::. PSG Balita
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Name
Date of birth
Date of visit
Age :
- Mo
Sex
*
Male
Female
Measured
*
Recumbent
Standing
Odema
*
No
Yes
Height
Weight
MUAC
Head circumference
IMT = n/a
Back
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WFH
Weight for Length
Weight for Length
z-score :
-
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WFA
Weight for Age
Weight for Age
z-score :
-
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HFA
Length for Age
Length for Age
z-score :
-
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BFA
BMI for Age
BMI for Age
z-score :
-
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HCFA
Head Circumference for Age
Head Circumference for Age
z-score :
-
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MUAC
Mid-Upper Arm Circumference for Age
Mid-Upper Arm Circumference for Age
z-score :
-
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