| Reg. Date | TB patient number | Full name | Sex (M/F) |
Age | Phone | Treatment unit | Treatment start date | Regimen | Disease site: pulmonary/extrapulmonary | Type of case | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| New | Relapse | Treatment after failure | Treatment after loss to follow-up | Transfer in | Other | ||||||||||