Child Death Audit

Please Fill up the detail below:

Name

Mother's Name

Age

Address

Date of Birth

Date of Death

Place of Birth

PHC Area

Sub Centre Area

Birth Weight

Place of Death

Probable Cause

Name and Designation of the person who conducted the First Investigation

Date of the First Investigation

Assigned Cause of Death/ Final Diagnosis

Remarks

OTP

Page Created On: 22^nd Apr 22 9:49 AM
Updated On: 29^th Apr 22, 11:32 AM

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