MoH-258

Notice:
1. Hakikisha umebeba kadi hii kila wakati unapotembela kituo cha afya.
Republic of Kenya
(Ensure that you carry this card every time you visit a health
Ministry of Health
facility)
National AIDs/STD Control
2. Muone daktari wakati wowote mwili unapopatwa na jambo lisilo la Programme
CCC Patient Appointment Card
kawaida. (Consult a doctor or nurse any time you feel unwell.)
3. Kumbuka kufuata maagizo ya daktari kuhusu matumizi ya dawa za
Name of Health facility
Anti-retroviral (ART). Remember to follow the doctor’s
instructions on the use of Antiretroviral drugs (ARVS). Patient’s name
4. ART ni dawa za kutumiwa milele. Kwa mawaidha zaidi, uliza daktari
Patient’s Unique No.
aliye karibu nawe. ART works and is life long treatment. For more
Date enrolled in CCC
information, consult your nearest health worker.
Date started ART
 Dose Visit Dose to last Client Type Visit Wt Viral load Next Viral No. of Date of
Jina La Dawa
by: (in Days) (Next Visit) Date (Kg) copies load due Days Next Visit
Drug Name
S/TS ST, ET, C (if applicable date Missed
today) Drug

ST-Standard package , ET -Express package (Pharmacy ) ,C- community dispensing, TS- Treatment supporter, S-self