TM Checklist PDF
TM Checklist PDF
TM Checklist PDF
1 DC Name Connectivity
2 CHC Name S.No Equipment Yes/No Remarks
3 Date 1 Router available/configured
2 Router power on
Hardware 3 PoE adapter available
Working/
S.No Equipment Not Working Remarks 4 LAN Cable connected
1 TV 5 Cable connectivity to CPU
2 CPU 6 Data Card available
3 Keyboard 7 All connectivity equipment connected to UPS
4 Mouse
5 Headphones Software
6 Webcamera S.No Application Yes/No Remarks
7 Bluetooth Dongle 1 Medintegra working
2 Biometric URL working
Power and UPS 3 Asha Plus Application working
S.No Equipment Yes/No Remarks
1 Power availability in CHC Consumables
2 UPS Working S.No Consumables Availability Remarks
3 UPS On 1 Printer Cartridge
4 UPS Battery Cable connectivity 2 A4 Sheets Quantity
5 UPS Power Backup (avg hrs) 3 CRF Forms
4 Register
Other Hardware
S.No Equipment Yes/No Remarks Medical
Available/
1 All Systems cables connected S.No Item Working Remarks
2 Biometric Device available 1 Digital Thermometer
3 Biometric Device working 2 BP Apparatus
4 HDMI Cable working 3 Stethoscope
5 Audio Splitter working 4 Examination Table
6 Audio Cable Working 5 Baby Weighing Scale
7 USB Extender Working 6 Adult Weighing Scale
8 X-Ray Digitizer Working 7 Height Measure scale
9 IP Camera 8 Pediatric Weighing scale
9 Measuring Tape
Printer 10 Asha Plus
S.No Equipment Yes/No Remarks 11 Foetal Doppler
1 Printer On 12 Glucometer
2 Printer Working 13 Derma Scope
3 Scanner Working 14 Cotton
15 Spirit
ANM Employee Number 16 Glucometer Strips (For Testing Sugar Levels)
17 RBS Strips (For Bood Test)
ANM Signature
18 Hand Gloves