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CASE RECORD FORM COVID-19 IN PREGNANCY PAKISTAN Adapted from WHO PREGNANCY MODULE FOR COVID-19 CASE RECORD FORM RAPID version 23MAR2020PARTICIPANT ID/ MR NO I I I I I I I I I I I I I I I I I I HOSPITAL

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How to fill out pregnancy module form 1

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Step 1: Start by opening the pregnancy module form 1.

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Step 2: Fill in your personal information such as your name, age, and contact details.

03

Step 3: Provide accurate information about your pregnancy history, including the number of previous pregnancies, any complications experienced, and the date of your last menstrual period.

04

Step 4: Answer the questions related to your current pregnancy, such as the estimated due date, any ongoing medical conditions, and any tests or screenings you have undergone.

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Step 5: If applicable, provide information about any medications or supplements you are currently taking, as well as any allergies or allergies experienced during previous pregnancies.

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Step 6: Review all the information you have provided and make sure it is accurate and complete.

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Step 7: Once you are satisfied with the form, sign and date it to confirm the accuracy of the information.

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Step 8: Submit the filled-out form to the relevant authority or healthcare provider as instructed.

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Step 9: Keep a copy of the form for your own records.

Who needs pregnancy module form 1?

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Pregnancy module form 1 is needed by pregnant women who are seeking medical care or assistance during their pregnancy. It is typically required by healthcare providers, hospitals, or government agencies to gather important information about the woman's pregnancy history and current condition. It helps in ensuring proper prenatal care and monitoring of the mother's health and the baby's development. Additionally, the form may also be required for administrative purposes such as eligibility for certain benefits or programs related to pregnancy and childbirth.

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What is pregnancy module form 1?

Pregnancy Module Form 1 is a specific form used to report pregnancy-related information for monitoring and public health purposes.

Who is required to file pregnancy module form 1?

Pregnant individuals or healthcare providers who manage pregnancies are typically required to file Pregnancy Module Form 1.

How to fill out pregnancy module form 1?

To fill out Pregnancy Module Form 1, gather necessary personal and medical information, follow the instructions provided on the form, and ensure all sections are accurately completed before submission.

What is the purpose of pregnancy module form 1?

The purpose of Pregnancy Module Form 1 is to gather data on pregnancies for research, healthcare planning, and to improve maternal and fetal health services.

What information must be reported on pregnancy module form 1?

Required information typically includes personal details, medical history, pregnancy duration, and any significant health concerns or complications.

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