SUM
SUM Hospital
Neonatal Medical Record System
Actions
Submit Record
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Sections
General Information
Registration / Birth Details
Maternal Details
Medical Problems (Mother)
Obstetric Problems
Labour / Delivery
Neonatal Details - Resuscitati...
Neonatal Details - Morbidity
Respiratory Disorders
CNS Disorders
Major Malformations
Neonatal Infections
Miscellaneous Morbidities
Treatment
Nutrition
Maternal Death
Screening
Condition at Discharge
Other Information
General Information
Centre Code
Baby's Hospital Record No.
High Risk Baby
Select High Risk Baby
Yes
No
Readmission
Select Readmission
Yes
No
Registration / Birth Details
Mother's Name
Father's Name
Date of Birth (dd/mm/yyyy)
Time of Birth (24 Hrs)
Sex
Select Sex
Male
Female
Birth Weight
Gestation (best estimate)
Mode of Delivery
Select Mode of Delivery
Normal
Cesarean
Forceps
Vacuum
Baby Attended at Birth by
Apgar 1 min
Apgar 5 min
Apgar 10 min
Single / Multiple
Select Single / Multiple
Single
Twin
Triplet
Other
Address
Tel Number
Mother Blood Group
Select Mother Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Baby Blood Group
Select Baby Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Maternal Details
Mother CR No
Unit
Maternal Age
Gravida
Para
Abortion
Still Birth
Previous IUGR
Select Previous IUGR
Yes
No
Antenatal Care
Select Antenatal Care
Yes
No
Booked
Select Booked
Yes
No
Others
Medical Problems (Mother)
Does the mother have any medical problems?
Select Does the mother have any medical problems?
Yes
No
Obstetric Problems
Did the mother have any obstetric problems during pregnancy?
Select Did the mother have any obstetric problems during pregnancy?
Yes
No
Labour / Delivery
Were there any problems during labour and delivery?
Select Were there any problems during labour and delivery?
Yes
No
Neonatal Details - Resuscitation
Did the baby require resuscitation at birth?
Select Did the baby require resuscitation at birth?
Yes
No
Neonatal Details - Morbidity
Did the baby have any morbidity requiring NICU care?
Select Did the baby have any morbidity requiring NICU care?
Yes
No
Respiratory Disorders
Did the baby have any respiratory distress?
Select Did the baby have any respiratory distress?
Yes
No
CNS Disorders
Did the baby have any CNS disorders?
Select Did the baby have any CNS disorders?
Yes
No
Major Malformations
Did the baby have any major malformations?
Select Did the baby have any major malformations?
Yes
No
Neonatal Infections
Did the baby have any neonatal infections?
Select Did the baby have any neonatal infections?
Yes
No
Miscellaneous Morbidities
Did the baby have any miscellaneous morbidity?
Select Did the baby have any miscellaneous morbidity?
Yes
No
Treatment
Did the baby receive any treatment?
Select Did the baby receive any treatment?
Yes
No
Nutrition
Start of Enteral Feed (Day of life)
Select Start of Enteral Feed (Day of life)
Yes
No
Time to reach (100ml/kg/day) (Day of life)
Time to reach (180ml/kg/day) (Day of life)
HMF Started On (Day of life)
Iron Started On (Day of life)
OG to Paladai Transition (Day of life)
KMC Started On (Day of life)
Other Mother Milk (Day of life)
Select Other Mother Milk (Day of life)
Yes
No
Formula (Day of life)
Select Formula (Day of life)
Yes
No
Maternal Death
Did the Mother Die?
Select Did the Mother Die?
Yes
No
Screening
Red Reflex
TSH (mlu/ml)
CCHD
Select CCHD
Pass
Fail
NBS
Select NBS
Normal
Abnormal
Awaiting
Icterus(mg/dl)
Condition at Discharge
Weight at Discharge
Head Circumference (in cm)
Length (in cm)
EUGR
Select EUGR
Yes
No
Other Information
Hospital Course
Select Hospital Course
Good
Fair
Poor
Diagnosis
Date of Discharge (dd/mm/yyyy)
Intrauterine Growth Category
Select Intrauterine Growth Category
AGA
SGA
LGA
NNPD Number
Date Entered By
Supervised By