1. | Demographics |
2. | Vital Signs |
 |     • Height |
 |     • Weight |
 |     • Pulse |
 |     • Respiratory Rate |
 |     • Temperature |
 |     • Blood pressure |
 |     • BMI (optional) |
3. | Triage and Identification of Emergency Conditions |
 |     • Based on IMAI Quick Check triage protocol within        WHO-IMAI guideline |
4. | Screening |
 |     • Chronic cough |
 |     • Malnutrition |
 |     • Anemia |
 |     • Genital/anal lesions |
 |     • Discharge/other genitourinary symptoms in males with genital        lesions |
 |     • Previous HIV testing |
 |     • Mosquito net |
 |     • Tobacco use |
 |     • Alcohol use |
 |     • Sexual activity |
 |     • Pregnancy in eligible females |
 |     • Family planning in females |
5. | Chief Complaint(s) |
6. | Diagnosis |
 |     • Based on MOH SIS diagnostic codes |
7. | Treatment |
 |     • 100% agreement, including labs, medications, and other treatments ordered |
8. | Referrals |
 |     • Including follow-up visits to the OPD, if any |
 |     • Patient Age and Sex |
 |     • Start and end time of consultation |
 |     • Health center |
 |     • Nurse education level |
 |     • Years of OPD experience of nurse |