HIV 1166 Helpline
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New HIV Helpline Case
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Basic Information
Report Date
Caller Information
Ticket Number
*
CLI
Other Contact No
Name
Gender
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Male
Female
Transgender
Child
Age
CNIC
Location
Province
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Azad Jamu & Kashmir
Balochistan
Gilgit Baltistan
Islamabad Capital Territory
Khyber Pakhtunkhwa
Punjab
Sindh
District
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Health Facility
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Address
Call Details
Call Type
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Information Request
Complaint
Referral
Follow-up
Information Category
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ART Centre Location
ART Services
Drug Availability
General Information
HIV Prevention
HIV Testing
PEP
PrEP
Referral Support
Complaint Category
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Appointment Issue
Confidentiality Concern
Drug Stock Out
Facility Closed
Other
Referral Issue
Service Delay
Staff Behaviour
Comments
AgentComments
DoctorComments
Status
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Completed
In Progress
Pending
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