School based immunization plan for DPT-2 and Td - Sub-center/ ANM area Form-SC-11A
Subcenter / ANM Area: RI Sessions plan
(MO IC to ensure this format is filled for all sub-centres/ ANM areas, including vacant sub-centres/ANM area)
District/ Corporation: NIZAMABD Block / Urban: ARMOOR PHC / UPHC: MENDORA SC / ANM area: VELKATUR/MENDORA :
Name of Medical Officer I/C: [Link] VINUTHNA Mobile no.: 9951196086 SUB CENTER: VELKATUR
Name of ANM: [Link] Mobile no.: 9959451813 Name & Designation of Supervisor: K. BHEEMANNA Mobile no.: 7893403424
Contact no. of Target beneficiaries per year Vaccine vials required Session day, week Name of ASHA/Mobilizer
School / Principal & month supporting session
5-6 yrs (DPT 10 yrs 16 yrs (Td) 5-6 yrs (DPT Td [(h+i)X1.11]
Sl. Village / Urban Name of Principal / Head master / mention date
Name of School Affiliatio n Booster2) (Td) 10th std Booster2) / 10
No. area / Head Master
1st std 5th std (g X 1.11 / 10)
a b c d e f g h i j k l m
1 VELKATUR ZPHS VELKATUR GOVT K SRINIVAS 9989025969 0 0 7 0 1 DEVAKALA
A SYTHISH
2 " MPPS VELKATUR GOVT 9948976891 0 2 0 0 1 Y RAJAMANI
KUMAR
3 " MPPS SC SCHOOL GOVT G SURENDAR 9502338801 0 2 0 0 1 S RAJALAXMI
LITTLE FLOWER MD AZMATH
4 " SCHOOL, VELKATUR
PVT 7989375342 101 50 0 12 6 DEVAKALA
PASHA
SRI
5 " PVT B GAJARAM 9553848383 52 8 0 6 1 DEVAKALA
VIVEKANANDA
NADMI MPPS SCHOOL,
6 GOVT T PRABHAKAR 9505327919 1 0 0 1 1 S RAJALAXMI
THANDA NADMI THANDA
MPPS
7 VENCHIRYAL GOVT SWAROOPA 9490558425 3 2 0 1 1 LAVANYA
VENCHIRYAL
TOTAL 157 64 7 20 12
Community based immunization plan for DPT Booster -2 and Td for school dropout children - Sub-center/ ANM area
Subcenter / ANM Area: RI Sessions plan
(MO IC to ensure this format is filled for all sub-centres/ ANM areas, including vacant sub-centres/ANM area)
District/ Corporation: NIZAMABD Block / Urban: ARMOOR PHC / UPHC: MENDORA SC / ANM area: VELKATUR/MENDORA :
Name of Medical Officer I/C: [Link] VINUTHNA Mobile no.: 9951196086 SUB CENTER: VELKATUR
Name of ANM: [Link] Mobile no.: 9959451813 Name & Designation of Supervisor: K. BHEEMANNA Mobile no.: 7893403424
Target beneficiaries per year Vaccine vials required AD syringes
required
Contact no. of 5-7 yrs (DPT Booster2) 10 -16 yrs (Td) 5-7 yrs (DPT Td [gX1.11] / 10
Sl. Village / Urban Address of Name of Anganwadi Session day, week &
Anganwadi (Aanganwadi (for school drop- Booster2)
No. area Aanganwadi centre worker month / mention date
worker children & School outs) (f X 1.11 / 10) [(f+g) X 1.11] / 10)
dropouts)
a b c d e f g h i j k
1 VELKATUR BC AREA T SRILATHA 9948826248 - - - - - -
2 VELKATUR SC AREA Y VIJAYA 8985867040 - - - - - -
3 VELKATUR BC & OC AREA U RAMADEVI 9133873742 - - - - - -
NADMI NADMI
4 B SUNITHA 9121689475 - - - - - -
THANDA THANDA GP
5 VENCHIRYAL MPPS SCHOOL G PADMA 7815839238 - - - - - -
TOTAL
Form-SC-11 B
Name of
ASHA/Mobilizer
supporting session