ICMR
 arrow Health Care of the Rural Aged Books
SECTION II
SCREENING SCHEDULE
  Key : Present 1
  Absent 0
(1-3) Job Number
(4-5) Card design
(6-7) Card Number
(8-9) Sub-centre
(10-11) Village
(12-14) Serial No.
(15) Visual handicap
(16) Hearing Deficit
(17) Headache
(18) Chest pain
(19) Abdominal pain
(20) Backache
(21) Pain in the joints
(22) Vague body pain
(23) Fever
(24) Cough
(25) Expectoration and haemoptysis
(26) Palpitation
(27) Oedema
(28) Giddiness
(29) Attacks of unconsciousness
(30) Fits
(31) Paralysis
(32) Micturition problem (including incontinence)
(33) Itching
(34) Swelling
(35) Non-healing ulcer
(36) Injury
(37) Altered gait
(38) Burning
(39) Numbness
(40) Loss of appetite
(41) Loss of weight
(42) Belching
(43) Constipation
(44) Sleeplessness
(45) Mood depressed
(46) Irritability
(47) Memory deficit
(48) Fear
(49) Excitement
50) Self neglect
<<Back | Index | Next>>