1.

Map Description of the Existing System

Description of the diffrent services currently undertaken at Jimma City Health Center

1.1. Services provided by Card Room are:

a) Identification of patient and send to appropriate rooms
b) Holding different documentaions
c) Make a stamp on different documents sent form diffrent providers.
d) Facillitating a health education to waiting patients

1.2. Services provided by OPD Service team are:

a) Giving a physical examination and PIHCT services
b) Laboratory Service
c) Pharmacy Service
d) Emergency Service
e) Financial Processing for Services
f) Injection and Dressing
g) Sick Baby Clinic/Growth Monitoring
h) TB and Leprosy Services
 1.3. Services provided by Prevention Service team are:
a) Vaccination Service

b) Antenatal Care and PMTCT

c) Family Planning Services

d) HIV Voluntary Counseling & Testing(VCT)

e) ART(Anti Retroviral Therapy) Service

f) Post Natal Services(PNC)

g) Growth Monitoring ( Well Baby Clinic )

1.4. Services provided by Prevention Service team are:

a) Inpatient service coordination
b) Delivery Service
c) Referal Service
d) Discharge Service

2. Documentation At Card Room

a) Integrated individual folder (summary sheet inside)
b) Patient form/card

c) Service ID card

d) Appointment card

e) Master patient index (MPI)
 f) Tracer Card

Description of Formats used

a) Integrated individual folder (summary sheet inside)
(One line per visit – not for clinical notes)
i. Folder

¾Ö?“ }sS< eU ___________________
NAME OF FACILITY

¾I¡U“ "`É lØ` ___________________ ¾} S²Ñu<uƒ k” ____________

MEDICAL RECORD NUMBER DATE OF REGISTRATION:
(DD/MM/YY)

eU _________________________________ ¾›vƒ eU ___________________

NAME FATHER’S NAME

¾›Áƒ eU -------------------------------- ë-------------------

GRAND FATHER’S NAME SEX

¾MŃ : k ” ---------- ¨`--------------¯ /U--------------° É T------------

DATE OF BIRTH DAY MONTH YEAR AGE

›É^h ¡MM ________________

ADDRESS: REGION

¨[Ç/¡õK-Ÿ}T _______________ kÖ“ /ÔØ ___________________
WOREDA/SUBCITY KATENA/GOTT

kuK? ________________ ¾u?ƒ lØ` _______________

KEBELE HOUSE NUMBER

eM¡ lØ` ___________________
PHONE NUMBER
*      Write the department providing service: IPD, OPD, ANC, FP, EPI, etc

ii. Summary Sheet

SUMMARY SHEET

** OPD / IPD Service – write diagnosis
FP, ANC, PNC – write complication, if any
EPI – write antigen given
 Serial
number in
service
Date Diagnosis / Complication registration
(DD/MM/YY) Service* or Service Detail ** book Cost
 b) Patient form/card
PATIENT CARD
MEDICAL RECORD NUMBER ___________
NAME __________________________________________AGE ____ SEX ______
Date
(DD/MM/YY)
c) Service ID card