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1
Best performance
award of Rs.1000/-
, Rs.500/- Rs.300/-
Rs.200/- Certificate
to ASHAs as Block
Level
Sl No.
Status of Training Module
5,6 & 7
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ASHA Selection
ASHA
Facilitator
Selection
Drug kit Status ASHA Diwas
Monthly Physical Data Report of ASHA Programm for the Month of
Name of:- BCM/BHM
Name of :- Block
Phase-I Phase-II
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Monthly Financial Data/Report of ASHA Programm for the Month of ________________20
Name of:- BCM/BHM Name of :- Block
Sl
No.
Amount spent under the head of
Capacity Building/Academic
Support programme- no of ASHA
Enrolled into 10th gradehrough
open School or IGNOU
Best performance award to
ASHAs
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Monthly Financial Data/Report of ASHA Programm for the Month of ________________20
Name of :- Block
Best performance award to
ASHAs
Rural Area Urban Area
Janani Evam Bal Surakchha Yojana for Institutional
Dellivery and full Immunization of the new born
400 200
* Registration 100 100
* BCG Immunization 300 100
5 to 10 Children 50
11 to 15 Children 100
16 to 20 Children 150
20 to above children 200
3 Providing DOTS under Tuberculosis Control Program
250 per
patient
PB Case 300
MB Case 500
Training
D.A. Per Day 100
T.A. Per Day
100
6 ASHA Diwas 86
7 For Motivating for Sterilization 150
8 for Motivationg client for Vasectomy/NSV 200
9 Home visit under HBNC and IMNCI (After 6 visits) 250
10 National Blindness Control Programme 175
11 Kalazar 100
12 Social Marketing of Sanitary napkins 1 per pack
13 Facilitating monthly meeting with Adolescent at village 50
14
Reporting death of women (15 to 40 years) and
Children (0-1 years) by ASHA to the
Block,PHC,MO/ANM within 24 hours of occurrence of
death
50
No of newly married couple mobilized by asha to
have first child after two year of Marriage
500 per
couple
No of couple mobilized to have birth space of three
years between first and secound child
500 per
couple
No. of couples mobilized for vasectomy/tubectomy
after having two child
1000 per
couple
15
Sl
No.
Program & Related Work
4
5
Mobilizing all the children of the village for Immunization (Under Muskan Ek Abhiyan) to be given to ASHA
For indentitying Patient of Leprosy and accompanying him/her to PHC
Incentive Details of ASHA Programe for the Month of ... 2013
Name of BCM/BHM:- BLOCK:- Date of Submission:-
2
By Cash
By
Whom
1
Incentives in Rs./- By
Cheque
Adarsh Dampati Yojana
Under RNTCP
Pruposed Under
HBNC( Part of
Child Health)
Under NBCP
Under RNTCP
Undera ARSH
Programme
Under MDR
(Meternal Death
Review)
Under FP
Programme
Mobilizing all the children of the village for Immunization (Under Muskan Ek Abhiyan) to be given to ASHA
Under National
Leprosy
Eradication
Programme
Incentive Details of ASHA Programe for the Month of ... 2013
Date of Submission:-
Under Universal
Immunization
Programme
Remarks
Under ASHA
Programme
Under Family
Planning &
Adarsh Dampati
Yojana
under JBSY
Programme
Adarsh Dampati Yojana

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