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Revised BHW Report

This document is a monthly report template for Barangay health workers in Ragay, Camarines Sur, Philippines. It includes sections for tracking pregnant women, deliveries, TB symptomatics, immunizations, reportable cases, animal bites, deaths, family planning, NCD risk assessments, and activities at the health center. The report is to be submitted by the Barangay Health Worker and checked by a nurse or midwife, with final approval from the Municipal Health Officer.

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16 views2 pages

Revised BHW Report

This document is a monthly report template for Barangay health workers in Ragay, Camarines Sur, Philippines. It includes sections for tracking pregnant women, deliveries, TB symptomatics, immunizations, reportable cases, animal bites, deaths, family planning, NCD risk assessments, and activities at the health center. The report is to be submitted by the Barangay Health Worker and checked by a nurse or midwife, with final approval from the Municipal Health Officer.

Uploaded by

juriallana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Province of Camarines Sur


Municipality of Ragay
Barangay _____________

BHW MONTHLY REPORT


FOR THE MONTH OF ______________________
I. PREGNANT WOMEN (Registered for the Month only) “PAGBUBUNTIS”
NAME AGE HUSBAND G-P LMP DATE VISITED

II.DELIVERED FOR THE MONTH ONLY “NANGANAK’


DEL. DATE
NAME AGE HUSBAND NAME OF CHILD DEL. AT DEL. BY
TYPE DEL.

III. TB SYMPTOMATICS (CASE FINDING FOR THE MONTH ONLY, SPUTUM SMEAR DONE). PLS. SURVEY YOUR PUROK
MONTHLY.
NAME AGE FAMILY HEAD DATE

IV. IMMUNIZATION (FULLY IMMUNIZED CHILD, FOR THE MONTH ONLY) “PAGBABAKUNA”
NAME OF CHILD BIRTHDATE NAME OF MOTHER DATE

V. REPORTABLE CASES (DENGUE, MEASLES, COVID-19, POLIO SUSPECTS, ADVERSE EFFECT FOLLOWING IMMUNIZATION,
ETC. (CASE FINDING FOR THE MONTH ONLY). ADVISED PATIENT TO VISIT RHU
NAME AGE FAMILY HEAD CASE DATE

VI. ANIMAL BITE (PLS SURVEY YOUR PUROK WEEKLY)


DATE OF TYPE OF SITE OF BODY VACCINATED
NAME AGE DATE
BIRTH EXPOSURE BITTEN Y/N

VII. DEATHS FOR THE MONTH ONLY (IN YOUR PUROK ONLY)
NAME AGE DATE OF DEATH CAUSE OF DEATH

VIII. FAMILY PLANNING (NEW ACCEPTOR ONLY)


NAME AGE FAMILY PLANNING METHOD USED DATE

IX. NCD RISK ASSESSMENT (FOR THE MONTH ONLY)


DATE OF
NAME AGE SEX DATE ASSESS
BIRTH

X. DUTY AND ACTIVITIES DONE AT CENTER ASSIGNED


DATE ACTIVITY

Submitted by: _______________________ Checked by: ______________________


BHW Nurse/ Midwife

Noted By: _______________________ Approved By: VIRGIN G. RAMIREZ, MD


Punong Barangay Municipal Health Officer

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