HANDOUT 10.2. Sample NACS Register Sample NACS Register Date ___⁄___⁄___ HIV status Tick if yes Quantity of specialized Nutritional status food product Exit reason (tick one ) prescribed (tick one ) years) edema? (cm) nutrition? or on pitting complications? BMI-for-age (kg) RUSF (cm) Outpatient or Inpatient or to (months (M/F) Client name Weight WHZ + − MUAC Medical MAM Unknown Normal Graduated Died Age BMI Bilateral Pregnant/postpartum? Counseled RUTF Sex SAM SAM F-75 F-100 FBF Transferred Treatment Length/height Lost failure ID 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
HANDOUT 10.2. Sample NACS Register Sample NACS Register Date ___⁄___⁄___ ID Client name Age (months or years) Sex (M/F) Length/height (cm) Weight (kg) WHZ MUAC (cm) BMI or BMI-for-age HIV status Tick if yes Nutritional status (tick one ) Quantity of specialized food product prescribed Exit reason (tick one ) + − Unknown Medical complications? Bilateral pitting edema? Pregnant/postpartum? Counseled on nutrition? SAM Inpatient SAM Outpatient MAM Normal F-75 F-100 RUTF FBF or RUSF Graduated Lost to Died Transferred Treatment failure 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Generic-NACS-Participant-Handouts-Dec2015.docx