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Live Demo Smart Field Data Collection Form — Parama Technologies
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Location Details Step 1 of 5
// Field Report
Location Details
Where is this report being filed from?
🏠 Household
🏫 School
🏥 Health Centre
🌾 Community
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// Field Report
Field Worker Details
Who is filing this report?
12550+
12 households
// Field Report
Health Observations
What issues were observed? Select all that apply.
🤒 Fever / Infection
👶 Child Malnutrition
💊 Medication Shortage
🚰 Water Quality
🏚️ Sanitation Issues
📚 School Dropout
💼 Livelihood Crisis
✅ No Issues Found
// Field Report
Interventions & Actions
What actions were taken during this visit?
💉 Medical Referral
📋 Awareness Session
📦 Distributed Kit
📝 Enrollment Done
📞 Escalated Case
🔄 Follow-up Scheduled
02040+
8 people
// Review & Submit
Confirm Your Report
Please verify the details before submitting.
📍 This report will be submitted to the Brightpath Foundation field database and visible in the live dashboard immediately.
// Live Dashboard — Brightpath Foundation
0 reports filed
0
Low
0
Medium
0
High
// Recent Submissions
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