Professional Documents
Culture Documents
Category I Boxes
Category II Boxes
Category III Boxes
Prolongation Pouches and Inj SM
Supervisory activities:
Supervisory Visit by DTO/2nd MO-TC DOTS Plus & TB-HIV STS STLS
MO-DTC Supervisor
Number of visits in last 1 month
IEC:
Number of TB Patient Provider meetings held
Number of Community meetings organized
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Microscopy Activities (To be filled in by only PHIs which are a DMC from Laboratory Register)
MDR-TB case finding activity (To be filled in by only PHIs which are a DMC from Laboratory Register)
Number of MDR-TB suspects identified
Sputum Nos.
containers*
Universal Nos
containers for C
& DST
Slides Nos.
Carbol Fuchsin Litres
(1% solution)
Methylene Blue Litres
(0.1% solution)
Sulphuric Acid Litres
(25% solution)
Phenolic solution Litres
(for disinfection-
~40% pure solution)
Immersion oil/ mL
Liquid Paraffin
(Heavy)
* PHIs that are not a DMC, but have been supplied with sputum containers, should complete this row.
Signature: .
Date: .
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