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Standards for Female and Male Sterilization Services - STATE ...

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<strong>St<strong>and</strong>ards</strong> <strong>for</strong> female <strong>and</strong> male <strong>Sterilization</strong> services 77Annexure 8Post-operative Instruction Card following<strong>Male</strong> <strong>Sterilization</strong>Name <strong>and</strong> type of hospital/facility ........................................................................................................................Camp.............................................................................................................PP centre.......................................................................................................PHC/CHC...................................................................................................District hospital...........................................................................................Medical college hospital..............................................................................Any other (specify)......................................................................................Acceptor’s name ........................................................................................................................Father’s name ........................................................................................................................Wife’s name ........................................................................................................................Address........................................................................................................................................................................................................................................................................................................................................................................Contact number (if available)........................................................................................................................Date of operationType of operation.............................../................................./................................ (D/M/Y)Conventional vasectomy / NSV...............................................................

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