Clinic Facilitias rorm = Page 5
30.
Is there a device for neasuring heigne?
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31.
Yes (please describe)
No
Other equipment (please list):
SUPPLIES
MEDICATION AND SUPPLIES
wt
{ ]
f ]
( ]
C ]
C ]
Parasite medicine
Diarrhea medicine
Blood pressure zedicine
Skin ointments
Other (please specify)
Other (please specify)
Other (please specify)
Oral contracesrives
Condoms
C
C
C
C
(
{
C
[
C
C
C
C
(
{
{
{
(
C
C
C
C
C
C
{
{
{
{
43.
IuUDs
C ]
44.
Qther family planning (please specify)
45.
Other family planning (please specify)
46.
Bandages
47.
Dressings
48.
Splints
het
oer
eed
fered
_aIvOoeOr
C ]
eet
Ura
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J
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oa
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J
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C ]
oe
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ee
34.
35.
36.
37.
38.
39.
40.
41.
42.
fat
Antibiotics
arn
33.
ee
(
Adequate
er
Pain medicine
ee
32.
Some out
Inadequate
na
None