Where is it kept in the facility: The custodian of the ART Distribution Form booklet is the pharmacist based at the health facility.
Description of fields:
Variable field name
Description of variable
ART Distribution Form for Stable Patients
Client Name
Enter the name of the client in the spaces provided in the order first, middle and last name
Client Unique ID
10 digit patient unique number (CCC Number). The format of the CCC number is: the First 5 digits (MFL code), a dash, then another 5-digit unique serial number assigned at the clinic
Date of ARV Distribution
Enter the date of ARV distribution in the format DD/MM/YYYY
ART Refill Model
Enter the clients model for ART distribution as follows:
