District Health Society, MadhubaniMONTHLY PHYSICAL DATA OF ASHA PROGRAMME FOR THE MONTH OF ………………….

Name of BCM/HM- Name of Month- Block-

SN

Blo

ck C

omm

unity

Mob

ilize

r in

Plac

e

No

Of A

SHA

' S B

ank

A/C

Ope

ned

No

Of A

SHA

Hav

ing

Icar

d

No

Of A

SHA

with

HB

NC

Kit

No

Of A

SHA

with

Sar

ies

Targ

et

Ach

ieve

men

t

Targ

et

Ach

ieve

men

t

No.

of D

rug

Kit

Rep

lishe

d

Targ

et A

SHA

Dis

trict

Tra

iner

Tea

m

Targ

et

Ach

ieve

men

t

Targ

et

Ach

ieve

men

t

1 Andhrathadhi2 Babubarhi3 Basopatti4 Benipatti5 Bisfi6 Ghoghardiha7 Harlakhi8 Jaynagar9 Jhanjharpur

10 Khajauli11 Khutauna12 Ladania13 Laukahi

14

15 Madhwapur16 Pandaul17 Rahika18 Rajnagar19 Kaluahi20 Phulpras

Total-

Name Of Block

ASHA Selectio

n

ASHA Fecilitat

or Selectio

n

Drug Kit Status

ASHA Diwas

Status of ASHA Traning Module 5, 6 & 7

Capacity Building Academic Support Programme No. of

ASHA's Enrolled into 10th grade of

Bachelor’sPreparatory Programme touch open

Schools or IGNOU

Best performance award of Rs. 1000/-, Rs. 500/- Rs.300/-

Candidate of ASHA as per District Level

No.

of N

ew A

SHA

with

D

rug

Kit

No.

of A

SHA

Pre

sent

in

ASH

A D

iwas

No.

of A

SHA

's Tr

aine

d in

Ph

ase-

I

No.

of A

SHA

's Tr

aine

d in

Ph

ase-

II

No.

of A

SHA

's Tr

aine

d in

Ph

ase-

III

No.

of A

SHA

's Tr

aine

d in

Ph

ase-

IV

Madhepur & Lakhnaur

Signature of BCM/HM Signature of MO-IC

District Health Society, MadhubaniMONTHLY FINANCIAL DATA/REPORT OF ASHA PROGRAMME FOR THE MONTH OF …………………….

Name of BCM/HM- Name of Month- Block-

SN

No.

of D

rug

kit R

eplis

ed

Am

ount

Pai

d fo

r Dru

g K

it R

eplis

hmen

t

No.

of N

ew D

rug

Kit

Proc

ured

Am

ount

Pai

d fo

r New

Dru

g K

it

No.

of H

BN

C k

it Pr

ocur

ed

Am

ount

pai

d fo

r H

BN

C k

it Pr

ocur

emen

t

No.

of S

aree

rece

ived

Am

ount

pai

d fo

r Sar

ee

No.

of A

SHA

Diw

as O

rgan

iaed

No.

of A

SHA

Pre

sent

in A

SHA

Diw

as

Am

mou

nt p

aid

to A

SHA

's on

Ash

a D

iwas

1 Andhrathadhi2 Babubarhi3 Basopatti4 Benipatti5 Bisfi6 Ghoghardiha7 Harlakhi8 Jaynagar9 Jhanjharpur

10 Khajauli11 Khutauna12 Ladania13 Laukahi

14

15 Madhwapur16 Pandaul17 Rahika18 Rajnagar19 Kaluahi20 Phulpras

Total-

Name of Block

Am

ount

ot b

e pa

id to

ASH

A in

Mod

ule

5,6

& 7

Tra

inin

g (T

A+D

A)

Am

ount

pai

d to

ASH

A in

Mod

ule

5,6

& 7

Tr

aini

ng (T

A+D

A)

Amount spent under the head of Capacity Building/

Academic Support Programme No. of ASHAs Enrolled into 10th grade or

Bachelor's Preparatory Programme through open

Schools or IGNOU.

Best performanceAward

to ASHA's

No.

of A

SHA

En

rolle

d

Am

ount

to b

e pa

id fo

r en

rollm

ent

Am

ount

pai

d fo

r en

rollm

ent

Am

ount

pai

d to

ASH

A

Rs.1

000/

-A

mou

nt p

aid

to A

SHA

R

s.500

/-A

mou

nt p

aid

to A

SHA

R

s.300

/-

Madhepur & Lakhnaur

Signature of BCM/HM Signature of MO-IC

District Health Society, MadhubaniInsentive Details of ASHA Programme

Name of BCM/HM- Block- Name of Month-

Programme & Related Work

Insentives in Rs.

Back dues By Cash By Whom Remarks

1 600 400

a. 100 1002nd ANC3rd ANC4th ANC

b.IFA 1st

100

100

IFA 2ndIFA 3rd

c.TT-1

100TT-2IFA 3rd

d. 300 200

2

Immunization5 to 10 Child 5011 to 15 Child 10016 to 20 Child 15021 and above 21 Child 200

For full immunization (within 1 year) 100

For full immunization (12-24 months) 50

Polio Round

Vitamin -A Round

For ASHA

For Facilitators

3 ASHA Diwas 100

Sl. No.

No. of Cases Where

ASHA is involved

Incentive to be paid

Incentive Paid in this

month

Cumulative Dues if not

paid

By Cheque

Rural Area

Urban Area

Janani Evam Bal Surkchha Yojnafor Institutional Delivery and full

Immunization of the new born1st ANC (Registration within 12 weeks)

Institutional Deliveries (after BCG Immunization)

75/- per day

100/- per day

150/- per day

4

Pariwar NiyojanSterilization 150

Vasectomy '/ NSV 200

IUD

5

Adarsh Dampati Yojana

500

500

1000

6 DOTs (After full treatment) 250

7Laprocy P.B. Case 300Laprocy M.B. Case 500

8 Kalazar (After full treatment) 100

9 175

10During TrainingDaily Allowance 100Travel Alloance 100

11 250

12 Social Marketing of Sanitary napkins

13

14

As per Guideline

For Ensuring spacing of 2 years after marriage

For Ensuring spacing of 3 years after the birth of 1st child

For Encouraging couple opts for a permanent limiting method up to 2

children

Cataract Operation (Motiyabind) under National Blindness Control

Programme

Home visit under HBNC and IMNCI (After 6 visits in institutional deliveries and 7 visit in home

deliveries)

Rs. 1 per pack

Reporting death of women (15 to 40 years) and children (0-1 Years) by

ASHA to the Block PHC, MO/ANM within 24 hours of death to Block PHC MO/ANM under maternal

Death Review Programme

200/- per registration

Facilitating monthly meeting with adolescent at village for 9 Mensural

Hygine districts only.

50 per meeting

Signature of BCM/HM Signature of MO-IC

District Health Society, MadhubaniVHSNC Monthly Status

Name of Block- Name of Month-

Sl. No. Name of Block Remarks

1Total-

BCM/BHM MO-IC

Total no. of Panchayat

Total No. of VHSNC consitituted with Bank Account

Total No. of VHSNC meeting conducted in the reporting month

ftyk LokLF; lfefr] e/kqcuh

iz[k.M dk uke & ekg dk uke&

1

Signature of MO-IC

vkn'kZ nEifr ;kstuk ¼izi=&D½

Ø0 la0

iz[k.Mksa dk uke

vk'kk dh la0

bl ;kstuk vUrxzZr fucaf/kr ;ksX; nEifr;ksa dh la[;k

'kknh ds ckn igys cPps ds

tUe esa 2 o"kZ dk varjky lqfuf'pr

djus okys ¼;ksX; nEifr dh la[;k½

igys vkSj nwljs cPps ds tUe esa 3 o"kZ dk

varjky lqfuf'pr

djus okys ¼;ksX; nEifr dh la[;k½

;kstuk ds vUrxZr ,d larku ds

ckn ca/;kdj.k

pquusokys nEifr;ksa dh la0½

;kstuk ds vUrxZr

nwljs cPps ds ckn

ca/;kdj.k pquus okys

nEifr;ksa dh la0

vH;qfDr

fcuk larku okys ;kX; nEifr

,d cPps okys ;ksX; nEifr

nks cPps okys ;ksX; nEifr

Signature of BCM/HMMadhubani

ftyk LokLF; lfefr] e/kqcuhA

izkIr LVkWd dh la0 forj.k dh la0

Condom OCP ECP Condom OCP ECP Condom OCP ECP1

lkekftd foi.ku laca/kh izfrosnuizkFkfed LokLF; dsUnz dk uke& ekg dk

uke&

dz0la0

LokLF; laLFkku dk uke

izkjafHkd LVkWd dh la0

BCM/HM MO-IC

Click here

Any Problem Please Contact- 9031870700

Report download from Web portal DHIS2 after VHSND report uploading

http://115.112.230.29/dhis

Click here

Any Problem Please Contact- 9031870700

Report download from Web portal DHIS2 after