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C Ase Format: Govt of Kerala Department of Homoeopathy

This document provides a format for reporting epidemic cases in homeopathy in Kerala, India. It includes sections for background information on the geographical location and demographics of the affected area, as well as historical data on previous epidemics. The format also includes sections for case definitions, biodata on individual patients, present illness details, psychological expressions, physical exam findings, and laboratory results to comprehensively document each epidemic case.

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Dr.Augustin.A.J
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616 views

C Ase Format: Govt of Kerala Department of Homoeopathy

This document provides a format for reporting epidemic cases in homeopathy in Kerala, India. It includes sections for background information on the geographical location and demographics of the affected area, as well as historical data on previous epidemics. The format also includes sections for case definitions, biodata on individual patients, present illness details, psychological expressions, physical exam findings, and laboratory results to comprehensively document each epidemic case.

Uploaded by

Dr.Augustin.A.J
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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C ASE FORMAT

GOVT OF KERALA
DEPARTMENT OF HOMOEOPATHY
RAPID ACTION EPIDEMIC CONTROL CELL IN HOMOEOPATHY

FORMAT FOR AN EPIDEM IC CASE TAKING

Reporting Centre: Date:

1.Background
Kara ward Village Panchayath/Municipality/Corporation
Geographical
Location Block Taluk District

Location
Map

Climatic Conditions Summer Winter Pre Monsoon Monsoon Post Monsoon

Demographic
Status
(population
Pyramid)

Organisations of Health Sources Allopathy Ayurveda Homoeopathy Others None

2.Historical Data

Previous occurance of epidemics of the same disease(Locally/Elsewhere):

In the same area In other area


Occurance of related diseases(if any):

Discovery of first cases of the present out break:

3.Methodology of investigations
Case Definitions
(Common symptoms of
the Case)

Page 1 of 4
4.Biodata
Name: Age: Sex(M/F)

Address: Occupation:

Religion:

Resident Migrant Traveller


Social Class:

Financial Status: APL/BPL


Personal Contacts Home Work School Other places:
Attended in special events or Ingestion of contaminated food Milk Water
parties
Visits out of the Community:

H/O Recurring injections Blood Products Attendance in large gatherings

Dwellings: Hilly/Riverbed/Marshy/Slum/Coastal/Urban/Rural
Health Status prior to the Epidemic:

Health Status during the Epidemic:

Domestic Hospitalised
Habits :

Other medicine consumption during the epidemic:

No. of other persons affected in the house:

Time of onset of Disease:

Aetiologic Factors if any (Specific):

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5.Present Illness – (vide database sheet)
Location Sensation/Pathology Modalities Concomitants/Acompaniments

A. Chief Complaints with duration

B. Accompaniments

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6.Psychic
Expressions

7.Physical features
Appetite: Thirst:
a.Functional generals Urination: Bowels:
Perspiration: Sleep:
Menstruation:
Pallor Cold in general
Icterus Cyanosis
b.Physical findings Clubbing Lymphadenopathy
Oedema Tourniquet Test
Signs of dehydration Mild/Moderate/Severe
Skin Normal/Cold/Dehydrated
Pulse: /mt R.R: /mt B.P: Temp:

c.Systemic Findings

d.Laboratory Findings

Place: Signature:
Date: Name of Doctor:

Page 4 of 4

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