Table 13. Proforma.

LSCS, lower-segment cesarean section; NICU, neonatal intensive care unit; IUGR, intrauterine growth restriction

Item	Details
Registered/unregistered
1. Patient name
2. Age
3. PRN
4. Address
5. Obstetric score
6. Height
7. Weight prior to pregnancy
8. Weight
9. BMI
10. Socioeconomic status	Upper/Upper middle/Lower middle/Upper lower/Lower
11. Educational status	Illiterate/primary/secondary/graduation/postgraduation
12. Presenting complaints
13. Obstetric history
14. Menstrual history
15. Past history
16. Personal history
17. Associated co-morbidities
18. Family history	Hypertension/diabetes mellitus/thyroid disorder/asthma/epilepsy/migraine/anemia H/o of blood transfusion or hematinic injections: Yes/No
19. General examination	Pallor, icterus, cyanosis, clubbing, lymphadenopathy, edema
20. Vital	P-            BP-
21. Systemic examination	RS, CVS, CNS, and P/A
22. Obstetric examination	Fundal height, lie, presentation, liquor, FHR, uterine contraction, P/S examination, and P/V examination
23. Investigation
24. Mode of delivery	LSCS/vaginal delivery
25. Provisional diagnosis
26. Obstetrical risk factors	Grand multipara/pre-eclampsia/eclampsia/Rh-incompatibility/heart disease/twin pregnancy/postterm pregnancy/previous cesarean/repeated miscarriages/gestational diabetes mellitus/IUGR/premature rupture of membranes
27. Fetal outcome	Full-term birth/premature birth/intrauterine death/IUGR/fetal distress/still birth/NICU admission/neonatal death
28. Baby birth weight
29. Postpartum period