Downloadable   Forms    

This Screen allows officials of state/UTs,Directorate of health services to furnish data to CBHI in the following proforma :

SI No.

Title

1.

Weekly Epidemiological Report on Cholera (A00) / Plague (A20) in State/UT(Form-01)

2.

Monthly Report on Institutional Cases and Deaths in the State / UT due to COMMUNICABLE Diseases not covered under any National Health Programme(New 2012 Form-2A)

3.

Monthly Report on Cases and Deaths Due to NON-COMMUNICABLE Diseases in the State / UT(New 2012 Form-3A)

4.

Monthly Report on Institutional Cases and Deaths in the State / UT due to COMMUNICABLE Diseases not covered under any National Health Programme(2013 Form-2A)

5.

Monthly Report on Cases and Deaths Due to NON-COMMUNICABLE Diseases in the State / UT(2013 Form-3A)

6.

Number of State/UT Govt. Employed Doctors and Dental Surgeons as on 31 December of the Reporting Year Name of the State/UT(Form-4)

7.

Number of State/UT govt. Employed* nursing and paramedical professional functioning in state government establishments as on 31 December of reporting year(Form-5)

8.

Number of Nursing and Paramedical Professional Functioning in Private Institutions as on 31 December of reporting year(Form-5A)

9.

Government* Allopathic Secondary / Tertiary Level Medical & Health Care Institutions and Beds in Rural & Urban areas in the State/UT as on 31st December of reporting year(Form-6A)

10.

Private sector* Allopathic Medical and Health Care Institution and Beds in Rural and Urban areas in the State/UT as on 31st December of reporting year(Form-6B)

11.

State / UT wise number of Doctors and Dental Surgeons employed in the Country as on 31 December of reporting year(Form-7)

12.

State/UT wise number of Doctors & Dental Surgeons employed in Private Institutions in the Country as on 31 December of reporting year(Form-7A)

13.

Number of Nursing and Paramedical Professional Functioning in Central Government Establishments as on 31 December of reporting year(Form-8)

14.

Proforma for Collection of Information from Specialised Cancer Institution(Form-9)

15.

Proforma for Collection of Information from Specialised Mental Institution(Form-10)

The users may click on the desired proforma and arrive at the screen for downloading the form for data entry.