Historical HMIS 35 and 36: Understanding Inpatient Registers in Nepal

In the uploaded workbook, the sheet labelled HMIS 35 is an admission register for inpatients. It records the admission serial number and date, referral source, patient and guardian details, address, occupation, age and sex, birth status where applicable, provisional diagnosis, payment status and remarks.

The sheet labelled HMIS 36 is a discharge register. It records admission and discharge dates, duration of stay, admission number, patient details, age group and sex, main diagnosis at discharge, operation, type of care, delivery and birth status, discharge condition, timing of death and remarks.

These labels do not match the current chapter-based numbering visible in Nepal’s official HMIS catalogue. Treat them as archival labels unless an authorized HMIS office confirms their edition and status.

The admission number is the key operational link between the admission register, clinical record and discharge register. Staff should record it consistently and verify dates so length of stay is plausible.

The provisional diagnosis at admission may change after assessment. The main diagnosis at discharge should reflect the condition chiefly responsible for the admission under the current coding and reporting instructions, not simply repeat an unconfirmed entry diagnosis.

The supplied discharge form includes outcomes such as recovered, not improved, referred, left against medical advice, absconded and died. These categories require current operational definitions so different wards and facilities classify the same event consistently.

Death within or after 48 hours, live birth and stillbirth are sensitive indicators. Validate dates, times and definitions against the current national guidance before aggregation, and use clinical review processes rather than the register alone to understand quality or preventability.

Complete the register as close to the event as possible from an authorized source record. Use approved codes and avoid inventing abbreviations. Supervisors should review missing fields, duplicate admission numbers, impossible dates, inconsistent age and sex entries, and mismatches between admission and discharge totals.

These registers contain names, addresses, diagnoses and other identifiable information. Keep paper registers in controlled areas and digital copies behind role-based access. Do not photograph, email or upload completed pages through unapproved channels.

Reports should use the minimum aggregated data required. Before sharing a table, assess whether a rare diagnosis, small location or unusual demographic combination could identify a patient. Training examples should be blank or safely synthetic.

Reliable inpatient data can support bed planning, referral review, service-volume monitoring, mortality review, medicine planning and quality improvement. Interpret trends alongside staffing, case severity, referral patterns and changes in coding or service availability.

The uploaded forms are archival learning material. Before printing or implementing any register, obtain the latest approved form, metadata, reporting schedule and indicator definitions from Nepal’s official HMIS or Department of Health Services channel.