22nd November 2017 UPDATED 10th Dec 2017
SECTION A BASIC : Client Management System
Name of client:
GENERATED ID:
Gestational Age (GA): Expected Date of Delivery:
Facility/Organization: [ ] Name of pregnancy school /Ghana Health Service Institution / Christian Health Association of Ghana Instituion/ Private Facility / individual signup
Assigned midwife/room:
EHP Service Subscription
[ ] Institution based Messages to assigned midwife on this client
[ ] Personal Health Promotion Messages and Titbits
[ ] e-BLOOD Pressure program
[ ] Trimester 3 (T3) Alerts
[ ] will need other finances after delivery
TrimesterSave Savings Program
Type of Savings(ToS): [ ] individual , [ ] Group
* if group state contributotors [ eg. Husband, donors etc ]
Preferred Savings Partner: [ ] Ecobank [ ] Other
.....detail attached