S, P and L Forms Explained: Which IDSP Form Do You Fill?

The three forms side by side

Names and user types come from the NCDC IDSP page and the IHIP manuals; rates and unit counts come from the NCDC IDSP page.

How one case moves from S to P to L

The three forms are not three separate systems. They are three levels of certainty about the same kind of event. IDSP training material defines them as: suspect case, identified by presenting symptoms; presumptive or probable case, a "diagnosis made on the typical history and clinical examination by a medical officer"; confirmed case, a "clinical diagnosis with positive laboratory identification".

Here is how that looks with a generic example (no real patient):

1. An ANM on a home visit finds a person with fever and rash. She records it on the S form as a syndrome.
2. The person attends the PHC OPD. The Medical Officer examines them and records a presumptive diagnosis on the P form.
3. If a test is needed, IHIP auto-forwards the P form case to the linked L form user, according to the IHIP manuals.
4. The lab enters the result on the L form. If the result is "Positive", a "Pathogen" field appears.
5. The DSU sees all three levels together and can spot a cluster early.

In our understanding, a case does not have to pass through all three: only P form cases that need a test are forwarded to a lab, and S form entries are syndromes rather than diagnoses. The forms complement each other.

S form in brief

The S form is for symptoms only. On the old paper form, its header read "(To be filled by Health Worker, Village Volunteer, Non-formal Practitioners)" and it counted cases and deaths in under-5 and over-5 columns across seven syndrome groups, from short fever to "unusual symptoms leading to death or hospitalization". On IHIP the S form sits with Health Sub Centre users and can be filled from the IHIP Android app. Full details: IHIP S form guide.

P form in brief

The P form records what a doctor thinks the illness is. The IHIP P form manual lists three kinds of entry: Presumptive Cases, Death and Aggregate. Aggregate entry needs DSO permission. The manual expects data to be entered every day. The older paper P form tally listed diseases such as acute diarrhoeal disease, malaria, dengue, measles, pneumonia, dog bite and snake bite, and states could add their own. Full details: IHIP P form guide.

L form in brief

The L form records lab results. Its menu, as given in the IHIP lab manuals, includes "Add Patient Record", "Line Listing", "Edit", "Update", "Save", "Summary", "Print" and "Submit", and Lab Details can be "Internal" or "External". The manuals ask labs to enter results within 7 days of testing, and the Date of Onset must be within 30 days before the reporting date. Back-dated entry is discouraged. Full details: IHIP L form guide.

Older paper forms: L1, L2, L3 and W

Before IHIP, IDSP ran on weekly paper forms. The IDSP Form Guidelines (historical) split the lab form into three:

• L1: peripheral labs at PHCs and CHCs. Form L1 covered malaria, tuberculosis and typhoid (Typhi Dot once introduced).
• L2: district public health lab and district or private hospital labs.
• L3: medical college, tertiary and reference labs.

There was also Form W, the "Reporting Format for Water Quality Monitoring". You may still see these names in old registers, training slides and exam questions. On IHIP the lab side is handled through the L form, with internal and external labs. What changed in the move is covered in IHIP vs the old IDSP portal.

Mistakes that cause double counting or gaps

• Doctor fills the S form, or ANM fills the P form. The manuals link each form to a user type (sub-centre, facility, lab), so keep to your own form and the three levels stay meaningful.
• Same patient entered twice on the P form by OPD and IPD staff. Agree inside the facility who enters what.
• Lab result not linked because the lab entered a new record instead of using the forwarded case. Check the forwarded list first.
• Late lab entry beyond the 7-day rule in the manuals.
• Silence instead of reporting. Performance is reviewed week by week on the Monday to Sunday IDSP week; see the reporting schedule.