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, CBC MIDLINE HEALTH EXTENSION WORKER INTERVIEW FORMMODULE 1 BACKGROUND INFORMATION OF THE HEALTH POST HE1.1Date (dd/mm/YYY) Gregorian CalendarHE1.2Region CodeHE1.3Zone CodeHE1.4Woreda NameHE1.5Woreda

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How to fill out cbnc midline health extension

01

Start by gathering all the necessary information and documents required to fill out the CBNC midline health extension form.

02

Begin by providing basic personal information such as name, address, contact number, and date of birth.

03

Proceed to fill out the various sections of the form related to health history, including any pre-existing medical conditions, medications currently being taken, and any allergies.

04

Next, provide information about any previous surgeries or medical procedures undergone.

05

Move on to the section regarding vaccination history and make sure to include details about immunizations received and their dates.

06

Include information about any ongoing or past medical treatment, including the name of the healthcare provider and the duration of treatment.

07

If applicable, complete the section related to reproductive health, including details about menstrual cycle, contraceptives used, and any history of pregnancy.

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Finally, review all the provided information to ensure accuracy and completeness before signing and submitting the CBNC midline health extension form.

Who needs cbnc midline health extension?

01

CBNC midline health extension is typically needed by individuals who require an extension of their health coverage under the CBNC program. This may include beneficiaries who have reached the end of their current coverage period and need to extend it for further medical care. Additionally, individuals who have experienced changes in their health status or require an update in their health information may also need to fill out the CBNC midline health extension.

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What is cbnc midline health extension?

CBNC Midline Health Extension is a form used to report health information for midline extension.

Who is required to file cbnc midline health extension?

Healthcare facilities and providers who are involved in midline extension procedures are required to file CBNC Midline Health Extension.

How to fill out cbnc midline health extension?

CBNC Midline Health Extension can be filled out online or by submitting a paper form with the required information.

What is the purpose of cbnc midline health extension?

The purpose of CBNC Midline Health Extension is to gather data on midline extension procedures and ensure compliance with health regulations.

What information must be reported on cbnc midline health extension?

The CBNC Midline Health Extension form requires information such as patient demographics, procedure details, and any complications or adverse events.

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