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HMIS Formats

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A. Forms to be submitted by States/U.T.s to Government of India

S.No

Form No.

Form Name

Periodicity

Submission Date

Download

Last Update Date

1.

NRHM/GOI/1/A

Annual Consolidated

Annual

30th April

Download

 

2.

NRHM/GOI/2/Q

Quarterly Consolidated

Quarterly

20th of Month following respective Quarter

Download

 

3.

NRHM/GOI/3/M

Monthly Consolidated

Monthly

20th of following Month

Download

 

 

B. Forms for use within States for internal reporting (Not to be sent to GOI)

S.No

Form No.

Form Name

Periodicity

Submission Date

Download

Last Update Date

4.

NRHM/SG/1/A

Annual format for State

Annual

15th April

Download

 

5.

NRHM/SG/2/Q

Quarterly format for State HQ

Quarterly

20th of Month following respective Quarter

Download

 

6.

NRHM/DHQ/1/A

Annual format for District

Annual

5th April

Download

 

7.

NRHM/DHQ/2/Q

Quarterly format for District

Quarterly

10th of Month following respective Quarter

Download

 

8.

NRHM/DHQ/3/M

Monthly format for District HQ

Monthly

10th of following Month

Download

 

C. Facility Level Forms for internal reporting 

 

S.No

Form No.

Form Name

Periodicity

Submission Date

Download

Last Update Date

9.

NRHM/DH/3/M

Monthly format for District Hospitals and equivalent hospitals

Monthly

5th of following Month

Download

 

10.

NRHM/SDH/3/M

Monthly format for Sub-District Hospitals and equivalent hospitals

Monthly

5th of following Month

Download

 

11.

NRHM/CHC/3/M

Monthly format for CHC’s and equivalent hospitals

Monthly

5th of following Month

Download

 

12.

NRHM/PHC/3/M

Monthly format for PHC’s and equivalent facilities

Monthly

5th of following Month

Download

 

13.

NRHM/HSC/3/M

Monthly format for SC’s and equivalent facilities

Monthly

5th of following Month

Download

 

 

D.Facility Level Forms for Infrastructure reporting  

 

S.No

Form No.

Form Name

Periodicity

Submission Date

Download

Last Update Date

14.

NRHM/DH/A/200

Format for District Hospitals - 101 to 200 Beds

Annual 

30th April

Download

  27th April 2010

15.

NRHM/DH/A/300

Format for District Hospitals - 201 to 300 Beds

Annual 

30th April

Download

    27th April 2010

16.

NRHM/DH/A/500

Format for District Hospitals - 301 to 500 Beds 

Annual

30th April

Download

    27th April 2010

17.

NRHM/SDH/A/50

Format for Sub-District Hospitals - 31 to 50 Beds

Annual 

30th April

Download

    27th April 2010

18.

NRHM/SDH/A/100

Format for Sub-District Hospitals - 51 to 100 Beds

Annual 

30th April

Download

    27th April 2010

19.

NRHM/CHC/A

Format for CHC’s

Annual

30th April

Download

    27th April 2010

20.

NRHM/PHC/A

Format for PHC’s

Annual

30th April

Download

    27th April 2010

21.

NRHM/HSC/A

Format for SC’s

Annual

30th April

Download

    27th April 2010

 

 

E.

NVBDCP 

 

S.No

Form No.

Form Name

Periodicity

Submission Date

Download

Last Update Date

1.

NRHM/NVBDCP/M/1

Format for District

Monthly

20th of following Month

Download

  26th May