IDENTIFICATION DATA
Name: A.A
Age:24
Pregnancy:————
Address:———-
2. PHYSICAL HEALTH
Height:180
Weight:70
BMI:21.6
LMP
EDD:
Pregnancy Status:
——————————————-
3. Vaccination& Antenatal Visit:
Vaccination 01:
Vaccination 02:
—————————————————-
Pregnancy History
—————————————————-
Children’s Details:
—————————————————-
Family History;
Family Tree
—————————————————-
7. ENVIRONMENTAL HEALTH
—————————————————
FAMILY PLANNING METHODS
——————————————————
ACTION PLAN
Date:
HEALT HNEEDS
ACTION BY FAMILY
ACTION BY HEALTH VISITOR
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