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Monthly Physical Performance report of ASHA Activitie s Name of the PHC : GUN
Name of the Distri
Maternal Health Child
trimester of pregnancy at
No. of 2 nd check up
No. of 3 rd check up
No. of 1st check up
1 S.salomi 4 4 5 2 1 1 1
2 K.salomi 3 3 4 1 3
3 B.sivaleela 3 2 0 2 4 4 3
4 T.Bharathi 2 0 4 3 0 0 2
5 T Rajyalakshmi 0 1 2 2 4 0 2
6 CH.Mariyamma 1 1 1 0 6 1 0 0
7 R.Sreedevi 1 1 1 1 2 1 0 0
8 J.Gopika rani 2 2 0 2 1 0 0 4
9 SK.Mahaboobee 1 1 2 0 1 1 0 3 0
10 Y.Padmavathi 5 5 1 2 0 1 0 1
11 B.Nagamalli 3 3 1 2 0 0 0 1
12 K.Mariyamma 2 2 1 2 0 1 0 1
13 T.Aruna 2 2 2 1 0 1
14 V.Nagarathnam 0 0 0
15
M.Nagamani 0 0 0
16 P.Chamundeswari 8 6 3 3 3
17 G.Varalashmi 3 3 3 2 0 0 1
18 Sk.Shabina 0 2 3 4 1
19 K.Nagamma 2 2 2 3 1
20 V.Sakkubai 2 3 4 0 2 2
21 SK.Guljarbee 2 3 3 0 2 2
22 B.Sundaramma 4 3 3 0 0 2
23 SK.Himam bee 0 2 2 0 0 0
24 K.Achamma 5 5 1 1 0 0 0 1
25 J.Mariyamma 0 0 1 1 0 1
26 R.Lakshmi 0 0 1 1 1
27 SK.Allabee 1 0 2 2 1 2 3
28 P.Nirmalarani 1 2 2 3 1 2 0 2
29 D.Prabhavathi 2 1 1 0 0 3
30 M.Bhulashmi 1 2 3 1 0
31 P.Vijayalakshmi 2 3 1 2 2 2
32 Sriram.Mispa 0 1 1 1 1 1 2
33 V.Meri Rani 3 1 1 2 1 0 2
34 M.Anantharajyam 2 2 3 2 2 1 4
35 Ch.Vijayalashmi 1 1 1 2 1 2
36 D.Rajitha 1 1 1 1 1 1
37 N.Sukhanya 0 2 1 1 1 2
38 M.Mariya Kumari 2 1 2 1
39 I.Sridevi 1 2 3 2 1 3
40 M.Mariyamma 4 4 0 0 0 1
41 M.Anitha 3 3 3 2
42 D.Mahalakshmi 1 2 4 0 1
43 M.Ch.Mariyamma 2 2 3 0
44 M.Mariyamma 1 1 3 3 0 0 4
45 M.Rojamma
46 T.Parisuddamm 2 2 1 1 0 2
47 N.Chinnammai 4 0 1 1 1 1
48 M.Sanjeevamma 3 2 2 1 3
6
Follow up of LBW babies
R/U
Name of the District
7
Follow up of SNCU discharge babies
R/U
Child Health
me of the PHC : GUNTUPALLI
8
Infant death reporting to Sub-centre and PHC
R/U
9
Intesive Diarrhoea Control Programme
R/U
:PRAKASAM APRIAL-17
10
R/U Complete Immunization in 1st year of age
11
R/U
0
1
1
1
1
0
0
0
1
4
2
1
5
0
Immunization
Full Immunization
0
0
1
2
0
2
2
1
3
2
2
3
0
3
Tubectomy
R/U
Vasectomy
R/U
Family Planning
3 3
2 2
2 2
2 3
1 2
2 1
2 5
0 0
5 6
0 0
0 0 0
2 0
4 3
3 3
3 0
0 2
5 0
2 2
2 1
2 1
1 2
2 1
1 1
2 2
3 1
0 0
2 1
0 2
1 0
0 2
2 3
Support to Peer Educator
16
R/U
Mobilizing Adolescents for AHD
17
R/U
RKSK (only for HPDs)
18
treatment)
R/U
Previous treated TB case (57 contacts, catg.II TB
19
8-9 months treatment
R/U
RNTCP
20
TB patient
R/U
Identification & Successful completion of DOTS
21 for TB
R/U
treatment
R/U
NLEP
R/U
endemic dist
27
R/U
akulam, Vizianagaram, East Godavari)
28
DH / Medical College
R/U
Mobilizing & attending VHND in the month
29
R/U
2
2
2
2
2
2
2
2
2
2
2
2
2
2
Attending VHSNC meeting
30
R/U
31 Atttending ASHA Day Meeting
R/U
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Routine & Recurrent activities
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
2 1 1
ities
Preparation of list of ANC beneficiaries to be
35
updated on monthly basis
R/U
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Preparation of list of eligible couples updated on
36
monthly basis
R/U
1
1
1
1
1
1
1
1
1
1
1
1
1
1
No.of ASHA attended 104 Fixed day health
37
services in villages
R/U
state
104 (by
budget)
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
1 1
Monthly Financial Performance report of ASHA Activities
Name of the Distri
Name of the PHC :Guntupalli
Maternal Health Ch
PHC/Institutons
No. of 2 nd check up
Sub Centre
No. of 3 rd check up
No. of 1st check up
Delivery)
Rs 60/- / Rs.300/- / Rs
Rs.240/- / Rs.160/- Rs.250/-
Rs.40/- Rs.200/- 200/-
R/U R/U R/U R/U R/U R/U R/U R/U
1 2 3 4
1 S.salomi 240 240 300 120 60 300 250
2 K.salomi 180 180 240 60 750
3 B.sivaleela 180 120 0 120 240 1200 750
4 T.Bharathi 120 0 240 180 0 0 500
5 T Rajyalakshmi 0 60 120 120 240 0 500
6 CH.Mariyamma 60 60 60 0 360 300 0 0
7 R.Sreedevi 60 60 60 60 120 300 0 0
8 J.Gopika rani 120 120 0 120 60 0 0 1000
9 SK.Mahaboobee 60 60 120 0 60 300 0 750
10 Y.Padmavathi 300 300 60 120 0 300 0 250
11 B.Nagamalli 180 180 60 120 0 0 0 250
12 K.Mariyamma 120 120 60 120 0 300 0 250
13 T.Aruna 120 120 120 60 0 250
14 V.Nagarathnam 0 0 0
15 M.Nagamani 0 0 0
16 P.Chamundeswari 480 360 180 180 750
17 G.Varalashmi 180 180 180 120 0 0 250
18 Sk.Shabina 0 1210 180 240 250
19 K.Nagamma 120 120 120 180 250
20 V.Sakkubai 120 180 240 0 120 500
21 SK.Guljarbee 120 180 180 0 120 500
22 B.Sundaramma 240 180 180 0 0 500
23 SK.Himam bee 0 120 120 0 0 0
24 K.Achamma 300 300 60 60 0 0 0 250
25 J.Mariyamma 0 0 60 60 0 250
26 R.Lakshmi 0 0 60 60 250
27 SK.Allabee 60 0 120 120 60 600 750
28 P.Nirmalarani 60 60 120 180 60 600 0 500
29 D.Prabhavathi 60 60 60 500
30 M.Bhulashmi 60 60 120 60 60 0
31 P.Vijayalakshmi 60 120 120 60 180 250
32 Sriram.Mispa 0 0 60 60 60
33 V.Meri Rani 180 60 60 120 60 0 500
34 M.Anantharajyam 120 120 180 120 120 300 1000
35 Ch.Vijayalashmi 60 60 60 120 300 500
36 D.Rajitha 60 60 60 60 300 250
37 N.Sukhanya 0 120 60 60 300 500
38 M.Mariya Kumari 120 60 120 60
39 I.Sridevi 60 120 180 120 60 750
40 M.Mariyamma 240 240 0 0 0 250
41 M.Anitha 180 180 180 500
42 D.Mahalakshmi 60 120 240 0 250
43 M.Ch.Mariyamma 120 120 180 0
44 M.Mariyamma 60 60 180 180 0 0 1000
45 M.Rojamma
46 T.Parisuddamm 120 120 60 60 0 500
47 N.Chinnammai 240 0 60 60 300 250
48 M.Sanjeevamma 180 120 120 60 750
Rreferral & Follow up of SAM Cases
5
to NRC
R/U
Rs.150/-
0
6
Follow up of LBW babies
R/U
Rs.200/-
Name of the District
7
Child Health
R/U
Rs.200/-
:PRAKASAM
8
and PHC
R/U
Rs.50/-
Financial Year
9
Programme
R/U
Rs.200/-
11
year of age
R/U
Rs.100/-
200
200
100
100
100
100
100
100
400
200
100
500
0
0
0
0
0
0
Immunization
12
age
R/U
Rs.50/-
100
100
150
100
100
100
150
100
100
150
150
0
0
0
50
0
50
0
100 100
200 50
200 250
0 0
500 300
0 0
0 0 0
200 0
300 100
200 0
300 100
0
200 0
200 100
200 50
200 50
100 100
200 50
100 50
200 100
300 50
0 0
100
200 50
0 100
100 0
0 100
200 150
No. of Counseling & Motivation for
14
men of Vasectomy
R/U
Rs.200/-
Family Planning
Accompanying the beneficiary for
15
PPIUCD
R/U
Rs.150/-
Support to Peer Educator
16
R/U
Rs.100/-
Mobilizing Adolescents for AHD
17
R/U
Rs.200/-
RKSK (only for HPDs)
18
6-7 months treatment)
R/U
Rs.1000/-
Previous treated TB case (57
contacts, catg.II TB 8-9 months
19
R/U
treatment
Rs.1500/-
RNTCP
of DOTS for TB
R/U
Rs.250/-
Complete treatment
R/U
Rs.650/-
NLEP
NLEP
MB - Dsetection + complete treatment
23
R/U
Rs.850/-
Preparation of Blood Slide
24
R/U
Rs.15/-
Complete treatment for RDT +ve PF
25 case & complete Radical treatment to
R/U
+ve PF & PC cases
NVBDC Programme
R/U
Hydrocele cases in non-endemic dist
Godavari)
27
R/U
Referral of AES / JE cases to the
28
nearest CHC / DH / Medical College
(Srikakulam, Vizianagaram, East
R/U
Rs.75/- Rs.200/- Rs.300/- Rs.300/-
Mobilizing & attending VHND in the
29
month
R/U
Rs.200/-
200
200
200
200
200
200
200
200
200
200
200
200
200
200
200
200
200
200
Attending VHSNC meeting
30
R/U
Rs.150/-
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
basis
Rs.100/-
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
200 100 100
monthly basis
Rs.100/- Rs.100/-
R/U R/U
35 36
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
100 100
0
Status of ASHA HBNC visits - (to be submitted by the state electronica
26-Apr
Sl. Name of the District
No
No. of
ASHA ASHA No. of
No. of
trined in started Newborns
ASHAs (in
module doing visitied
Position)
6th & 7th home for HBNC
visits
1 JANAKAVARAMPANGULURU
2 KORISAPADU
3 MARELLA
4 MEDARAMETLA
5 MODEPALLI
6 PRASANGULAPADU
7 SANTHANUTHALAPADU
8 BANDLAMUDI
9 VEMULAPADU
10 CHINAGANJAM
11 Thimmasamudram
12 EPURUPALEM
13 PANDILLAPALLI
14 SANTHARAVUR
15 VETAPALEM
16 ARDHAVEEDU
17 BESTAWARIPETA
18 GALIZERGULLA
19 MOKSHAGUNDAM
20 PUSALAPADU
21 THURIMELLA
22 YACHAVARAM
23 CHANDALUR
24 DONAKONDA
25 KURICHEDU
26 MUNDLAMURU
27 THALLUR
28 AKAVEEDU
29 ANUMALAVEEDU
30 KOMAROLU
31 KRISTAMSETTYPALLI
32 RAJUPALEM
33 SANJEEVARAOPETA
34 Lingasamudram
35 Machavaram
36 Ponnaluru
37 Voletivaripalem
38 GURAVAJIPETA
39 HANUMANTHUNI PADU
40 NAGIREDDYPALLI
41 PEDACHERLO PALLE
42 VELIGANDLA
43 KAMEPALLI
44 PETLUR
45 ZARUGUMILLI
46 GAJJALAKONDA
47 TARLUPADU
48 THIPPAYAPALEM
49 DRONADULA
50 GUNTUPALLI 45 43 57 55
51 SANTHAMAGULURU
52 YEDDANA PUDI
53 AMMANABROLU
54 ETHAMUKKALA
55 KARAVADI
56 KOTHA PATNAM
57 MADDIPADU
58 NAGULUPPALA PADU
59 POTHAVARAM
60 TANGUTUR
61 CHANDRA SEKHARA PURAM
62 CHERUKURU
63 DAGGUPADU
64 DUDDUKUR
65 INKOLLU
66 KARAMCHEDU
67 SWARNA
68 Chetlamitta
Not Give
y the state electronically and physically to DC (CH)
No. of No. of
LBW / No. of ASHAs HBNC
high Risk No. of Newborn who have payment
babies sick deaths received expenditu
reported newborns reported the HBNC re in this
out of referred under payment Month
those HBNC in this (Rs.)
visited Month
0 0 0 0 0
ASHA Functionality Report For the month of A
1 Set of2 3 4 5
Managem
Newborn
home ent of
visits
visits for Attending childhood
within first Supportin
newborn VHNDs/Pr illness
SL. day of g
Name of the district care as omoting especially
No birth in institutiona
specified immunizati diarrhea
case of l delivery
in the on and
home
HBNC pneumoni
deliveries
guidelines a
Rular
1 JANAKAVARAMPANGULURU
2 KORISAPADU
3 MARELLA
4 MEDARAMETLA
5 MODEPALLI
6 PRASANGULAPADU
7 SANTHANUTHALAPADU
8 BANDLAMUDI
9 VEMULAPADU
10 CHINAGANJAM
11 Thimmasamudram
12 EPURUPALEM
13 PANDILLAPALLI
14 SANTHARAVUR
15 VETAPALEM
16 ARDHAVEEDU
17 BESTAWARIPETA
18 GALIZERGULLA
19 MOKSHAGUNDAM
20 PUSALAPADU
21 THURIMELLA
22 YACHAVARAM
23 CHANDALUR
24 DONAKONDA
25 KURICHEDU
26 MUNDLAMURU
27 THALLUR
28 AKAVEEDU
29 ANUMALAVEEDU
30 KOMAROLU
31 KRISTAMSETTYPALLI
32 RAJUPALEM
33 SANJEEVARAOPETA
34 Lingasamudram
35 Machavaram
36 Ponnaluru
37 Voletivaripalem
38 GURAVAJIPETA
39 HANUMANTHUNI PADU
40 NAGIREDDYPALLI
41 PEDACHERLO PALLE
42 VELIGANDLA
43 KAMEPALLI
44 PETLUR
45 ZARUGUMILLI
46 GAJJALAKONDA
47 TARLUPADU
48 THIPPAYAPALEM
49 DRONADULA
50 GUNTUPALLI 0 44 84 76 0
51 SANTHAMAGULURU
52 YEDDANA PUDI
53 AMMANABROLU
54 ETHAMUKKALA
55 KARAVADI
56 KOTHA PATNAM
57 MADDIPADU
58 NAGULUPPALA PADU
59 POTHAVARAM
60 TANGUTUR
62 CHERUKURU
63 DAGGUPADU
64 DUDDUKUR
65 INKOLLU
66 KARAMCHEDU
67 SWARNA
68 Chetlamitta
69 Chinthala
70 Korraprolu
71 Peda araveedu
72 GOTLAGATTU
73 KAKARLA
74 KONAKANAMITLA
75 MARRIPUDI
76 UPPALAPADU
77 GUDLURU
78 KAREDU
79 SINGARAYAKONDA
80 Annasamudram
81 Dupadu
82 Mutukula
83 Palutla
84 Pullalacheruvu
85 Tripuranthakam
86 Venkatadripalem
87 Y.Palem
Urban
1 PPUnit, Ongole
2 PPUnit, Chirala
3 Markapuram
4 Giddalur
Total 0 44 84 76 0
ort For the month of APRIAL-17
6 7 8 9 10 11 12
Fever
Total Total
cases Successful referral of
Holding or number of Number of
Household seen/mala ASHAs the IUD, female
attending ASHAs ASHAs
visits with ria slides acting as sterilization or male
village/VH who are who did
nutrition made in DOTS sterilization cases
SNC functional not
counseling malaria provider and/or providing
meeting on at least report/not
endemic OCPs/Condoms
6/10 tasks known
area
54 0 27 0 310 34
54 0 27 0 310 34 0
0
0
ASHAs working under NRHM
Sl. No. Name of the ASHA Name of the Sub-Center Name of the Village
52 48
NOTE : Please mention All Asha's Mobile Numbers and Aadhar Numbers its very
ASHAs working under NRHM Account Data for online fund transfer - Prakasam District
Performance
based
incentive ASHA (Beneficiary) Bank ASHA (Beneficiary) Bank Name Adhar Nunber
proposed for Account No.
the month (in Asha day
Rs.) meeting T.A
2460 150 11310205369 State Bank of India 666314030589
To be Trained 4th
Round
25