mmu mandatory disclosure formats monthly …...18 fatepura state gov. gj-18-g-3936 25 25 75 2 1888 6...

22
Month April Year Planned Actual OCP/ ECP Condom IUCD 1 Surendranagar Limbadi State Gov. GJ-18-G-3931 25 25 75 1 1249 11 0 0 10 0 0 0 0 235 314 0 0 0 2 Patan Sami State Gov. GJ-18-G-3918 25 25 77 1 1555 18 0 30 19 0 0 0 0 139 247 0 0 7 3 Idar State Gov. GJ-18-G-3919 25 25 75 1 1416 15 0 1 15 0 0 0 0 87 122 0 0 2 4 Khedbhrama GJ-18-G-3920 25 25 43 4 3087 62 0 0 0 0 0 0 0 340 507 2 0 9 5 Vijaynagar GJ-18-G-3921 25 25 59 4 2080 12 0 0 0 0 0 0 0 68 172 0 0 71 6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 25 25 76 1 1997 24 0 7 11 0 0 0 0 115 239 0 0 1 7 Deyodar State Gov. GJ-18-G-3924 25 22 51 2 972 7 0 5 9 0 0 0 0 126 151 0 0 2 8 Dhanera State Gov. GJ-18-G 8049 25 25 75 3 1558 23 0 2 8 0 0 0 0 172 182 0 0 1 9 Amirgadh State Gov. GJ-18-G-3922 25 25 97 2 1713 16 0 0 9 0 0 0 0 76 141 0 0 3 10 Danta State Gov. GJ-18-G-3923 25 25 72 1 1321 19 0 0 12 0 0 0 0 135 150 1 0 4 11 Kawant MMU-1 PPP Mode (Deepak Foundation) GJ-18-G-3925 27 27 58 7 1876 61 0 14 0 0 0 0 0 297 360 1 0 5 12 Kawant MMU-2 State Gov. GJ-18-G-3932 25 25 87 1 1555 28 0 0 9 0 0 0 0 370 424 0 0 0 13 Shahera State Gov. GJ-18-G 8050 25 25 74 2 1860 9 0 1 31 0 0 0 0 332 393 0 0 2 14 Morva State Gov. GJ-18-G-3933 25 20 60 3 1434 10 0 4 14 0 0 0 0 246 311 0 0 20 15 Mahisagar (Lunavada) Kadana State Gov. GJ-18-G-3934 25 25 75 2 1908 9 0 0 11 0 0 0 0 146 286 0 0 0 16 Garbada State Gov. GJ-18-G-3935 25 25 75 1 1702 6 0 0 12 0 0 0 0 179 228 0 0 0 17 Limkheda State Gov. GJ-18-G 8051 25 25 75 1 2002 5 0 0 13 0 0 0 0 212 410 4 0 5 MMU Mandatory Disclosure Formats Monthly Reporting Format Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required. 2017-18 S. No of District District MMU Type (Single/ 2/3 vehicle unit) Name of operating agency (State DHS/NGO /Private Provider) Please provide name if NGO or private Registration Number Number of Trips No. of X ray No. of patients referred to higher facilities No. of children screened under RBSK No. of Lab tests No. of blood smears collected / RDT tests done for Malaria No. of sputum collected for TB detection No. of minor surgical operations No. of children screened for refractive errors No. of FP cases Number of Villages visited Number of AWCs covered No. of OPD No. of ANC No. of children immunized (if applicable) PPP Mode (Vishvakalyan Society, Idar) Sabarkantha Banaskantha Chhota Udepur Panchmahal Dahod

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Page 1: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month April Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 25 25 75 1 1249 11 0 0 10 0 0 0 0 235 314 0 0 0

2 Patan Sami State Gov. GJ-18-G-3918 25 25 77 1 1555 18 0 30 19 0 0 0 0 139 247 0 0 7

3 Idar State Gov. GJ-18-G-3919 25 25 75 1 1416 15 0 1 15 0 0 0 0 87 122 0 0 2

4 Khedbhrama GJ-18-G-3920 25 25 43 4 3087 62 0 0 0 0 0 0 0 340 507 2 0 9

5 Vijaynagar GJ-18-G-3921 25 25 59 4 2080 12 0 0 0 0 0 0 0 68 172 0 0 71

6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 25 25 76 1 1997 24 0 7 11 0 0 0 0 115 239 0 0 1

7 Deyodar State Gov. GJ-18-G-3924 25 22 51 2 972 7 0 5 9 0 0 0 0 126 151 0 0 2

8 Dhanera State Gov. GJ-18-G 8049 25 25 75 3 1558 23 0 2 8 0 0 0 0 172 182 0 0 1

9 Amirgadh State Gov. GJ-18-G-3922 25 25 97 2 1713 16 0 0 9 0 0 0 0 76 141 0 0 3

10 Danta State Gov. GJ-18-G-3923 25 25 72 1 1321 19 0 0 12 0 0 0 0 135 150 1 0 4

11 Kawant MMU-1PPP Mode

(Deepak Foundation) GJ-18-G-3925 27 27 58 7 1876 61 0 14 0 0 0 0 0 297 360 1 0 5

12 Kawant MMU-2 State Gov. GJ-18-G-3932 25 25 87 1 1555 28 0 0 9 0 0 0 0 370 424 0 0 0

13 Shahera State Gov. GJ-18-G 8050 25 25 74 2 1860 9 0 1 31 0 0 0 0 332 393 0 0 2

14 Morva State Gov. GJ-18-G-3933 25 20 60 3 1434 10 0 4 14 0 0 0 0 246 311 0 0 20

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 25 25 75 2 1908 9 0 0 11 0 0 0 0 146 286 0 0 0

16 Garbada State Gov. GJ-18-G-3935 25 25 75 1 1702 6 0 0 12 0 0 0 0 179 228 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 25 25 75 1 2002 5 0 0 13 0 0 0 0 212 410 4 0 5

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No. of FP cases

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

PPP Mode (Vishvakalyan Society, Idar)

Sabarkantha

Banaskantha

Chhota Udepur

Panchmahal

Dahod

Page 2: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No. of FP cases

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13

19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074 12 0 0 10 0 0 0 0 184 220 1 0 2

20 Valia State Gov. GJ-18-G-3938 25 25 75 1 2208 7 0 0 12 0 0 0 0 180 207 0 0 6

21 Dediapada State Gov. GJ-18-G-3939 25 25 71 1 2792 15 0 8 20 0 0 0 0 441 622 2 0 0

22 Sagbara State Gov. GJ-18-G-3940 25 25 54 1 1809 6 0 8 11 0 0 0 0 282 363 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 25 25 72 1 1912 12 0 0 10 0 0 0 0 227 251 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 25 25 75 2 2215 7 0 3 18 0 0 0 0 391 571 0 0 3

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26 Tapi Nizer State Gov. GJ-18-G-3941 25 25 50 1 2101 12 0 0 10 0 0 0 0 245 261 0 0 1

27 Porbandar Ranavav State Gov. GJ-18-G-3926 25 25 65 1 1501 8 0 0 14 0 0 0 0 120 131 0 0 7

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 25 25 50 2 2031 13 0 0 10 0 0 0 0 185 428 0 0 0

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 25 25 71 2 1406 5 0 0 10 0 0 0 0 122 166 0 0 0

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 21 21 49 6 1237 45 0 26 0 0 0 0 0 8 23 0 0 0

Surat

Bharuch

Narmada

Page 3: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month May Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 27 27 81 3 1411 12 0 0 10 0 0 0 0 186 225 0 0 0

2 Patan Sami State Gov. GJ-18-G-3918 27 26 82 1 1612 18 0 23 11 0 0 0 0 174 305 0 0 7

3 Idar State Gov. GJ-18-G-3919 27 27 81 2 1388 11 0 2 14 0 0 0 0 89 131 0 0 2

4 Khedbhrama GJ-18-G-3920 27 27 48 0 3253 51 0 0 0 0 0 0 0 434 603 0 0 12

5 Vijaynagar GJ-18-G-3921 27 27 64 3 2014 6 0 0 0 0 0 0 0 61 123 1 0 69

6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 27 27 81 2 1871 15 0 4 10 0 0 0 0 121 225 0 0 2

7 Deyodar State Gov. GJ-18-G-3924 27 26 60 1 1139 14 0 6 16 0 0 0 0 130 153 0 0 1

8 Dhanera State Gov. GJ-18-G 8049 27 26 78 2 1455 16 0 3 15 0 0 0 0 115 133 0 0 7

9 Amirgadh State Gov. GJ-18-G-3922 27 25 94 2 1528 11 0 0 20 0 0 0 0 78 125 0 0 1

10 Danta State Gov. GJ-18-G-3923 27 27 76 1 1599 12 0 0 9 0 0 0 0 101 118 0 0 19

11 Kawant MMU-1PPP Mode

(Deepak Foundation) GJ-18-G-3925 24 24 63 7 1929 72 0 16 0 0 0 0 0 337 422 2 0 5

12 Kawant MMU-2 State Gov. GJ-18-G-3932 27 27 69 3 2303 18 0 0 12 0 0 0 0 434 474 1 0 4

13 Shahera State Gov. GJ-18-G 8050 27 27 81 1 2035 14 0 5 34 0 0 0 0 328 475 0 0 6

14 Morva State Gov. GJ-18-G-3933 27 27 81 2 2160 18 0 2 10 0 0 0 0 238 300 3 0 22

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 27 26 78 2 1913 16 0 0 11 0 0 0 0 115 277 0 0 0

16 Garbada State Gov. GJ-18-G-3935 27 27 81 3 2001 13 0 0 14 0 0 0 0 221 276 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 27 27 81 1 1973 12 0 0 13 0 0 0 0 239 496 0 0 0

Panchmahal

Dahod

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

Page 4: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

18 Fatepura State Gov. GJ-18-G-3936 27 26 78 1 2207 16 0 2 12 0 0 0 0 190 326 2 0 13

19 Jhagadia State Gov. GJ-18-G-3937 27 27 83 2 2222 15 0 0 13 0 0 0 0 257 283 0 0 1

20 Valia State Gov. GJ-18-G-3938 27 27 81 2 2238 14 0 1 16 0 0 0 0 193 226 0 0 5

21 Dediapada State Gov. GJ-18-G-3939 27 27 76 2 2015 16 0 5 16 0 0 0 0 322 536 0 0 1

22 Sagbara State Gov. GJ-18-G-3940 27 27 58 1 1948 14 0 11 23 0 0 0 0 400 506 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 27 27 75 1 2013 11 0 0 10 0 0 0 0 232 264 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 27 27 81 1 2571 11 0 4 17 0 0 0 0 417 606 0 0 11

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 23 8 24 2 626 2 0 0 0 0 0 0 0 14 14 0 0 5

26 Tapi Nizer State Gov. GJ-18-G-3941 27 27 54 1 2404 15 0 0 12 0 0 0 0 264 295 1 0 4

27 Porbandar Ranavav State Gov. GJ-18-G-3926 27 27 69 1 1302 17 0 1 12 0 0 0 0 96 118 1 0 13

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 27 27 54 1 2069 10 0 0 20 0 0 0 0 181 311 0 0 0

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 27 25 69 4 1293 16 0 0 10 0 0 0 0 120 196 0 0 1

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 22 21 48 0 1004 33 0 33 0 0 0 0 0 15 19 0 0 0

Bharuch

Narmada

Surat

Page 5: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month June Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 25 25 75 2 1375 10 0 10 10 0 0 0 0 222 283 0 0 0

2 Patan Sami State Gov. GJ-18-G-3918 25 25 79 2 1431 22 0 15 12 0 0 0 0 128 229 0 0 6

3 Idar State Gov. GJ-18-G-3919 25 24 72 2 1287 11 0 12 15 0 0 0 0 64 117 0 0 0

4 Khedbhrama GJ-18-G-3920 26 26 44 1 2624 29 0 0 0 0 0 0 0 188 315 0 0 2

5 Vijaynagar GJ-18-G-3921 26 26 59 4 2418 3 0 0 0 0 0 0 0 59 120 0 0 88

6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 25 24 71 4 1718 21 0 15 17 0 0 0 0 101 215 0 0 0

7 Deyodar State Gov. GJ-18-G-3924 25 25 58 3 1134 14 0 15 13 0 0 0 0 128 187 0 0 3

8 Dhanera State Gov. GJ-18-G 8049 25 25 73 2 1415 22 0 12 10 0 0 0 0 160 169 0 0 5

9 Amirgadh State Gov. GJ-18-G-3922 25 25 93 1 1459 18 0 10 11 0 0 0 0 86 123 0 0 1

10 Danta State Gov. GJ-18-G-3923 25 25 71 2 1184 12 0 10 11 0 0 0 0 122 131 0 0 1

11 Kawant MMU-1PPP Mode

(Deepak Foundation) GJ-18-G-3925 22 22 59 12 2102 64 0 15 0 0 0 0 0 299 374 1 0 3

12 Kawant MMU-2 State Gov. GJ-18-G-3932 25 24 67 2 2017 22 0 11 11 0 0 0 0 418 490 2 0 0

13 Shahera State Gov. GJ-18-G 8050 25 25 73 2 2129 21 0 17 24 0 0 0 0 351 542 0 0 2

14 Morva State Gov. GJ-18-G-3933 25 25 75 1 2192 16 0 11 11 0 0 0 0 208 239 1 0 14

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 25 25 75 3 1963 15 0 11 9 0 0 0 0 137 269 0 0 0

16 Garbada State Gov. GJ-18-G-3935 25 25 75 2 1907 12 0 12 12 0 0 0 0 209 238 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 25 25 75 2 1954 13 0 11 15 0 0 0 0 265 493 0 0 5

Panchmahal

Dahod

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

Page 6: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases S.

No

of D

istr

ict

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

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of b

lood

sm

ears

col

lect

ed

/ RD

T te

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for M

alar

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No.

of s

putu

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olle

cted

for

TB d

etec

tion

18 Fatepura State Gov. GJ-18-G-3936 25 25 75 1 2231 16 0 12 12 0 0 0 0 188 311 0 0 4

19 Jhagadia State Gov. GJ-18-G-3937 25 25 78 3 2150 10 0 9 9 0 0 0 0 370 414 0 0 2

20 Valia State Gov. GJ-18-G-3938 25 25 75 2 2367 13 0 10 10 0 0 0 0 302 343 0 0 5

21 Dediapada State Gov. GJ-18-G-3939 25 25 71 3 2030 12 0 10 11 0 0 0 0 368 506 0 0 0

22 Sagbara State Gov. GJ-18-G-3940 25 25 54 2 1783 10 0 13 17 0 0 0 0 361 422 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 25 25 69 1 2053 15 0 10 12 0 0 0 0 337 434 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 25 25 75 1 2413 10 0 12 13 0 0 0 0 343 502 0 0 6

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 21 11 33 3 1042 2 0 0 0 0 0 0 0 26 26 0 0 7

26 Tapi Nizer State Gov. GJ-18-G-3941 25 25 50 2 2491 16 0 11 12 0 0 0 0 363 380 0 0 0

27 Porbandar Ranavav State Gov. GJ-18-G-3926 25 25 65 2 1152 12 0 9 9 0 0 0 0 129 141 0 0 5

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 25 24 48 2 1752 13 0 11 18 0 0 0 0 156 391 0 0 1

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 25 25 70 1 1177 17 0 10 9 0 0 0 0 145 252 0 0 0

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 22 17 37 0 703 17 0 13 0 0 0 0 0 9 12 0 0 0

Bharuch

Narmada

Surat

Page 7: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month July Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 26 26 73 2 1744 9 0 4 9 0 0 0 0 297 378 0 0 0

2 Patan Sami State Gov. GJ-18-G-3918 26 26 65 1 1233 6 0 7 11 0 0 0 0 83 145 0 0 1

3 Idar State Gov. GJ-18-G-3919 26 26 78 1 1541 11 0 10 19 0 0 0 0 81 125 0 0 0

4 Khedbhrama GJ-18-G-3920 26 24 42 2 4693 52 0 0 0 0 0 0 0 240 402 0 0 2

5 Vijaynagar GJ-18-G-3921 26 25 57 7 4124 9 0 0 0 0 0 0 0 77 143 0 0 76

6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 26 26 78 1 2445 22 0 5 14 0 0 0 0 92 177 0 0 1

7 Deyodar State Gov. GJ-18-G-3924 25 25 52 2 1034 11 0 11 11 0 0 0 0 115 177 0 0 2

8 Dhanera State Gov. GJ-18-G 8049 25 24 51 1 1204 6 0 1 11 0 0 0 0 120 128 0 0 2

9 Amirgadh State Gov. GJ-18-G-3922 25 25 78 2 1294 5 0 5 10 0 0 0 0 109 134 0 0 0

10 Danta State Gov. GJ-18-G-3923 25 25 69 1 1306 7 0 10 8 0 0 0 0 150 155 1 0 3

11 Kawant MMU-1PPP Mode

(Deepak Foundation) GJ-18-G-3925 26 25 63 8 2128 40 0 13 4 0 0 0 0 375 407 0 0 0

12 Kawant MMU-2 State Gov. GJ-18-G-3932 23 23 56 1 2243 18 0 3 9 0 0 0 0 396 505 0 0 10

13 Shahera State Gov. GJ-18-G 8050 26 26 78 1 2646 16 0 3 30 0 0 0 0 377 552 0 0 2

14 Morva State Gov. GJ-18-G-3933 26 26 78 2 2335 7 0 6 12 0 0 0 0 247 278 2 0 2

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 26 26 78 1 2084 14 0 8 12 0 0 0 0 294 350 0 0 0

16 Garbada State Gov. GJ-18-G-3935 26 26 78 2 2079 13 0 12 15 0 0 0 0 185 348 0 0 1

17 Limkheda State Gov. GJ-18-G 8051 26 26 78 2 2350 12 0 10 14 0 0 0 0 363 570 0 0 2

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

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tric

t

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(Sin

gle/

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veh

icle

un

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g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

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of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

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of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

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of c

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ren

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ened

un

der R

BSK

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of L

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ber o

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PD

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NC

No.

of c

hild

ren

imm

uniz

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f ap

plic

able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

Panchmahal

Dahod

Page 8: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

S. N

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e of

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ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

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of s

putu

m c

olle

cted

for

TB d

etec

tion

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of m

inor

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gica

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ions

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of c

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for

refr

activ

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rors

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of c

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BSK

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ber o

f Vill

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f ap

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No. of FP cases

18 Fatepura State Gov. GJ-18-G-3936 26 26 78 3 2580 10 0 9 12 0 0 0 0 217 363 2 0 10

19 Jhagadia State Gov. GJ-18-G-3937 26 26 83 2 2417 9 0 4 11 0 0 0 0 379 536 0 0 1

20 Valia State Gov. GJ-18-G-3938 26 26 78 1 2615 9 0 6 12 0 0 0 0 379 437 0 0 3

21 Dediapada State Gov. GJ-18-G-3939 26 26 74 1 2188 13 0 2 7 0 0 0 0 348 557 0 0 0

22 Sagbara State Gov. GJ-18-G-3940 26 26 56 2 2013 10 0 3 14 0 0 0 0 311 353 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 26 26 75 1 2424 9 0 9 10 0 0 0 0 438 564 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 26 26 78 1 3044 5 0 12 12 0 0 0 0 550 616 0 0 3

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 22 13.5 43 4 1470 3 0 0 0 0 0 0 0 53 53 0 0 14

26 Tapi Nizer State Gov. GJ-18-G-3941 26 26 52 1 2985 11 0 7 12 0 0 0 0 429 456 0 0 2

27 Porbandar Ranavav State Gov. GJ-18-G-3926 26 26 62 2 1159 3 0 10 9 0 0 0 0 138 155 0 0 6

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 26 26 52 4 2208 16 0 4 10 0 0 0 0 192 461 0 0 1

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 26 24 68 1 1648 12 0 6 9 0 0 0 0 181 294 0 0 0

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 15 13 23 0 771 14 0 12 0 0 0 0 0 11 14 0 0 0

Bharuch

Narmada

Surat

Page 9: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month August Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 25 25 75 1 2044 11 0 5 10 0 0 0 0 268 324 0 0 0

2 Patan Sami State Gov. GJ-18-G-3918 25 20 63 1 1773 13 0 6 11 0 0 0 0 102 139 1 0 4

3 Idar State Gov. GJ-18-G-3919 25 24 72 1 1749 13 0 6 13 0 0 0 0 79 118 0 0 0

4 Khedbhrama GJ-18-G-3920 26 26 45 4 6221 94 0 0 0 0 0 0 0 360 533 0 0 1

5 Vijaynagar GJ-18-G-3921 25 25 59 5 3379 10 0 0 0 0 0 0 0 144 345 0 0 63

6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 25 25 75 1 2737 17 0 8 13 0 0 0 0 124 281 0 0 0

7 Deyodar State Gov. GJ-18-G-3924 25 24 53 2 1180 12 0 5 9 0 0 0 0 122 151 0 0 1

8 Dhanera State Gov. GJ-18-G 8049 25 6 15 1 419 16 0 4 10 0 0 0 0 65 76 0 0 0

9 Amirgadh State Gov. GJ-18-G-3922 25 22 79 1 1365 13 0 6 9 0 0 0 0 114 147 0 0 0

10 Danta State Gov. GJ-18-G-3923 25 25 72 1 1489 15 0 8 11 0 0 0 0 72 88 0 0 0

11 Kawant MMU-1PPP Mode

(Deepak Foundation) GJ-18-G-3925 19 19 47 7 2146 29 0 8 0 0 0 0 0 242 283 0 0 4

12 Kawant MMU-2 State Gov. GJ-18-G-3932 25 25 65 1 2092 16 0 5 14 0 0 0 0 412 478 0 0 0

13 Shahera State Gov. GJ-18-G 8050 25 25 75 3 2750 15 0 5 20 0 0 0 0 403 509 0 0 1

14 Morva State Gov. GJ-18-G-3933 25 25 75 2 2255 12 0 6 9 0 0 0 0 282 331 0 0 1

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 25 25 75 2 2056 18 0 5 17 0 0 0 0 310 401 0 0 0

16 Garbada State Gov. GJ-18-G-3935 25 25 75 1 1957 17 0 6 9 0 0 0 0 140 289 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 25 25 75 1 1954 14 0 7 8 0 0 0 0 335 482 0 0 2

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

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U T

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(Sin

gle/

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veh

icle

un

it)

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e of

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ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

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of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

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rors

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un

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BSK

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of L

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ber o

f Vill

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ber o

f AW

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cove

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PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

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able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

Panchmahal

Dahod

Page 10: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

S. N

o of

Dis

tric

t

Dis

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MM

U T

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gle/

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icle

un

it)

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e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

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of b

lood

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lect

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/ RD

T te

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done

for M

alar

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of s

putu

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olle

cted

for

TB d

etec

tion

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inor

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erat

ions

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of c

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BSK

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imm

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f ap

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No. of FP cases

18 Fatepura State Gov. GJ-18-G-3936 25 25 73 1 2476 16 0 8 8 0 0 0 0 245 277 2 0 14

19 Jhagadia State Gov. GJ-18-G-3937 25 25 80 2 2590 17 0 6 12 0 0 0 0 296 565 0 0 0

20 Valia State Gov. GJ-18-G-3938 25 25 75 1 2882 13 0 5 15 0 0 0 0 422 493 0 0 3

21 Dediapada State Gov. GJ-18-G-3939 25 25 70 1 2099 17 0 8 9 0 0 0 0 389 535 0 0 0

22 Sagbara State Gov. GJ-18-G-3940 25 25 54 1 2273 14 0 9 12 0 0 0 0 475 528 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 25 25 70 1 2402 16 0 5 12 0 0 0 0 385 481 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 25 25 75 1 3205 16 0 4 16 0 0 0 0 497 567 0 0 5

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 19 11 35 4 1449 5 0 0 0 0 0 0 0 38 38 0 0 3

26 Tapi Nizer State Gov. GJ-18-G-3941 25 25 50 1 3356 11 0 7 10 0 0 0 0 382 407 1 0 5

27 Porbandar Ranavav State Gov. GJ-18-G-3926 25 25 63 1 1166 11 0 5 10 0 0 0 0 118 130 0 0 4

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 25 25 46 1 2281 16 0 5 12 0 0 0 0 164 347 0 0 1

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 25 25 70 1 1752 13 0 7 10 0 0 0 0 250 319 0 0 0

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 13 11 27 0 986 23 0 0 0 0 0 0 0 31 31 1 0 1

Bharuch

Narmada

Surat

Page 11: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month September Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 25 24 72 2 1795 10 0 8 10 0 0 0 0 230 279 0 0 1

2 Patan Sami State Gov. GJ-18-G-3918 25 14 47 2 983 19 0 6 11 0 0 0 0 118 206 0 0 0

3 Idar State Gov. GJ-18-G-3919 25 25 75 1 1728 11 0 7 11 0 0 0 0 94 154 0 0 1

4 Khedbhrama GJ-18-G-3920 26 26 45 5 7529 120 0 0 0 0 0 0 0 480 743 0 0 5

5 Vijaynagar GJ-18-G-3921 26 26 61 6 4017 11 0 0 0 0 0 0 0 163 426 0 0 118

6Arvalli (Modasa)

Meghraj State Gov. GJ-18-G 8053 25 24 74 1 2479 18 0 9 12 0 0 0 0 82 171 0 0 0

7 Deyodar State Gov. GJ-18-G-3924 26 26 47 3 1201 12 0 9 10 0 0 0 0 180 205 0 0 0

8 Dhanera State Gov. GJ-18-G 8049 25 25 75 2 1496 15 0 7 11 0 0 0 0 281 296 0 0 0

9 Amirgadh State Gov. GJ-18-G-3922 25 25 60 1 1576 13 0 7 10 0 0 0 0 161 202 0 0 0

10 Danta State Gov. GJ-18-G-3923 25 25 50 2 1754 14 0 8 11 0 0 0 0 247 280 0 0 0

11 Kawant MMU-1PPP Mode(Deepak

Foundation)GJ-18-G-3925 21 21 53 4 2503 28 0 16 0 0 0 0 0 221 249 1 0 7

12 Kawant MMU-2 State Gov. GJ-18-G-3932 25 23 58 1 1919 15 0 8 9 0 0 0 0 343 405 1 0 0

13 Shahera State Gov. GJ-18-G 8050 25 25 75 2 2408 16 0 7 17 0 0 0 0 349 503 0 0 5

14 Morva State Gov. GJ-18-G-3933 25 23 69 1 2092 17 0 7 8 0 0 0 0 305 350 0 0 2

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 25 23 69 1 2041 11 0 6 11 0 0 0 0 322 429 0 0 1

16 Garbada State Gov. GJ-18-G-3935 25 24 71 2 1949 19 0 8 10 0 0 0 0 203 360 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 25 23 69 1 2012 17 0 9 16 0 0 0 0 369 537 0 0 1

18 Fatepura State Gov. GJ-18-G-3936 25 23 69 1 2222 12 0 7 10 0 0 0 0 261 378 5 0 14

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

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tric

t

Dis

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MM

U T

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(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

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ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for T

B

dete

ctio

n

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

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for

refr

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BSK

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of L

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ber o

f Vill

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of A

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No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

Panchmahal

Dahod

Page 12: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

19 Jhagadia State Gov. GJ-18-G-3937 25 25 79 2 2865 13 0 6 9 0 0 0 0 286 522 0 0 0

20 Valia State Gov. GJ-18-G-3938 25 25 75 1 2857 12 0 8 10 0 0 0 0 398 457 0 0 0

21 Dediapada State Gov. GJ-18-G-3939 25 25 71 1 2148 15 0 6 15 0 0 0 0 350 488 0 0 0

22 Sagbara State Gov. GJ-18-G-3940 25 25 53 1 2061 15 0 7 13 0 0 0 0 276 334 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 25 25 71 1 2453 12 0 6 9 0 0 0 0 337 434 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 25 25 75 2 3042 14 0 7 13 0 0 0 0 458 482 0 0 0

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 5 3 8 2 292 0 0 0 0 0 0 0 0 0 0 0 0 2

26 Tapi Nizer State Gov. GJ-18-G-3941 25 25 50 2 3621 16 0 8 9 0 0 0 0 379 420 0 0 1

27 Porbandar Ranavav State Gov. GJ-18-G-3926 25 24 59 1 1566 11 0 7 11 0 0 0 0 205 228 1 0 2

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 25 25 50 2 2931 17 0 9 12 0 0 0 0 240 460 0 0 0

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 25 25 71 2 1784 11 0 8 9 0 0 0 0 228 308 0 0 13

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 18 16 33 0 1353 33 0 24 0 0 0 0 0 86 86 1 0 0

Bharuch

Narmada

Surat

Page 13: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month October Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

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IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 23 22 66 1 1601 12 0 8 12 0 0 0 0 225 275 0 0 0

2 Patan Sami State Gov. GJ-18-G-3918 23 23 72 1 1353 12 0 8 11 0 0 0 0 113 179 1 0 3

3 Idar State Gov. GJ-18-G-3919 23 23 69 1 1610 12 0 10 14 0 0 0 0 80 124 0 0 1

4 Khedbhrama GJ-18-G-3920 20 20 32 1 4302 49 0 0 0 0 0 0 0 331 541 0 0 0

5 Vijaynagar GJ-18-G-3921 20 20 50 5 2331 4 0 0 0 0 0 0 0 116 315 0 0 10

6Arvalli (Modasa)

Meghraj State Gov. GJ-18-G 8053 23 23 69 2 2041 11 0 9 12 0 0 0 0 87 180 0 0 0

7 Deyodar State Gov. GJ-18-G-3924 23 23 54 2 1077 12 0 9 15 0 0 0 0 151 175 0 0 1

8 Dhanera State Gov. GJ-18-G 8049 23 23 69 1 1297 14 0 8 10 0 0 0 0 271 290 0 0 0

9 Amirgadh State Gov. GJ-18-G-3922 23 22 77 1 1298 14 0 9 9 0 0 0 0 164 248 0 0 0

10 Danta State Gov. GJ-18-G-3923 23 23 65 1 1732 14 0 11 11 0 0 0 0 223 263 0 0 0

11 Kawant MMU-1PPP Mode(Deepak

Foundation)GJ-18-G-3925 17 17 40 17 1496 25 0 0 0 0 0 0 0 126 153 1 0 7

12 Kawant MMU-2 State Gov. GJ-18-G-3932 23 23 59 1 1935 28 0 9 10 0 0 0 0 379 414 3 0 0

13 Shahera State Gov. GJ-18-G 8050 23 22 66 1 1811 15 0 8 28 0 0 0 0 293 426 0 0 0

14 Morva State Gov. GJ-18-G-3933 23 22 66 2 1557 16 0 10 10 0 0 0 0 245 292 1 0 1

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 23 23 68 2 1857 13 0 8 13 0 0 0 0 238 405 0 0 0

16 Garbada State Gov. GJ-18-G-3935 23 22 66 1 1580 13 0 7 10 0 0 0 0 132 245 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 23 23 69 2 1770 17 0 8 15 0 0 0 0 304 490 0 0 0

18 Fatepura State Gov. GJ-18-G-3936 23 23 69 1 1812 12 0 7 12 0 0 0 0 221 299 2 0 9

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for T

B

dete

ctio

n

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

Panchmahal

Dahod

Page 14: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for T

B

dete

ctio

n

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

19 Jhagadia State Gov. GJ-18-G-3937 23 23 74 1 2711 14 0 8 12 0 0 0 0 315 537 0 0 0

20 Valia State Gov. GJ-18-G-3938 23 23 69 1 2385 12 0 7 11 0 0 0 0 347 362 0 0 0

21 Dediapada State Gov. GJ-18-G-3939 23 21 57 2 1657 16 0 7 14 0 0 0 0 267 394 0 0 0

22 Sagbara State Gov. GJ-18-G-3940 23 22 49 1 1705 15 0 7 13 0 0 0 0 319 393 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 23 23 63 1 2158 11 0 8 12 0 0 0 0 279 349 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 23 23 69 3 2552 12 0 9 10 0 0 0 0 415 449 0 0 0

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26 Tapi Nizer State Gov. GJ-18-G-3941 23 23 46 3 2802 13 0 6 11 0 0 0 0 314 387 0 0 1

27 Porbandar Ranavav State Gov. GJ-18-G-3926 23 23 55 2 1350 12 0 9 11 0 0 0 0 165 181 0 0 4

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 23 23 43 2 1728 15 0 8 14 0 0 0 0 214 462 0 0 0

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 23 23 65 1 1350 15 0 8 14 0 0 0 0 228 290 0 0 7

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 18 16 33 7 1566 48 0 21 0 0 0 0 0 210 246 1 0 0

Bharuch

Narmada

Surat

Page 15: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month November Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 25 25 75 4 1816 13 0 7 12 0 0 0 0 233 313 0 0 1

2 Patan Sami State Gov. GJ-18-G-3918 25 25 78 3 1566 23 0 13 9 0 0 0 0 133 219 0 0 6

3 Idar State Gov. GJ-18-G-3919 25 25 75 1 1602 12 0 8 12 0 0 0 0 80 123 0 0 0

4 Khedbhrama GJ-18-G-3920 26 24 43 3 4340 63 0 0 0 0 0 0 0 283 457 0 0 6

5 Vijaynagar GJ-18-G-3921 26 25 59 4 2484 2 0 0 0 0 0 0 0 108 226 0 0 39

6Arvalli (Modasa)

Meghraj State Gov. GJ-18-G 8053 25 25 76 11 2246 41 0 7 14 0 0 0 0 235 496 0 0 0

7 Deyodar State Gov. GJ-18-G-3924 25 25 57 1 1224 10 0 7 12 0 0 0 0 178 197 0 0 1

8 Dhanera State Gov. GJ-18-G 8049 25 25 75 1 1438 16 0 9 9 0 0 0 0 280 287 0 0 5

9 Amirgadh State Gov. GJ-18-G-3922 25 25 88 1 1619 13 0 8 12 0 0 0 0 158 256 0 0 1

10 Danta State Gov. GJ-18-G-3923 25 23 65 1 1462 13 0 7 9 0 0 0 0 161 170 0 0 0

11 Kawant MMU-1PPP Mode(Deepak

Foundation)GJ-18-G-3925 23 23 57 12 1881 26 0 22 0 0 0 0 0 166 197 1 0 9

12 Kawant MMU-2 State Gov. GJ-18-G-3932 25 25 67 16 2236 14 0 7 12 0 0 0 0 337 393 1 0 0

13 Shahera State Gov. GJ-18-G 8050 25 25 75 13 2301 26 0 6 35 0 0 0 0 348 545 0 0 13

14 Morva State Gov. GJ-18-G-3933 25 25 73 12 1913 10 0 8 12 0 0 0 0 279 359 0 0 1

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 25 25 75 10 2232 10 0 9 16 0 0 0 0 239 413 0 0 0

16 Garbada State Gov. GJ-18-G-3935 25 25 75 8 2022 13 0 6 10 0 0 0 0 213 396 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 25 25 75 1 2270 11 0 7 15 0 0 0 0 369 594 0 0 3

18 Fatepura State Gov. GJ-18-G-3936 25 25 75 16 2118 11 0 8 35 0 0 0 0 260 360 1 0 11

Panchmahal

Dahod

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for T

B

dete

ctio

n

Page 16: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases S.

No

of D

istr

ict

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for T

B

dete

ctio

n

19 Jhagadia State Gov. GJ-18-G-3937 25 25 79 2 3441 11 0 6 10 0 0 0 0 395 571 0 0 0

20 Valia State Gov. GJ-18-G-3938 25 25 75 4 2641 14 0 8 10 0 0 0 0 274 284 0 0 1

21 Dediapada State Gov. GJ-18-G-3939 25 25 70 15 2137 11 0 8 12 0 0 0 0 340 488 1 0 0

22 Sagbara State Gov. GJ-18-G-3940 25 24 52 14 2003 15 0 9 11 0 0 0 0 216 229 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 25 25 69 4 2493 13 0 9 10 0 0 0 0 363 402 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 25 25 75 6 2748 17 0 8 12 0 0 0 0 443 492 0 0 0

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26 Tapi Nizer State Gov. GJ-18-G-3941 25 24 48 4 3617 13 0 6 9 0 0 0 0 373 420 0 0 2

27 Porbandar Ranavav State Gov. GJ-18-G-3926 25 25 62 1 1598 13 0 5 11 0 0 0 0 252 319 0 0 13

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 25 25 49 6 1896 14 0 8 11 0 0 0 0 181 368 0 0 0

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 25 25 70 1 1791 30 0 9 12 0 0 0 0 277 368 0 0 12

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 19 18 36 3 1869 79 0 0 0 0 0 0 0 170 180 1 0 0

Bharuch

Narmada

Surat

Page 17: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month December Year

Plan

ned

Actu

al

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 24 24 72 4 1752 11 0 6 12 0 0 0 0 217 298 0 0 4

2 Patan Sami State Gov. GJ-18-G-3918 25 25 78 3 1491 13 0 12 15 0 0 0 0 186 272 1 0 11

3 Idar State Gov. GJ-18-G-3919 25 24 72 2 1516 16 0 10 12 0 0 0 0 93 128 0 0 0

4 Khedbhrama GJ-18-G-3920 26 26 45 4 5253 60 0 0 0 0 0 0 0 281 511 1 0 4

5 Vijaynagar GJ-18-G-3921 26 26 59 4 3246 9 0 0 0 0 0 0 0 108 409 0 0 60

6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 25 25 70 15 2326 32 0 9 15 0 0 0 0 254 587 0 0 0

7 Deyodar State Gov. GJ-18-G-3924 25 25 59 2 1251 15 0 9 10 0 0 0 0 175 195 1 0 3

8 Dhanera State Gov. GJ-18-G 8049 25 25 74 1 1503 11 0 8 11 0 0 0 0 314 330 0 0 9

9 Amirgadh State Gov. GJ-18-G-3922 24 24 88 2 1806 12 0 9 12 0 0 0 0 155 263 0 0 0

10 Danta State Gov. GJ-18-G-3923 24 24 67 1 1402 14 0 8 14 0 0 0 0 111 127 0 0 0

11 Kawant MMU-1PPP Mode

(Deepak Foundation) GJ-18-G-3925 20 20 49 10 1872 26 0 8 0 0 0 0 0 324 361 0 0 5

12 Kawant MMU-2 State Gov. GJ-18-G-3932 25 25 65 17 2337 15 0 9 13 0 0 0 0 400 478 0 0 0

13 Shahera State Gov. GJ-18-G 8050 24 24 72 19 2501 34 0 8 31 0 0 0 0 345 592 0 0 11

14 Morva State Gov. GJ-18-G-3933 25 24 72 12 2214 17 0 8 11 0 0 0 0 269 369 0 0 1

15 Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3934 25 25 75 11 2201 18 0 8 16 0 0 0 0 255 421 0 0 0

16 Garbada State Gov. GJ-18-G-3935 25 25 75 2 2065 16 0 10 12 0 0 0 0 234 437 0 0 0

17 Limkheda State Gov. GJ-18-G 8051 25 25 75 11 2238 12 0 9 11 0 0 0 0 296 393 1 0 3

18 Fatepura State Gov. GJ-18-G-3936 25 25 75 11 2611 19 0 10 34 0 0 0 0 281 403 4 0 15

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) Pl

ease

pro

vide

nam

e if

NG

O o

r priv

ate

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

Chhota Udepur

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

Panchmahal

Dahod

Page 18: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Plan

ned

Actu

al

OC

P/ E

CP

Con

dom

IUC

D

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) Pl

ease

pro

vide

nam

e if

NG

O o

r priv

ate

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

No. of FP cases

19 Jhagadia State Gov. GJ-18-G-3937 25 25 81 4 3276 11 0 9 11 0 0 0 0 328 552 0 0 0

20 Valia State Gov. GJ-18-G-3938 25 25 75 6 2887 11 0 9 10 0 0 0 0 450 467 0 0 1

21 Dediapada State Gov. GJ-18-G-3939 25 25 71 9 2170 15 0 8 20 0 0 0 0 415 588 0 0 0

22 Sagbara State Gov. GJ-18-G-3940 25 25 54 14 2362 15 0 9 16 0 0 0 0 445 506 0 0 0

23 Mandvi State Gov. GJ-18-G 8052 25 25 72 5 2444 12 0 9 12 0 0 0 0 415 491 0 0 0

24 Umarpada State Gov. GJ-18-G-3945 25 25 75 3 2834 10 0 9 11 0 0 0 0 450 506 0 0 9

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26 Tapi Nizer State Gov. GJ-18-G-3941 25 25 50 7 3409 11 0 6 11 0 0 0 0 394 432 0 0 1

27 Porbandar Ranavav State Gov. GJ-18-G-3926 24 24 60 2 1687 12 0 8 10 0 0 0 0 208 300 0 0 21

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 25 25 49 12 2131 14 0 7 10 0 0 0 0 200 432 0 0 0

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 24 24 68 2 1749 36 0 6 10 0 0 0 0 240 317 0 0 20

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 21 20 36 0 1016 43 0 8 0 0 0 0 0 42 42 0 0 0

Bharuch

Narmada

Surat

Page 19: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Month up to December Year

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

1 Surendranagar Limbadi State Gov. GJ-18-G-3931 225 223 664 20 14787 99 0 48 95 0 0 0 0 2113 2689 0 0 6

2 Patan Sami State Gov. GJ-18-G-3918 226 209 641 15 12997 144 0 120 110 0 0 0 0 1176 1941 3 0 45

3 Idar State Gov. GJ-18-G-3919 226 223 669 12 13837 112 0 66 125 0 0 0 0 747 1142 0 0 6

4 Khedbhrama GJ-18-G-3920 228 224 387 24 41302 580 0 0 0 0 0 0 0 2937 4612 3 0 41

5 Vijaynagar GJ-18-G-3921 227 225 527 42 26093 66 0 0 0 0 0 0 0 904 2279 1 0 594

6 Arvalli (Modasa) Meghraj State Gov. GJ-18-G 8053 226 224 670 38 19860 201 0 73 118 0 0 0 0 1211 2571 0 0 4

7 Deyodar State Gov. GJ-18-G-3924 226 221 491 18 10212 107 0 76 105 0 0 0 0 1305 1591 1 0 14

8 Dhanera State Gov. GJ-18-G 8049 225 204 585 14 11785 139 0 54 95 0 0 0 0 1778 1891 0 0 29

9 Amirgadh State Gov. GJ-18-G-3922 224 218 754 13 13658 115 0 54 102 0 0 0 0 1101 1639 0 0 6

10 Danta State Gov. GJ-18-G-3923 224 222 607 11 13249 120 0 62 96 0 0 0 0 1322 1482 2 0 27

11 Kawant MMU-1PPP Mode

(Deepak Foundation) GJ-18-G-3925 199 198 489 84 17933 371 0 112 4 0 0 0 0 2387 2806 7 0 45

12 Kawant MMU-2 State Gov. GJ-18-G-3945 223 220 593 43 18637 174 0 52 99 0 0 0 0 3489 4061 8 0 14

13 Shahera State Gov. GJ-18-G-3932 225 224 669 44 20441 166 0 60 250 0 0 0 0 3126 4537 0 0 42

14 Morva State Gov. GJ-18-G 8050 226 217 649 37 18152 123 0 62 97 0 0 0 0 2319 2829 7 0 64

15Mahisagar (Lunavada)

Kadana State Gov. GJ-18-G-3933 226 223 668 34 18255 124 0 55 116 0 0 0 0 2056 3251 0 0 1

16 Garbada State Gov. GJ-18-G-3934 226 224 671 22 17262 122 0 61 104 0 0 0 0 1716 2817 0 0 1

17 Limkheda State Gov. GJ-18-G-3935 226 224 672 22 18523 113 0 61 120 0 0 0 0 2752 4465 5 0 21

18 Fatepura State Gov. GJ-18-G 8051 226 223 667 37 20145 118 0 64 147 0 0 0 0 2062 3013 20 0 103

MMU Mandatory Disclosure Formats

Monthly Reporting Format

Note. To be filled and uploaded every month for all MMU in the NHM State Website under MMU Mandatory Disclosure. Each line should represent one MMU. Please add rows as required.

2017-18

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r

Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

Sabarkantha PPP Mode (Vishvakalyan Society, Idar)

Banaskantha

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No. of FP cases

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

Chhota Udepur

Dahod

Panchmahal

Page 20: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

Pla

nned

Act

ual

OC

P/ E

CP

Con

dom

IUC

D

S. N

o of

Dis

tric

t

Dis

tric

t

MM

U T

ype

(Sin

gle/

2/3

veh

icle

un

it)

Nam

e of

ope

ratin

g ag

ency

(S

tate

DH

S/N

GO

/Priv

ate

Prov

ider

) P

leas

e pr

ovid

e na

me

if N

GO

or p

rivat

e

Reg

istr

atio

n N

umbe

r Number of Trips

No.

of X

ray

No.

of p

atie

nts

refe

rred

to

high

er fa

cilit

ies

No.

of c

hild

ren

scre

ened

un

der R

BSK

No.

of L

ab te

sts

No.

of b

lood

sm

ears

col

lect

ed

/ RD

T te

sts

done

for M

alar

ia

No.

of s

putu

m c

olle

cted

for

TB d

etec

tion

No.

of m

inor

sur

gica

l op

erat

ions

No.

of c

hild

ren

scre

ened

for

refr

activ

e er

rors

No. of FP cases

Num

ber o

f Vill

ages

vis

ited

Num

ber o

f AW

Cs

cove

red

No.

of O

PD

No.

of A

NC

No.

of c

hild

ren

imm

uniz

ed (i

f ap

plic

able

)

19 Jhagadia State Gov. GJ-18-G-3936 226 226 719 19 23746 112 0 48 97 0 0 0 0 2810 4200 1 0 6

20 Valia State Gov. GJ-18-G-3937 226 226 678 19 23080 105 0 54 106 0 0 0 0 2945 3276 0 0 24

21 Dediapada State Gov. GJ-18-G-3938 226 224 631 35 19236 130 0 62 124 0 0 0 0 3240 4714 3 0 1

22 Sagbara State Gov. GJ-18-G-3939 226 224 484 37 17957 114 0 76 130 0 0 0 0 3085 3634 0 0 0

23 Mandvi State Gov. GJ-18-G-3940 226 226 636 16 20352 111 0 56 97 0 0 0 0 3013 3670 0 0 0

24 Umarpada State Gov. GJ-18-G 8052 226 226 678 20 24624 102 0 68 122 0 0 0 0 3964 4791 0 0 37

25Nani Naroli(Mangrol)

PPP Mode(Deep , Surat)

GJ-18-G-3943 90 47 143 15 4879 12 0 0 0 0 0 0 0 131 131 0 0 31

26 Tapi Nizer State Gov. GJ-18-G-3941 226 225 450 22 26786 118 0 51 96 0 0 0 0 3143 3458 2 0 17

27 Porbandar Ranavav State Gov. GJ-18-G-3926 225 224 560 13 12481 99 0 54 97 0 0 0 0 1431 1703 2 0 75

28 Ahwa -Dang Ahwa State Gov. GJ-18-G-3942 226 225 441 32 19027 128 0 52 117 0 0 0 0 1713 3660 0 0 3

29 Gir Somnath (Veraval)

Kodinar State Gov. GJ-18-G-3927 225 221 622 15 13950 155 0 54 93 0 0 0 0 1791 2510 0 0 53

30 Kachchh BhujPPP Mode (Shroffs

Foundation Trust,Kutch)

GJ-18-G-3944 169 153 322 16 10505 335 0 137 0 0 0 0 0 582 653 4 0 1

Bharuch

Narmada

Surat

Page 21: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

MMU Quarterly Reporting Format Year 2017-18(Up to December'17)

3-vehicle unit

2-vehicle unit

Single vehicle 3-vehicle unit

2-vehicle unit

Single vehicle

3-vehicle unit

2-vehicle unit

Single vehicle

1

1.1. Name of MMU service

1.1Total number of MMU sanctioned 30

1.2No of MMU functional out of 1.1 30

1.3 No of MMUs fitted with GPS 30

1.4

Opearational agency (state/ NGO/ Other private agency).

30 4

1.5No. of MMUs having recommended staff 30

iMedical Officers (1 or 2 according to MMU type) 30

ii Radiographer 0

iv Nurse 30

v Laboratory Technician 30

vi Pharmacist 30

vii Helper 0

viiiDrivers (1 , 2 or 3 according to MMU type) 30

ix

Specialists (ObGYn, Paediatrician, Physician etc.)

0

1.7

No. of MMUs with monthly route chart displayed in state website 30

2 Performance details

2.1Average number of OPD cases per MMU per month

2014

i.Avg. no. of ANC per MMU per month 17

ii.

Avg. no. of child immunization per MMU per month (ifvMMU conducting immunization)

0

iii.

Avg. no. of clients received temporary FP methods per MMU per month

17

a OCP/ ECP 7

b Condoms 10

c IUCD cases 0

iv.

Avg. no. of minor surgical operations per MMU per month

0

v.

Avg. no. of children screened for refractive errors per MMU per month

0

vi.

Avg. no. of children screened under RBSK per MMU per month

0

2.3

Average no. of lab investgations per MMU per month

231

MMU Mandatory Disclosure Formats

Note. To be filled and updated quarterly under NHM MMU Mandatory Disclosure in State NHM website

Financial year: 2016-17 (up to December'17)Quarter

Rashtriya MMU Implementation (Yes or No), If yes please attach photosSl. No. Indicators

NHM State Budget NGO/ Any other source

Remarks, if any

Please enclose package of services provided by MMU (as enclosure)

Please enclose package of services provided by MMU (as enclosure)

Please enclose package of services provided by MMU (as enclosure)

Page 22: MMU Mandatory Disclosure Formats Monthly …...18 Fatepura State Gov. GJ-18-G-3936 25 25 75 2 1888 6 0 1 12 0 0 0 0 199 296 2 0 13 19 Jhagadia State Gov. GJ-18-G-3937 25 25 82 1 2074

3-vehicle unit

2-vehicle unit

Single vehicle 3-vehicle unit

2-vehicle unit

Single vehicle

3-vehicle unit

2-vehicle unit

Single vehicle

Sl. No. Indicators

NHM State Budget NGO/ Any other source

Remarks, if any

Please enclose package of services provided by MMU (as enclosure)

Please enclose package of services provided by MMU (as enclosure)

Please enclose package of services provided by MMU (as enclosure)

2.4

Avg. no. of X-ray investigations per MMU per month

0

2.5

Avg. no. of blood smears collected / RDT tests done for Malaria, per MMU per month

319

2.6

Avg. no. of sputum collected for TB detection per MMU per month

0

2.8Average Number of patients referred to higher facilities

5

3 Operational details

3.1Avg. no. of trips per MMU per month 24

3.2Avg. no. of camps per MMU per month 0

3.3No. of villages covered by MMUs 704

3.4No. of AWCs covered by MMUs 789

3.5Average operational cost per month per MMU 139550

iHuman Resources (for all staff under 1.6) 95550

ii POL 44000

i Vehicle Maintenance 0

iiAdmin and management costs 0

3.6Average operational cost per patient(OPD) per MMU

69

3.7Average operational cost per trip per MMU 5894