Variables in Monthly Visit Form (MVF)
Question#	Question	Field name	Response nature	Response options
1	PID Number	PID	###
2	Visit month number	Month no	##
3	Initials of the pregnant mother	mvf _A	XX
4	Researcher code	mvf _B	##
5	Date of Interview (According to English Calender)	mvf _C	##-XXX-##	dd-mmm-yy
6	Weight of pregnant mother (kg)	mvf _1	##.##
Ask for the last one month (1= Yes, 2= No, 9=Not applicable)
7	Has she visited any health facility for health check up?	mvf _2	#	1=Yes, 2=No
8	If yes, Place of visit	mvf _2_a	##	1=Study site, 2= Bhaktapur hospital 3=Maternity hospital, 4=Patan hospital, 5= TU Teaching hospital,     6= Dhulikhel hospital, 7= Kathmandu Medical College (KMC), 8= Govt. Health center, 9=Not Applicable (if mvf_2=2), 10=Other
9	If yes, Reason for visit?	mvf _2_b	#	3= Regular ANC visit , 4= Due to illness, 5 =other, 9=Not Applicable (if mvf_2=2)
10	If yes, how many times has she visited in the last month?	mvf _2_c	##	99 if mvf_2=2
11	Has she suffered from any problem/illness?	mvf _3	##	2= No, 3=Nausea/vomiting, 4= Diarrhea, 5=Cough /cold, 6= Fever, 7= Abdomen pain / backache, 8= Headache/vertigo/dizziness, 9=NA, 10=Skin problem, 11=Eye/ENT problem, 12= Vaginal bleeding, 13=discharge, 14= Other
12	If others Or more problem/illness, specify.	mvf _3 txt	TXT	TEXT if mvf_3=14 NA if mvf_3ǂ14
13	Any investigation done during the last month?	mvf_4	#	1=Yes, 2=No
14	If yes, specify name of the test	mvf _4_a	TXT	TEXT if mvf_4=1 NA if mvf_4=2
15	Is the test finding normal?	mvf _4_b	#	1=Yes, 2=No, 9= Not applicable (if mvf_4=2)
16	If no specify the finding of the test.	mvf _4_c	TXT	TEXT if mvf_4_b=2 NA if mvf_4_bǂ2
17	Is she taking any medication?	mvf _5	#	2=No, 3= Symptomatic, 4= Antibiotics, 5=Anti-hypertensive,  6=Anti-gastritis, 7= steroid ( Progesterone), 8= Aspirin, 9=NA, 10= vitamins or nutrient, 11=Local application medicine, 12= Other
18	If yes, specify  name of medicine	mvf_5_a	TXT	NA if mvf_5=2 TEXT if mvf_5ǂ2
19	If more medicines in  use, specify  name of medicine group	mvf_5_b	TXT	TEXT if more medicines NA if no more medicines
20	Has she been taking any vitamins/nutrients supplement including B12?	mvf_6	#	1=Yes, 2=No
21	If yes specify name of vitamins/nutrients.	mvf _6_a	TXT	TEXT if mvf_6=1 NA if mvf_6=2
22	How many days has she taken vitamins/nutrient?	mvf _6_b	##	99 if mvf_6=2
23	Hospitalization/referral to other health facility?	mvf _7	#	1= hospitalization, 2 = No, 3= Referred
24	If hospitalization/referred, specify reason	mvf _7_txt	TXT	NA if mvf_7=2 TEXT if mvf_7ǂ2
25	Remarks		TXT