Daily Sheetto Be Filled by The UCMO: Area Incharge Codes
Daily Sheetto Be Filled by The UCMO: Area Incharge Codes
Daily Sheetto Be Filled by The UCMO: Area Incharge Codes
Vaccination Date: Name of UCMO: ____dr dawood____________________ No. of Teams Reported: (Mobile: 28 Fixed: 2 Transit Point: 1) SIA Name: __sNID_____
School/Madrassa Coverage
HH coverage Out of HH Coverage Missed Children Data (OPV Doses) House Hold
Vaccinated
New born
HRMP
No. of Recorded Missed Children on the back No. of Children Covered by the team on same
of tally sheet day
Daily Target
Returned
Given
Used
NA R NA R
Blue
Red
0-11 12-59 0-11 12-59
A1 A2 B1 B2 Months Months Months Months C1 C2 C1 C2 # # # # #
8 AIC
9 AIC
10 AIC
11 AIC
12 AIC
13 AIC
14 AIC
15 AIC
Afernoon
Used
# # # #
0 15 40 17 23
1 AIC ubaid 2220
0 0 0
2 AIC zakria 2223
12 0 20 13 7
3 AIC bismillah 2224
4 AIC
5 AIC
6 AIC
Sub - Total 0 15 12 0
60 30 30 0 0 0
Grand Total 15 12
Signature of UCMO:______________________________
Total Vials: Given: 1720 Used: 1337 Return: 389 Unusable Vacine Vail: 0 Name of UCMO:_________________________________
Year: 2018 Province: Balochistan
HH coverage
Daily Target
Serial No.
A1
1 AIC 2218
2 AIC 2219
3 AIC 2220
4 AIC 2221
5 AIC 2222
6 AIC 2223
7 AIC 2224
8 AIC
9 AIC
10 AIC
11 AIC
12 AIC
13 AIC
14 AIC
15 AIC
Sub - Total 0
0
Grand Total 0
# #
5 AIC
6 AIC
Sub - Total 0 0
Grand Total 0
0 0 0 0
0-11 M 12-59 M
Retured
Given
Used
# #
0 0
0 0 0 0
0
School/Madrassa Coverage
Missed Children Data
R NA R
12-59
Months C1 C2 C1 C2 #
0 0 0 0 0
0
0 0 0
Signature of AIC
Afernoon
Morning
0 0
e Vacine Vail: 0
by the UCMO
2 Transit Point: 1)
HRMP
Given
Used
# # # #
0 0 0 0 0 0
(OPV Doses)
Returned
ne Distribution Record
Unusable Vaccine Vails
__sNID_____
0 0 0 0 0 0
Signature of UCMO:______________________________
Name of UCMO:_________________________________
NID_____
Signature of AIC
Afernoon
Morning
0 0
______________
_______________
Year: 2018 Province: Balochistan
HH coverage
Daily Target
Serial No.
A1
1 AIC 2218
2 AIC 2219
3 AIC 2220
4 AIC 2221
5 AIC 2222
6 AIC 2223
7 AIC 2224
8 AIC
9 AIC
10 AIC
11 AIC
12 AIC
13 AIC
14 AIC
15 AIC
Sub - Total 0
0
Grand Total 0
# #
1 AIC naveed
2 AIC zakria
3 AIC bismillah
4 AIC
5 AIC
6 AIC
Sub - Total 0 0
Grand Total 0
0 0 0 0
0-11 M 12-59 M
Retured
Given
Used
# #
0 0
0 0 0 0
0
School/Madrassa Coverage
Missed Children Data
R NA R
12-59
Months C1 C2 C1 C2 #
0 0 0 0 0
0
0 0 0
Signature of AIC
Afernoon
Morning
0 0
e Vacine Vail: 0
by the UCMO
2 Transit Point: 1)
HRMP
Given
Used
# # # #
0 0 0 0 0 0
(OPV Doses)
Returned
ne Distribution Record
Unusable Vaccine Vails
Name of UCMO:_________________________________
Signature of AIC
Afernoon
Morning
0 0
______________
_______________
Year: 2018 Province: Balochistan
HH coverage
Daily Target
Serial No.
A1
1 AIC 2218
2 AIC 2219
3 AIC 2220
4 AIC 2221
5 AIC 2222
6 AIC 2223
7 AIC 2224
8 AIC
9 AIC
10 AIC
11 AIC
12 AIC
13 AIC
14 AIC
15 AIC
Sub - Total 0
0
Grand Total 0
# #
1 0
1 AIC ubaid
0 1
2 AIC zakria
3 AIC bismillah
4 AIC
5 AIC
6 AIC
Sub - Total 1 1
Grand Total 2
0 0 0 0
0-11 M 12-59 M
Retured
Given
Used
# #
20 1 19 0
20 1 19 0
0 7 20 7 13 0
0 7
60 9 51 0
7
School/Madrassa Coverage
Missed Children Data
R NA R
12-59
Months C1 C2 C1 C2 #
0 0 0 0 0
0
0 0 0
Signature of AIC
Afernoon
Morning
0 0
e Vacine Vail: 0
by the UCMO
2 Transit Point: 1)
HRMP
Given
Used
# # # #
0 0 0 0 0 0
(OPV Doses)
Returned
ne Distribution Record
Unusable Vaccine Vails
Name of UCMO:_________________________________
ID______
Signature of AIC
Afernoon
Morning
0 0
______________
_______________
Year: 2018 Province: Balochistan
HH coverage
Daily Target
Serial No.
A1
1 AIC 2218
2 AIC 2219
3 AIC 2220
4 AIC 2221
5 AIC 2222
6 AIC 2223
7 AIC 2224
8 AIC
9 AIC
10 AIC
11 AIC
12 AIC
13 AIC
14 AIC
15 AIC
Sub - Total 0
0
Grand Total 0
# #
1 AIC ubaid
2 AIC zakria
3 AIC bismillah
4 AIC
5 AIC
6 AIC
Sub - Total 0 0
Grand Total 0
0 0 0 0
0-11 M 12-59 M
Retured
Given
Used
# #
0 0
0 0 0 0
0
School/Madrassa Coverage
Missed Children Data
R NA R
12-59
Months C1 C2 C1 C2 #
0 0 0 0 0
0
0 0 0
Signature of AIC
Afernoon
Morning
0 0
e Vacine Vail: 0
by the UCMO
2 Transit Point: 1)
HRMP
Given
Used
# # # #
0 0 0 0 0 0
(OPV Doses)
Returned
ne Distribution Record
Unusable Vaccine Vails
Name of UCMO:_________________________________
ID______
Signature of AIC
Afernoon
Morning
0 0
______________
_______________
Year: 2017 Province: Balochistan
HH coverage
Daily Target
Serial No.
A1
# #
1 AIC
2 AIC
3 AIC
4 AIC
5 AIC
6 AIC
Sub - Total 0 0
Grand Total 0
240 0 1 15 58 4
146 0 0 10 36 6
227 0 3 12 38 11
349 0 0 9 56 3
176 0 0 2 35 17
181 0 6 3 33 5
157 0 2 4 29 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1476 0 12 55 285 48
0-11 M 12-59 M
Retured
Given
Used
# #
0 0
0 0 0 0
0
School/Madrassa Coverage
Missed Children Data
R NA R
12-59
Months C1 C2 C1 C2 #
4 0 19 0 4 16
16 6 25 1 10 54
43 4 14 19 10 0
4 0 16 2 3 27
29 0 15 4 7 17
2 0 10 4 0 6
6 2 11 0 0 4
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
104 12 110 30 34
124
152 122 64
Signature of AIC
Afernoon
Morning
0 0
e Vacine Vail: 0
by the UCMO
Transit Point: )
HRMP
Given
Used
# # # #
85 0 1 55 171 55
46 0 0 18 128 107
75 0 0 58 159 83
143 0 0 56 118 79
124 0 0 31 112 81
111 0 0 71 111 61
124 0 0 15 86 59
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
Name of UCMO:_________________________________
Signature of AIC
Afernoon
Morning
0 0
______________
_______________
Daily sheetto be filled by the UCMO
Year: 2017 Province: Balochistan District:__quetta______________ Tehsil:
__chiltan town______________ UC:___aghberg___________ Campaign Day: _______
Vaccination Date: Name of UCMO: ________________________ No. of Teams Reported: 29 (Mobile: 29 Fixed: 29 Transit Point: ) SIA Name: _______
School/Madrassa Coverage
HH coverage Out of HH Coverage Missed Children Data House Hold
HRMP
No. of Recorded Missed Children on the back No. of Children Covered by the team on same
of tally sheet day
Daily Target
Returned
Given
Used
NA R NA R
Afernoon
Morning
0-11 12-59 0-11 12-59
A1 A2 B1 B2 Months Months Months Months C1 C2 C1 C2 # # # # #
Used
# # # #
1 AIC zakria 0 0 0 0 20 0 20 0
2 AIC naveed 5 3 0 0 20 8 12 0
3 AIC bismillah 0 3 0 0 20 3 17 0
4 AIC
5 AIC
6 AIC
Sub - Total 5 6 0 0
60 11 49 0 0 0
Grand Total 11 0
Signature of UCMO:______________________________
Total Vials: Given: 1540 Used: 1142 Return: 398 Unusable Vacine Vail: 0 Name of UCMO:_________________________________