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Client Registration (Edit Client)
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ClientUniqueID
ClientName
SpouseName
ClientSiblingNumber
PWD
Select an option
Yes
No
ClientAge
ContactNumber
ConsentForContactBack
Select an option
Yes
No
Address
NumberOfChildren
ClientType
Select from the given options
Current User
Ever User
Never User
PeriodOfUsingCurrentFP
EverMethods
Condom
Pills
Injection
IUD
PPIUCD
Implant
Male Sterilization
Female Sterilization
Withdrawal
Rhythm
LAM
ReasonForDiscontinuation
Side Effects
Unavailability of Products
Affordability
Husband/In-Law's Disagreement
Desire for More Children
Other
NeverUseReasons
Husband/In-Law's Disagreement
Misconceptions/Myth/Religion
Lack of Awareness
Shyness
Affordability
Other (Specify)
OtherReason
ClientRegisteredAt
Household Visit
Neighborhood Meeting
Orientation Meeting
ClientReferred
Yes
No
DateOfRegistration
FollowUpVisitDate
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