Federal police hospital Monthly report - NCD Date:____/____/___ To ___/____/_____
S.No Activity Number
NCT_HTN Number of Individuals screened for hypertension
NCT_HTN. 1 18 - 29 years, Male
NCT_HTN. 2 18 - 29 years, Female
NCT_HTN. 3 30 - 39 years, Male
NCT_HTN. 4 30 - 39 years, Female
NCT_HTN. 5 40 - 69 years, Male
NCT_HTN. 6 40 - 69 years, Female
NCT_HTN. 7 >=70 years, Male
NCT_HTN. 8 >=70 years, Female
NCD_HTNDX.1.2 Number of Individuals screened for hypertension by result of
screening
NCD_HTNDX.1.2. 1 Raised BP
NCD_HTNDX.1.2. 2 Normal BP
NCD_HTNDX.2 Hypertensive patients enrolled to care by Type of Treatment
NCD_HTNDX.2. 1 Healthy life style counciling (HLC) only
NCD_HTNDX.2. 2 Pharmacological management and HLC
NCD_HTNDX.2.3 Hypertensive patients by timing of enrollment
NCD_HTNDX.2.3. 1 Newly enrolled to care
NCD_HTNDX.2.3. 2 Previously in care
NCD_DMDX.2.3 Hypertensive patients enrolled to care by age and sex
NCD_DMDX.2.3. 1 18 - 29 years, Male
NCD_DMDX.2.3. 2 18 - 29 years, Female
NCD_DMDX.2.3. 3 30 - 39 years, Male
NCD_DMDX.2.3. 4 30 - 39 years, Female
NCD_DMDX.2.3. 5 40 - 69 years, Male
NCD_DMDX.2.3. 6 40 - 69 years, Female
NCD_DMDX.2.3. 7 >=70 years, Male
NCD_DMDX.2.3. 8 >=70 years, Female
NCD_DMDX.1.1 Number of Individuals screened for Diabetes Mellitus by
result of screening
NCD_DMDX.1.1. 1 Raised blood sugar
NCD_DMDX.1.1. 2 Normal blood sugar
NCD_DMDX.1.2 Individuals screened for Diabetes Mellitus by age and sex
NCD_DMDX.1.2. 1 < 40 years, Male
NCD_DMDX.1.2. 2 < 40 years, Female
NCD_DMDX.1.2. 3 >= 40 years, Male
NCD_DMDX.1.2. 4 >= 40 years, Female
NCD_DMDX.2.2 Diabetic patients enrolled to care by type of treatment
NCD_DMDX.2.2. 1 Healthy life style counseling (HLC) only
NCD_DMDX.2.2. 2 Pharmacological management and HLC
NCD_DMDX.2.3 Diabetic patients enrolled to care by age and sex
NCD_DMDX.2.3. 1 < 15 years, Male
NCD_DMDX.2.3. 2 < 15 years, Female
NCD_DMDX.2.3. 3 15 - 29 years, Male
NCD_DMDX.2.3. 4 15 - 29 years, Female
NCD_DMDX.2.3. 5 30 - 39 years, Male
NCD_DMDX.2.3. 6 30 - 39 years, Female
NCD_DMDX.2.3. 7 >= 40 years, Male
NCD_DMDX.2.3. 8 >= 40 years, Female
NCD_DMDX.2.4 Diabetic patients by Timing of enrollment
NCD_DMDX.2.4. 1 Newly enrolled to care
NCD_DMDX.2.4. 2 Previously in care
Name:_________________________ Signature:___________ Referral out____________In___________