MONTHLY DATA CAPTURE FORMAT (MDCF)

(As per Enrolment Register, Account, Passbook and cooking cost detail)

Name of the School_____________________________ Enrollment Pre-Primary________ Enrollment Primary_________

Month____________Year__________________

School Type I. Government Category( Primary/Upper

II. EGS/AIE Centre Village
III. Local Body Block
IV. Madarsa/Maqtab Distt.
Area I Rural II urban State

Cook Cum Helper Detail

Cook cum helper Name Gender M/F Category Below poverty Line Mode of Honorarium Remarks
Payment

Meals Availed Status

No. of Actual Total Opening Amount Expenditure Closing Balance in
school Number of Meals balance Received during the Balance Passbook
Days days Meal Served during Month month
During Served. during the
Month. month
Primary
Rice
Pre- Primary

Primary
Ingredient
Pre-
Primary
Primary
Transportation
Pre-
Primary
Interest
others
School Expenses (in Rs.)
I. Management, Monitoring and Evaluation Total Expenditure Date of Expenditure During the Cumulative Expenditure at
expenses during the month month school

Children Health Status

1.) No. of children from class 1 to 8 who had received 4 IFA tablets (Boys)
2.) No. of children from class 1 to 8 who had received 4 IFA tablets (Girls)
3.) No of children screened by mobile health (RBSK) team
4.) No. of children referred by mobile health (RBSK) team
School Inspection
School inspection one during the month by
Member of Task Force
District
Block/Taluka level Officials
SMC Members

Untoward incidents during the Month (if Any) ________________________________

MDM Incharge Name__________________ Signature of SMC Chairperson___________

Contact No______________ Name & Signature of Head of the

School_______________ Contact No______________