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Annex 1: Attendance Sheets at District and Sub county level

Name of District
Activity Title
Location of Activity
Date of activity

No. Name of participant Sex Telephone Sub county Health Facility Designation Signature
contacts
Name of District
Activity Title
Location of Activity
Date of Payment
No. Name of participant Place of work Designation SDA Signature
Telephone No. of Transport
contact Days refund
attended
Annex 1: Attendance Sheets at District and Sub county level

Name of District
Activity Title
Location of Activity
Date of activity

No. Name of participant Sex Telephone Sub county Health Facility Designation Signature
contacts
Name of District
Activity Title
Location of Activity
Date of Payment
No. Name of participant Place of work Designation SDA Signature
Telephone No. of Transport
contact Days refund
attended
Annex 1: Attendance Sheets at District and Sub county level

Name of District
Activity Title
Location of Activity
Date of activity

No. Name of participant Sex Telephone Sub county Health Facility Designation Signature
contacts
Name of District
Activity Title
Location of Activity
Date of Payment
No. Name of participant Place of work Designation SDA Signature
Telephone No. of Transport
contact Days refund
attended

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