Menu
Home
About
About Swami
Organisation Structure
Code of Conduct
+
Wings
Spiritual Wing
Educational Wing
Service Wing
+
Chennai Metro
Chennai East Coast
Chennai Metro South
Chennai Metro West
Chennai North
Tiruvallur
Tiruvallur East
Tiruvallur West
Cuddalore
Puduchery
+
Rest of Tamilnadu
Coimbatore
Dharmapuri
Dindigul
Erode
Kanchipuram South
Kanchipuram North
Kanyakumari
Karur
Krishnagiri
+
Rest of Tamilnadu
Madurai
Nagai / Nagapattinam
Namakkal
Nilgiris
Ramnad and Sivagangai
Salem
Thanjavur
Theni
Tirunelveli
+
Rest of Tamilnadu
Tirupur
Trichy
Tiruvannamalai
Tuticorin
Vellore
Villupuram
Virudhunagar
+
+
+
TN Kshetras
Liquid Love
Contact Us
SSSSOTN Medical Activities Report Form sample
Home
SSSSOTN Medical Activities Report Form sample
"
*
" indicates required fields
SSSOTN MEDICAL ACTIVITIES REPORT
Name of the Medical Seva Dal
*
(Reporter)
Contact number
*
of the reporting person
Email
*
of the reporting person
District
*
of the activity
Select the District
Chennai East Coast
Chennai North
Chennai North-West
Chennai South
Chennai South-East
Chennai West
Coimbatore
Cuddalore
Dharmapuri
Dindigul
Erode
Kanchi North
Kanchi South
Kanyakumari
Karur
Madurai
Mayiladudurai
Nagai
Namakkal
Nilgiris
Puducherry
Salem
Sivaganga and Ramnad
Thanjavur
Theni
Thiruvannamalai
Tirunelveli
Tirupathur
Tirupur
Tiruvallur East
Tiruvallur West
Trichy
Tuticorin
Vellore
Viluppuram
Virudhunagar
Date
*
of the activity
MM slash DD slash YYYY
Venue
*
of the activity
Is this an adopted village
*
Yes
No
Is this a Tribal Village
*
Yes
No
Is this a SSSVIP Village
*
Yes
No
Type of Camp /
*
Activity
Select An Option
General Medical Camp
Comprehensive Medical Camp
Diabetic Camp
Cardiac Medical Camp
Eye Camp
Dental Camp
Mental Health Check up
Gynaec Special Camp
Paediatric Camp
Ortho Camp
ENT Camp
Homeopathy Camp
Siddha Camp
Ayurvedic Camp
Blood Donation Camp
Veterinary Camp
Virtual Consultation
Hrudaya Sangamam
Sai Kripa
Health Awareness camp (Preventive Care)
COVID Awareness Camp
COVID Vaccination Camp
SSS MOBILE MEDICAL CAMP
Other
No. of UG Doctors participated
Numeric please
No. of PG Doctors participated
Numeric please
No. of Para Medical staff participated
Numeric please
No. of Sevadals participated
Numeric please
No. of Beneficiaries
OP Patients
OP - Male
*
No. of Male patients
OP - Children
*
No. of Children patients
OP - Female
*
No. of Female patients
Special Tests / Treatments
Echo
ECG
No. of Male patients
Cataract Surgery
Cataract Screened for Male
Cataract Screened for Mahilas
Cataract Surgery done for Male
Cataract Surgery done for Mahilas
Free vision test done for school children Boys
Free vision test done for school children Girls
Free Spectacle issued:
Ultrasonogram
X-Ray
Blood Test
Blood donation Team From
Blood donors participated Male
Blood donors participated Mahilas
Blood Units collected from Male
Blood Units collected from Mahilas
Sai Protein distributed
mention in Kilogram
Free Medicine
distributed under Sai Dhanvanthri Project
Others
Please specify
Veterinary Camp
Veterinary Camp Team From
details
No. of Animals treated
details
SSSSSMH MOBILE MEDICAL CAMP
Dental cases
treated
Yoga Training given
Cancer Screening done
Papsmear done
Mammogram done
OTHER DETAILS
Approximate
*
cost for the camp
Date submitted
the report
MM slash DD slash YYYY
Please upload photos
with Dress code Scarf and banner)
Max. file size: 2 MB.
Comment
Feedback if any
I submit this activity at the Lotus Feet of our Beloved Bhagawan
Comments
This field is for validation purposes and should be left unchanged.
