061529 / 23063175

 

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