MONTHLY PROGESS REPORT ON SCREENING OF BLOOD 1. Name of the Blood Bank and location : 2. Reporting month : 3. Year : 4. Total Volume of Blood collected by Source : Source Units collected Voluntary : Replacement : Total : 1.1 HIV Category of Donors No.of Samples Tested No.found Sero - Reactive Remarks Month Cumulative Month Cumulative Voluntary Male Female Total Replacement Male Female Total Total Male Female Total 1.2 Other Blood Transfusion Related Diseases Type of test Category of donors No.of samples tested No.found Sero-Reacive Remarks Month Cumulative Month Cumulative HbsAg Voluntary Replacement Total H.C.V Voluntary Replacement Total Voluntary Malaria Replacement Total Stock position of HIV Tests 2.1 Opening Balance from Previous month : 2.2 Tests received during the month : 2.3 No.of Tests used during the month : 2.4 Closing balance of Tests : 2.5 Date of Expiry of Kits in Stock : 2.6 Remarks if any : Date: Signature: Note: Designation: 1. The HIV Testing for donated Blood be done by single ERS 2. Maintain confidentiality of donors 3. Please dispatch this report on the last working day of every month of APSACS
