CENTRAL COUNCIL OF INDIAN MEDICINEccimindia.org/downloads/Visitation proforma (U) 2011-12.doc ·...
Transcript of CENTRAL COUNCIL OF INDIAN MEDICINEccimindia.org/downloads/Visitation proforma (U) 2011-12.doc ·...
PART-ICENTRAL COUNCIL OF INDIAN MEDICINE
NEW DELHI
VISITATION PROFORMA FOR ASSESSMENT OF AVAILABLE FACILITIES OF TEACHING AND PRACTICAL TRAINING OF UNANI COLLEGE
Section ‘A’-General Information
Name of the College with Complete Address (mentioning taluka, distt. and other details)
Information of communication
Contact No. of College
Contact No. of Hospital
Fax
Information of Principal Name
Office Tel No.
Resident Tel No.
Mobile No.
Information of President of Society of College (For private college)
Name & Address
Office Tel No.
Residence Tel No.
Mobile No.
Information of Secretary of Society of College (For private college)
Name & Address
Office Tel. No.
Residence Tel No.
Mobile No.
Information of concerned Health Secretary/Ayush Secretary dealing with the education of Unani
Name & Address
Office Tel No.
Residence Tel No.
Unani-Visitation Profr. 2011-12
1
Mobile No.
Information of the State Govt. Director/Commissioner of Unani / Ayush
Name & Address
Office Tel No.
Residence Tel No.
Mobile No.
Important information of connectivity
Name of Nearest Airport & Distance (km)
Name of Nearest Railway station & Distance (km)
1.
2.
3.
Fee Structure For Management seats
For Government seats
Name of the fee fixation authority
Name of competent authority conducting entrance examination for Govt. seats
Name & Address
Telephone Number
Name of competent authority conducting entrance examination for Management seats
Name & Address
Telephone Number
Name of the other Unani Colleges within radius of 50 km
1.
2.
3.
Name and year of 1st
affiliation of University Name
Year of 1st affiliation
Year of 1st permission of State Govt.
Unani-Visitation Profr. 2011-12
2
DETAILS OF LAND To be filled up by college
Verification by Visitors as Correct/Not correct
Total area of land with Society/Trust (in acres)
Ownership of land (Own/Lease/Rented)
In the name of the Society/Trust
In the name of President/Secretary
Whether entire land is in one plot or more than one. If more than one, then size and distance between these plotsWhether the land available with the Society/Trust is entirely for Unani College and attached Hospital or for any other Institute also, if so, details thereof.Information regarding other institutions/colleges being by the same society/trust. Whether they are in same campus or anywhere else.Total area of land allotted to the Unani college (in acres)
Total area of land allotted to the Unani hospital (in acres)
Total area of land allotted to the hostels (in acres)
Name of other institutions running in the campus of Unani CollegeTOTAL CONSTRUCTED AREA OF COLLEGE Note: Please furnish details in Annexure-ITOTAL CONSTRUCTED AREA OF HOSPITAL Note: Please furnish details in Annexure-I
INFORMATION OF ADMITTED STUDENTS Name of the Course
To be filled up by college Verification by Visitors as correct/Not
Sanctioned Seats by GOI /CCIM vide order no… dated ….
Number of Students admitted in the year 2010-11
Date of last admission of the student
Govt quota Management quota
UGPG (Sub. Wise)
* If required additional sheet be attached in prescribed format regarding information of PG Course
Note- List of Under-graduate Students admitted in the Year 2010-11 be furnished as per Annexure- IIList of Subject Wise Post Graduate Students admitted in the Year 2010-11 be furnished as per Annexure III
Unani-Visitation Profr. 2011-12
3
SECTION –BFINANCIAL INFORMATION
Total income of college in the year 2010 (To be filled up by college)
TOTAL EXPENDITURE IN THE YEAR JAN. TO DEC.2010 (To be filled up by college)
Total Salary of teaching staff
Total Salary of non teaching staff
Total Salary of paramedical & other hospital staff
Total Expenditures on purchase of new books
Total Expenditures on furniture & fixtures
Total Expenditure on equipments & instruments
Total Purchase of raw drugs
Total Purchase of prepared medicines
Total Purchase of Lab Chemicals
Building construction & other expenditure
Total Verification by Visitors as correct / Not correct
MONTH WISE EXPENDITURE IN THE YEAR Jan. to Dec. 2010 (To be filled up by college)S. No. Month Total
Salary of teaching staff
Total Salary of non teaching staff
Total Salary of paramedical & other hospital staff
Total Expenditures on purchase of new books
Total Expenditures on furniture & fixtures
Total Expenditure on equipments & instruments
Total Purchase of raw drugs
Total Purchase of prepared medicines
Total Purchase of Lab Chemicals
Building construction & other expenditure
Verificati-on by Visitors as correct / Not
1 January
2 February
3 March
4 April
5 May
6 June
7 July
8 August
9 September
10 October
11 November
12 December
13 Total 14 Grand Total expenditure of the year 201015 TOTAL INCOME OF
Unani-Visitation Profr. 2011-12 4
THE YEAR 2010
Unani-Visitation Profr. 2011-12 5
DETAILS OF MUSEUM
Name of the Department Number of Charts, Models & Specimens Available (To be filled up by college)
Verification by Visitors as correct / NotCorrect
Charts Models Specimens Charts Models Specimens1. Kulliyat2. Tashreehul Badan3. Ilmul Advia wa-
Saidla 4. Tahaffuzi wa Samaji
Tib5. Niswan wa Atfal6. Moalajat7. Jarahat
INFORMATION ABOUT VARIOUS SECTIONS IN COLLEGE
To be filled up by college Verification by Visitors as correct / Not correct
LIBRARY - -
1. Number of books available
Unani -
Modern -
Others -
Total -
2. Seating arrangement in reading room
3. Number of computers with internet facility
HOSTEL - -
1. Total number of room available for Boys
2. Total number of rooms available for Girls
3. Seats available for Boys
4. Seats available for Girls
5. Mess facility for Boys – available/not available
6. Mess facility for Girls – available/not available
HERBAL GARDEN - -
Number of Plants
Number of species
Irrigation facility- Available/Not available
NAME & DETAILS OF SPORTS AND GAMES FACILITY
TRANSPORT FACILITY – Exists /Not
PHARMACY- Functioning/Non Functioning *If, Yes, details of Pharmacy be furnished as perAnnexure-IV
Unani-Visitation Profr. 2011-12 6
SECTION C
INFORMATION OF TEACHING & PRACTICAL TRAINING (Jan. to Dec. 2010) for UG
S.No. Subject Number of Classes held (to be filled up by college)
Verification by Visitors as correct / Not correct
Theory Practical/Clinical
Theory Practical
1. Tashreehul Badan2. Munafeul Aza3. Umoore Tabiya4. Mantiq, Falsafa & Haiyat5. Arabic6. Tarikhe Tib7. Ilmul Advia I
(Kulliyat & Mufradat)8. Ilmul Advia II
(Murakkabat & Saidala)9. Ilmul Amraz & Sareeriyat10. Ilmus Samoom & Tibbe
Qanooni11. Tahaffuzi wa Smamji Tib12. Moalajat- I13. Moalajat- II14. Jarahiyat15. Amraz Ain, Uzn, Anf wa
Halaq 16. Qabalat, Niswan wa Atfal17. Number of educational tours
conducted for teaching & practical purpose in the year 2010-11
For PG
S.No. Subject Number of classes & practical/clinical held (to be filled up by college)
Verification by Visitors as correct / Not correct
Theory Practical Theory Practical1. Kulliyate Umoore Tabiya2. Moalajat3. Ilmul Advia4. Ilmus Saidla 5. Tahaffuzi wa Samaji Tib6. Qabalat wa Amraze Niswan7. Ilmul Jarahat 8. Ilmul Amraz9. Ilaj Bit Tadbeer10 Amraze Jild o Zohrawiya11. Tashreehul Badan12. Munafeul Aza13. Amraze Uzn, Anf wa Halaq14. Ilmul Atfal
Unani-Visitation Profr. 2011-12 7
NUMBER OF EXISTING TEACHING STAFF (where seven Deptt. exists)S.No.
Department Number of Teachers as per CCIM Norms (to be filled up by college)
No. of Existing Teachers
Verification by Visitors as Correct/Not correct
P R L P R L P R L1. Deptt. of
Kulliyat For UG 1 1 1
Additional for PG course
1 or 1 2
2. Deptt. of Tashreeh-ul-Badan
For UG 1 2 2
Additional for PG course
1 or 1 2
3. Deptt. of Ilmul Advia wa-Saidla
For UG 1 1 2 one in each subj.
Additional for PG course
1 or 1 2
4. Deptt. of Tahaffuzi-wa Samaji Tib
For UG 1 1 2
Additional for PG course
1 or 1 2
5. Deptt. of Moalajat
For UG 1 2 2
Additional for PG course
1 or 1 2
6. Deptt. of Niswan-wa- Atfal
For UG 1 2 2
Additional for PG course
1 or 1 2
7. Deptt. of Jarahat For UG 1 1 2
Additional for PG course
1 or 1 2
Total Number of teachers
Professor-Readers-Lecturers -
Unani-Visitation Profr. 2011-12 8
NUMBER OF EXISTING TEACHING STAFF (where fourteen Deptt. exists)S.No.
Department Number of Teachers as per CCIM Norms (to be filled up by college)
No. of Existing Teachers
Verification by Visitors as Correct/Not correct
P R L P R L P R L1. Kulliyat For UG 1 1 1
Additional for PG course
1 or 1 1
2. Tashreehul Badan
For UG 1 1 1
Additional for PG course
1 or 1 1
3. Munafeul Aza For UG 1 1 1
Additional for PG course
1 or 1 1
4. Ilmul Advia wa-Saidla
For UG 1 1 1
Additional for PG course
1 or 1 1
5. Ilmul Amraz- For UG 1 1 2
Additional for PG course
1 or 1 1
6. Tibbe Qanooni wa Ilmus Samoom
For UG 1 1 1
Additional for PG course
1 or 1 1
7. Tahaffuzi-wa Samaji Tib
For UG 1 1 2
Additional for PG course
1 or 1 1
8. Moalajat For UG 1 1 2
Additional for PG 1 or 1 1
9. Niswa wa Atfal For UG 1 1 1
Additional for PG 1 or 1 1
10. Ilmul Qabalat For UG 1 1 1
Additional for PG 1 or 1 1
11. Jarahiyat For UG 1 1 1
Additional for PG1 or 1 1
12. Ain, Uzn, Anf, Halaque
For UG 1 1 1
Additional for PG1 or 1 1
13. Amraze Jild wa Amraz Zohrawiya
For UG 1 1 1Additional for PG 1 or 1 1
14. Ilaj Bid Tadbeer For UG 1 1 1Additional for PG 1 or 1 1
Total Number of teachers
Professor-Readers-Lecturers -
Unani-Visitation Profr. 2011-12 9
INFORMATION OF TEACHERS To be filled up by college Verification of information by Visitors
as correct / NotProfessor Reader Lecturer Total
1. Total number of teachers retired from the college (Jan. to Dec. 2010)
2. Total number of teachers transferred/left from the college (Jan. to Dec. 2010)
3. Total number of teachers newly appointed in the college (Jan. to Dec. 2010)
4. Total number of teachers reemployed after retirement from Govt. or Grant In Aid colleges (Jan. to Dec. 2010)
SALARY INFORMATION* To be filled up by college Verification of information by Visitors as correct / Not correct
Pay Scale of teachers As per State Govt./UGC(If none of these please mention reason thereof )
1.Mode of payment through Bank Yes/No (If none please mention reason thereof )2.GPF & CPF is deducted from the
salaryYes/No (If none please mention reason thereof)
3.Teachers promotion policy as per norms of CCIM/Govt./UGC.
Yes/No (If none please mention reason thereof)
4.Existing pay scale of teaching staff ( State Govt./UGC/others)
[Pl. tick whichever applicable]
Pay Scale of ProfessorPay Scale of ReaderPay Scale of Lecturer
NOTE:- DETAIL INFORMATION OF TEACHING STAFF BE FURNISHED AS PER ANNEXURE-V***Note: To ascertain the availability of actual numbers of teachers in the College, visitors after verification of the following records should filled up correct information and should provide the certification:-
1. Documents to be examined: Acquaintance Roll Attendance register Personal file Time table Other duties e.g. examinations. NSS etc. University approval Attendance of teaching staff through Biometric Machine Identity Card
2. Observation of the visitors:
S. No. Document to be examined Available for number of teachers Remarks
1. Attendance Register2. Acquaintance Roll3. Personal file4. Time Table5. University approval6. Attendance of teaching staff through
Biometric Machine7. Identity Card
Certification by visitation team:Above listed documents and registers are examined thoroughly in relation to list of available number of teachers submitted by the college. On examining all the above documents, the visitor certifies that the names of teachers mentioned in the list are/not correlating with other documents listed above. On the basis of all the above documents, the visitors certifies that college is having _______ number of teachers.
Signature of CCIM visitation team
Unani-Visitation Profr. 2011-12 10
INFORMATION OF NON -TEACHING STAFF OF VARIOUS DEPARTMENTS
S.No.
Department No. of Existing Non-Teaching Staff ( To be filled up by college)
Verification by Visitors as correct / Not correct
Lab. Tech.
Lab Asstt.
Muse. Keeper
Peon Lab Tech.
Lab Asstt.
M. Keeper Peon
1. Kulliyat - 1 - 12. Tashreeh- ul-
Badan 2 Tec 1 1 1
3. Ilmul Advia wa-Saidla
1 labAttnd
- 1
4. Tahaffuzi-wa Samaji Tib
- 1 1 1
5. Moalajat 1 -- -- 16. Niswa-wa-
Atfal-- -- -- 1
7. Jarahat -- -- -- 1
OTHER NON- TEACHING STAFF IN THE COLLEGELIBRARY STAFF
Librarian 1Asst. Librarian 1Library Attendant/Peon 1PHARMACY STAFFDeputy Superintendent (M.D. Ilmul Advia/ Saidla)Machine Operator Labourer (Number) HERBAL GARDEN STAFF 1.
2.Note: Housekeeping may be from out sources with minimum three sweepers NOTE: DETAIL INFORMATION OF NON-TEACHING STAFF BE FURNISHED AS PER ANNEXURE-VI
***Note: To ascertain the availability of actual numbers of non-teaching staff in the College, visitors after verification of the following records should filled up correct information and should provide the certification:-
1. Documents to be examined: Acquaintance Roll Attendance register Attendance of non-teaching staff through Biometric Machine Identity Card
2. Observation of the visitors:
S.No. Document to be examined Available for number of non- teaching staff
Remarks
1. Attendance Register2. Acquaintance Roll3. Attendance of non teaching staff
through Biometric Machine4. Identity Card
Certification by visitation team:Above listed documents and registers are examined thoroughly in relation to list of available number of non-teaching staff submitted by the college. On examining all the above documents, the visitor certifies that the names of non-teaching staff mentioned in the list are/not correlating with other documents listed above. On the basis of all the above documents, the visitors certifies that college is having _______ number of non-teaching staff.
Signature of CCIM visitation team
Unani-Visitation Profr. 2011-12 11
STAFF REQUIRED FOR HOSPITAL
Name of Post Staff Required as Per Norms of CCIM
Number of Existing Staff (To be filled up by college)
Verification by Visitors as Correct /Not correct
Superintendent (Principal or Dean of the college may also be ex-officio)
1
Deputy Superintendent 1Hakeem (for OPD for clinical subjects)
Professors, Readers and Lectures of Tibbi College
Medical Specialist 1 Part timeSurgeon 1 Part timeGynaecologist 1 Part timeRadiologist 1 Part timePathologist 1 Part timeAnesthetist 1 Part time/on callX-ray technician 1 Clinical Registrar 1 for each clinical deptt.RMO 1House Officer/PG student 1 for 20 bedsMatron/Nursing Superintendent 1Staff Nurse 1 for 10 beds (and 1 for general
OPD and 1 for Gynae. OPD)Ward boy/Ayah/ANM 1 for 20 beds ( and 2 for OPD)Pharmacist 2Store Keeper 1Head Clerk 1 Cook 1 Kitchen Attendant/ Cook 1 Plumber 1 on contract basisWatch Men 3 on contract basisLift men for multi-storeyed Building
3 on contract basis
Electrician 1 (part time)Dark Room Attendant 1Dressers(for OPD) 2Operation Theatre Attendant
1
Labour Room Attendant 2Safaiwala 2 (outsourcing) Statistician part timePhotographer part time ILAJ BID TADBEER DEPARTMENT STAFF - -Ilaj bit tadbeer hakeem
1 Male1 Female
Ilaj bit tadbeer Technician 2Ilaj bit tadbeer Assistant
1 Male1 Female
Physiotherapist 1Safaiwala 1 (outsourcing)
NOTE:- DETAIL INFORMATION OF HOSPITAL STAFF ALONG WITH SALARY DETAILS BE FURNISHED AS PER A NNEXURE -VII
***Note: To ascertain the availability of actual numbers of Hospital Staff in the College , visitors after verification of the following records should filled up correct information and should provide the certification:-
Unani-Visitation Profr. 2011-12 12
1. Documents to be examined: Attendance register Acquaintance Roll Personal file Duty roster Attendance of staff of Hospital through Biometric Machine Identity Card
2. Observation of the visitors:
S.No. Document to be examined Available for number of Hospital staff
Remarks
1. Attendance register
2. Acquaintance Roll3. Personal file4. Duty roster5. Attendance of Hospital staff
through Biometric Machine6. Identity Card
Certification by visitation team:
Above listed documents and registers are examined thoroughly in relation to list of available number of Hospital staff submitted by the college. On examining all the above documents, the visitor certifies that the names of Hospital staff mentioned in the list are/not correlating with other documents listed above. On the basis of all the above documents the visitor certifies that College Hospital is having _______ number of Hospital staff.
Signature of CCIM visitation team
Unani-Visitation Profr. 2011-12 13
SECTION DFACILITIES AVAILABLE IN THE HOSPITAL
OPD FACILITIESS. no. Name of Department Equipment, Instrument, Furniture etc
required as per norms of CCIMDepartmental Equipment, Instrument, Furniture Available or Not (To be filled up by college)
Verification by Visitors as correct / Not correct
1 Moalajat View Box BP Instrument Stethoscope Examination Table Thermometer Tongue depressor Weighing machine Torch Measuring tape Weight and height measuring stand Hammer
2. Ilmul Jarahat Autoclave/sterilization facilities Minor OT Instruments for anorectal examination Examination Table BP instrument Surgical Blades Suturing material Rubber catheter View Box Stethoscope Cheetle’s forceps Torch
3 Ain, Uzn, Anaf wa Halaq Sterilization facilities Tuning fork Ophthalmoscope/ fundoscope Auroscope Tongue depressor Examination Table View Box BP Instrument Stethoscope ENT kit Torch Bull`s lamp
4 Qabalat wa Amraze Niswan Sterilization facilities Weighing machine Sim’s speculum Cusco’s speculum Examination Table Lamp stand Torch View Box BP Instrument Stethoscope Measuring tape Washbasin
5 Amraze Atfal Scale Weighing machine Torch View Box BP Instrument Stethoscope
6 Ilaj bit tadbeer As per Moalajat7 Emergency Facilities available (Equipment,
Instrument, Furniture etc)8 Minor OT Facilities available (Equipment,
Instrument, Furniture etc)
Note: Every Deptt. shall have proper seating arrangements for internees/students
Unani-Visitation Profr. 2011-12 14
NUMBER OF PATIENTS ATTENDED OPD (Jan. to Dec. 2010)(Note:- Patients of Medical Camp OPD should not be included)
S.No. Month MoalajatincludingIlaj bit tadbeer
Jarahatincluding Ain, Uzn, Anaf wa Halaq
Qabalat wa Amraze Niswan
Amraze Atfal Tahaffuzi wa Samaji Tibb
Verification by Visitors as correct / Not correct
1. Jan. 2. Feb.3. March.4. April5. May6. June7. July8. August9. Sept.10. Oct.11. Nov.12. DecTotal Grand total
DETAILS OF IPD PATIENTS (Jan. to Dec. 2010)1. Total Number of Patients Admitted in the Year 2010S .No. Month Moalajat Jarahat Ain, Uzn,
Anaf wa Halaq
Qabalat wa Amraze Niswan
Amraze Atfal
Ilaj bit tadbeer
Verification by Visitors as correct / Not
1. Jan. 2. Feb.3. March.4. April5. May6. June7. July8. August9. Sept.10. Oct.11. Nov.12. DecTotal Grand Total
2. Total Number of Bed Days OccupiedS.No. Month Moalajat Jarahat Ain, Uzn,
Anaf wa Halaq
Qabalat wa Amraze Niswan
Amraze Atfal
Ilaj bit tadbeer Verification by Visitors as correct / Not correct
1. Jan. 2. Feb.3. March.4. April5. May6. June7. July8. August9. Sept.10. Oct.11. Nov.12. DecTotalGrand total
Unani-Visitation Profr. 2011-12 15
Note: To calculate the total number of bed days occupied of the months, please calculate the date wise total number of patients, remained on bed at midnight.IPD SECTIONS WITH BED STRENGTH Name of the Department % of Bed Distribution
as per CCIM normsNumber of Existing Bed strength (To be filled up by college)
Verification by Visitors as correct / Not
(i) Moalajat and Ilaj bit tadbeer 40%
(ii) Jarahat 10%
(iii) Ain, Uzn, Anaf wa Halaq 10%
(iv) Qabalat wa Amraze Niswan 20%
(v) Amraze Atfal 05%
(vi) Others 15%
Total Number of Beds
Note: Visitors, while verifying the information of fully functional hospital alongwith the genuineness of the working of the hospital should verify following documents and should provide following certification.
*** A. For IPD Status: IPD & OPD registers Case Sheet of IPD patients Discharge cards of IPD patients Cash receipts of each collected for Lab and other investigations of IPD patients. Bank document of depositing the daily cash collected from IPD and lab investigation etc.
are not available at the time of hearing. Lab register Nursing register IPD medicine, Indent register is not maintained because all the medicines prescribed are
to be bought from outside. Duty roster of nursing staff Duty roster of Doctors Diet register Any other relevant document/record
S.No Records/documents to be examined
Available / NA Correlation with IPD register
Remarks(Separate sheet may attached for recording the observations)
1. Number and name of the IPD wards alongwith the number of beds
2. Original IPD Case sheets
3. Discharge Cards
4. IP Medicine indent register
5. Nursing staff duty roster
6. Doctors duty roster
7. IP diet register
8. Cash receipts for IPD charges/lab charges
Unani-Visitation Profr. 2011-12 16
B. For OPD Status: OPD Register Dispensing Register Investigations register-Lab/X-ray Cash Receipts Doctors attendance
The OPD & IPD register should be examined alongwith other registers to find a co-relation in the entries in all the registers and relation with the original case papers.
S.No Records/documents to be examined
Available / NA Correlation with OPD register
Remarks(Separate sheet may attached for recording the observations)
1. Number and name of the OPD departments
2. Original OPD Case Register3. OPD Medicine Dispensing
Register4. Nursing staff duty roster5. Doctors duty roster6. OPD Investigation Register7. Cash receipts for OPD
charges/lab charges
Certification by Visitation team:
The IPD registers are/not properly printed with hospital name, are maintained/not maintained properly. IPD registers have entry of_____ patients name/OPD registration number/IPD registration number /DOA/DOD/diagnosis/name of treating doctor/brief of treatment given/signature of attending doctor. The IPD register are certified, signed and authenticated by superintendant/Dy. superintendant/ Principal. Above listed registers/ documents examined in relation with entries in IPD register and found/not found correlating and are/ not satisfactory. In view of the above observations I am of the opinion that the college hospital is/not genuinely functional hospital and figures of IPD bed occupancy of ______% during last one year as reported by the college hospital appears to be acceptable/not acceptable.
Signature of CCIM visitation team
DETAILS OF DRUG DISTRIBUTION IN OPD & IPD (Jan. to Dec.2010)
Note:-Detail Information be furnished as per Annexure-VIII
INFORMATION ABOUT VARIOUS SECTIONS IN THE HOSPITAL
To be filled up by college
Verification by Visitors as correct / Not correct
LABOUR ROOM- Functional/Non FunctionalAntenatal Room with attached Toilet-Functional/Non FunctionalFacilities for Neonatal care - Available/Not Available Other Available Facilities, Equipments, InstrumentsNote:- Details be furnish as per annexure-IXNumber of Deliveries performed during the year 2010
Unani-Visitation Profr. 2011-12 17
OPERATION THEATRE- Functional/Non FunctionalAir conditioning- Exist/Not
Pre Operative Room with attached toilet- Exist/Not
Sterilization room – Exist/Not
Changing and wash room with attached toilet - Exist/Not
Total Number of operations done during the year 2010
Details of Available equipments, Instruments and other facilities in Operation theatreNote:- Details be furnished as per annexure-X Fumigation Details AMBULANCE - Available/Not Available
OTHER FACILITIES AVAILABLE IN THE HOSPITAL
To be filled up by college
Verification of information by Visitors as correct / Not
X-Ray Total number of X-rays done in the year 2010
ECG Total number of ECG done in the year 2010
USG Total number of USG done in the year 2010
INFORMATION OF ILAJ BIL TADBEER DEPARTMENTName of the Instrument Number of Instruments Available
(To be filled up by college)Verification by Visitors as correct / Notcorrect
Apparatus needed for - Hajamat (Cupping Set)
Dal’k Table
Riyazat
Taleeq (Aquarium for leeches)
Fasd (Venesection Set)
Hamam
Others
TADABEER BEING CARRIED OUT
TOTAL NUMBER OF REGIMENS CARRIED OUT IN THE YEAR 2009 (To be filled up by college)
VERIFICATION BY VISITORS AS CORRECT / NOT CORRECT
Fasad Hajamat Dal’kRiyazatTaleeqHamamOthers DETAILS OF MEDICAL CAMPS CONDUCTED BY COLLEGE IN THE YEAR 2010S.No. TO BE FILLED UP BY COLLEGE VERIFICATION OF
INFORMATION BY VISITORS AS CORRECT / NOT CORRECT
NATURE OF THE CAMP DATE PLACE NUMBER OF PATIENTS
* If required additional sheet be attached in the prescribed format.
Unani-Visitation Profr. 2011-12 18
ANNEXURE -I
DETAILS OF AREA OF COLLEGE AND HOSPITALDETAILS OF AREA OF COLLEGE::
TOTAL CONSTRUCTED AREA
NAME OF DEPARTMENT & SECTIONS To be filled up by college Verification by Visitors as correct / Not correct
1. Administrative wing
2. Kulliyate Tib 3. Munafeul Aza 4. Tashreeh-ul-Badan 5. Ilmul Advia wa saidla6. Ilmul Amraz7. Moalajat8. Niswan wa Atfal9. Ilmul Qabalat 10. Jarahat11. Ain Uzn, Anaf wa Halaq12. Ilaj Bil Tadber13. Tahaffuzi wa Samaji Tib14. Library+ Reading room15. Pharmacy16. Auditorium17. Staff Room18. Common Room19. Canteen20. Class Rooms 21. Tutorial room for PG22. Area of Dissection Hall23. Munafeul Aza Lab.24. Saidla lab AREA OF MUSEUMS1. Tashreehul badan2. Munafeul Aza3. Ilmul advia4. Ilmul Amraz5. Jarahat6. Tahaffuzi wa Samaji tib 7. Kulliyate TibOTHERS1.2.Total Constructed Area
Cont……………………..
Unani-Visitation Profr. 2011-12 19
AREA OF VARIOUS SECTIONS AVAILABLE IN THE HOSPITAL
TOTAL CONSTRUCTED AREA OF HOSPITAL VARIOUS SECTIONS IN THE HOSPITAL Sections if exist please
mention Area (To be filled up by college)
Verification by Visitors as correct / Not correct
ADMINISTRATIVE BLOCK- - -1. Reception 2. Registration counter3. Office of Medical Superintendent/ Medical
Deputy Superintendent4. RMO Room5. Store Room
OPD SECTIONS - - -1. Moalajat including Ilaj Bit Tadbeer
2. Jarahat including Ain, Uzn, Anaf, Halaq-wa-Asnan
3. Qabalat-wa-Amaz-e-Niswan
4. Amraz-e-Atfal
5. Emergency
6. Tahaffuzi-wa-Samaji Tib
7. Minor OT
Total area of IPD wards Clinical Pathology & Biochemistry LabArea of store room of Drugs Dispensary
Record Room
Labour room
Operation Theater Recovery Room OTHERS - -
1.2.Total Constructed Area
TOTAL CONSTRUCTED AREA OF HOSTEL (Sq.ft.)
Area for Girls Hostel
Area for Boys Hostel
Total Land for Herbal Garden
Number of Staff Quarters available
Unani-Visitation Profr. 2011-12 20
ANNEXURE-II
LIST OF UNDER-GRADUATE STUDENTS ADMITTED IN THE YEAR 2010-11
S. No.
To be filled up by college Verification of information by Visitors as correct / Not
Name of the Student
Father’s Name
Date of Birth
Date & Number of fee receipt
Residential Address
Govt. Quota /Management Quota
Percentage of PCB in 10+2
Category (Gen./SC/ST/ OBC/others )
* If required additional sheet be attached in the prescribed format.
ANNEXURE-III
LIST OF POST GRADUATE STUDENTS ADMITTED IN THE YEAR 2010-11
S.No. NAME OF PG SUBJECT Permitted Seats by GOI / CCIM vide order no….dated …..
Number of Admitted Students
1. Kulliyat-Umoor-e-Tabiya
2. Munafeul Aza
3. Ilmul Advia
4. Ilmus Saidla
5. Tahaffuzi-wa-Samaji Tib
6. Ilmul Atfal
7. Moalajat
8. Ilmul Amraz
9. Ilaj Bil Tadbeer
10. Amraze Jild o Zohrawiya
11. Tashreehul Badan
12. Ilmul Jarahat
13. Amrazee Uzn, Anf wa Halaq
14. Qabalat wa Amraze Niswan
GRAND TOTAL
Unani-Visitation Profr. 2011-12 21
ANNEXURE-IV
DETAILS OF SAIDLA (PHARMACY)
DETAILS OF EQUIPMENT & INSTRUMENTSEssential Equipment and Instruments Available Number of
Equipment and Instruments (to be filled up by College)
Verification by Visitors as Correct/Not correct
1. Pulveriser2. Grinder3. Mixer4. Filtering Machine5. Tablet Making Machine6. Pill making machine7. Heating machine8. Capsule Filling Machine9. Air Tight Desiccators 10. Moisture absorbing machine etc.11. Tablet coating pans & fitting press12. Granulator drying chamber13. Distillation apparatus/Qara’ Ambiq 14. Weighing Machine15. Pestle and Mortar16. Others
DETAILS OF PREPARED MEDICINES IN THE YEAR 2010NAME OF PREPARED MEDICINE QUANTITY OF
PREPARED MEDICINE VERIFICATION BY VISITORS AS CORRECT / NOT CORRECT
1.2.3.4.5.6.7.8.9.10.11.12.13.14.15.* IF REQUIRED ADDITIONAL SHEET BE ATTACHED
TOTAL EXPENDITURE ON PURCHASE OF RAW MATERIALS IN THE YEAR 2010To be filled up by college Verification of Information by
Visitors as correct/ notName of the Company Date Voucher number Amount 1.2.3.4.5.* If required additional sheet be attached in the prescribed format.Note: Information to be filled up by college as per proforma and be verified by Visitors
Unani-Visitation Profr. 2011-12 22
ANNEXURE-V
PROFORMA TO FURNISH THE DETAILS OF TEACHING STAFF
S. No.
Name of the Teacher
Fath
er's
Nam
e
Dat
e of
Bir
th
UG
Qua
lific
atio
n (U
nive
rsity
&
yea
r)
PG Q
ualif
icat
ion
with
subj
ect
(Uni
vers
ity
& y
ear)
Date wise details of Experience in chronological order (1st appointment to till date)
Dep
artm
ent
(Sub
ject
)
Nat
ure
of p
rese
nt a
ppoi
ntm
ent
(reg
ular
/ con
trac
tual
/ de
puta
tion)
Pres
ent
Res
iden
tial A
ddre
ss
(Wor
king
Pla
ce )
Perm
anen
t Add
ress
Nam
e of
Sta
te B
oard
&
Reg
istr
atio
n N
o.
Ban
k A
ccou
nt N
umbe
r in
whi
ch
Sala
ry is
Dra
wn
Tel
epho
ne N
o. &
Mob
ile N
o. o
f T
each
er
Photograph of Teacher (Attested by the Principal)
Signature of Teacher ( At the time of visitation)
Ver
ifica
tion
of in
form
atio
n
by V
isito
rs a
s cor
rect
/ N
ot
Dur
atio
n(d
/m/y
)
Des
igna
tion
Nam
e of
the
colle
ge
Sur
Nam
e
Firs
t Nam
e
Seco
nd n
ame
Note: Please attach the certified copies of Under-graduate and Post-graduate degree, Registration certificate, experience certificates and relieving order along with original affidavit as per prescribed format of newly appointed teaching staff after last visitation. The provisional certificates will be considered only for two years after passing the examination.
ANNEXURE-VI
PROFORMA TO FURNISH THE DETAILS OF NON TEACHING STAFF
S.No. Name of Employee
Father’s Name
Qualification Date of Appointment
Nature of Appointment
(regular/ contractual/Part time)
Designation Name of working department
Pay Scale
Verification of information by
Visitors as correct / not correct
Unani-Visitation Profr. 2011-12 23
ANNEXURE-VII
PROFORMA TO FURNISH THE DETAILS OF HOSPITAL STAFF
S.No. Name of Employee
Father’s Name
Qualification Date of Appointment Nature of appointment (regular/
contractual/Part time)
Designation Name of working department
Pay Scale
Verification of information by
Visitors as correct / not
ANNEXURE-VIII
DETAILS OF DRUG DISTRIBUTION IN OPD & IPD (JAN. TO DEC. 2010)
S.No. Name & Quantity of Drugs obtained from own Pharmacy
Name & Quantity of Drugs purchased from market
Name & Quantity of utilised Drugs along with balance Verification by Visitors as correct / Not correct
Unani Drugs Modern Drugs Unani Drugs Modern DrugsUtilised Balance Utilised Balance
1.2.3.4.5.6.7.8.9.10.11.12.
* If required additional sheets be attached in the prescribed format
Unani-Visitation Profr. 2011-12 24
ANNEXURE IX
DETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR LABOUR ROOM
S.No. Essential Equipment and Instruments Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/not correct
1. Well equipped labour room with attached oxygen tent.
2. Incubator3. Suction Machine - 14. Oxygen Cylinder - 15. Pulse Oxymeter6. Others
ANNEXURE XDETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR OPERATION THEATRE
S.No. Essential Equipment and Instruments
Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/not correct
1. Necessary Instruments relating to the subject be kept in hospital. Instruments used in Operation theatre – Latest instrument for operation,Leeching, Cupping, Venesection &Autoclave
2. Oxygen Cylinder3. Suction Machine4. Enema5. X-ray View Box 6. Pulse oxymeter7. Anaesthesia machine8. Others
Unani-Visitation Profr. 2011-12 25
ANNEXURE XIDETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR DEPARTMENT OF TASHREEHUL BADAN (ANATOMY)
S. No.
DISSECTION HALL To be filled up by college Verification of information by Visitors as correct/not correct
1. Number of tables
2.Preservative tank- Exists/Not
3.No of cadavers available at the time of visitation
4.No of cadavers dissected/demonstrated in the year 2010
ANNEXURE XIIDETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR PHYSIOLOGY LABORATORY
S.NO. Essential Equipment and Instruments
Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/notcorrect
1. Microscope 2. Microtome3. Haemocytometer 4. Haemoglobinometer5. Tissue Slide6. Refrigerator7. BMR Apparatus8. Spirometer9. BM Instruments10. Stethoscope11. Kymograph Instruments
including electrometer& accessories
12. Albuminometer13. Urino meter14. Centrifugal machine15. Distillation apparatus16. Glassware for urine
examination &other necessary accessories
17. Dissecting trays18. Necessary chemical etc.19. Sphygmomanometer20. Tonometer
Unani-Visitation Profr. 2011-12 26
ANNEXURE XIII
DETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR MAHIYATUL AMRAZ LABORATORY
S.No. Essential Equipment and Instruments
Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/notcorrect
1. Pathological and Biochemical laboratory well equipped for all types of routine and histological examination should be attached with hospital and necessary accommodation for this laboratory also be provided.
2. Others
ANNEXURE XIV PROGRESS MADE BY INSTITUTION IN LAST THREE YEARS ON SALIENT POINTS –
S.No.
Important Information of College
Progress made by college (To be filled up by college)
1. Construction of college & hospital building
2. Appointment of Teaching staff
3. Number of Seminar organized by the college/attended by teaching staff
4. ROTP attended by the staff
5. Research work carried out by teaching staff
6. Publication of teachers
Unani-Visitation Profr. 2011-12 27
7. Quality of work presented/published (National /International journals)
8. Any contribution/ innovation made by the college/faculty for the System
9. Conduct of examination in time ort not
10. Appointment of Non-Teaching staff
11. Appointment of Paramedical and other Hospital staff
12. Expansion of Various
Departments of College
13. Expansion of Herbal Garden, Plantation of New Plants
14. Development of Pharmacy
15. Progress in Hospital OPD
16. Progress in Hospital IPD
17. Progress of Ilaj Bil Tadbeer Department
Unani-Visitation Profr. 2011-12 28
ANNEXURE XV
NOTARISED AFFIDAVIT TO BE FILLED UP BY TEACHER IN THE GIVEN FORMAT
S.No Information of Teacher To be filled up by Teacher1. Name of the Teacher (Sur Name- First
Name- Middle Name)2. Change of the Name (if Applicable after
marriage) 3. Date of Birth ( dd /m m/ yyy y )
( xx/xx/xxxx)4. UG Qualification (University & year) Year
Name of the University
5. PG Qualification with subject (University & year) of completion
SubjectYear Name of the University
6. Ph.D. ( if applicable) Subject
Year
Name of the University
7. Post wise details of Experience in chronological order (* Date, Month and Year wise experience should be mentioned)
Duration(dd/mm/
yyyy)
Designation Name of the college
8. Present working Department (Subject)9. Present Designation 10. Name of present working college11. Permanent Residential Address12. Local Residential address13. State Board/Council Registration detail No. -
State Board -14. Bank detail Salary Account Number
Name & Branch of Bank 15. Contact Number Mobile Number
Residence NumberPermanent Residence NumberEmail ID
I hereby solemnly affirm that the above information is correct as per my record and knowledge. I further affirm that if any information given in this affidavit is found to be incorrect/ false, I shall be liable to be blacklisted or debarred from service and to face any disciplinary action.
Date: Signature of Deponent
Signature of Principal with stamp
Unani-Visitation Profr. 2011-12 29
Pass Port Size Photograph (To be attested by Principal)
ANNEXURE XVI
CHECK LIST FOR ELIGIBILITY OF INDIVIDUAL TEACHER
Name of the Teacher Department S. No.
UG teacher Yes/No
1. Degree/Diploma in Unani Medicine 2 Certified copy of UG degree Certificate submitted 3. Certified copy of PG degree Certificate submitted 4. If only PG diploma in concerned subject, approval of the
CCIM for teaching is given 5. Copy of CCIM,s approval for PG diploma is submitted
6. Certified copy of PG diploma Certificate submitted7. If Professor, whether having total teaching experience of
10 years in a recognized Institution in the respective discipline
8 If Reader, whether having total teaching experience of 5 years in a recognized Institution in the respective discipline
9. If Senior Lecturer, whether having total teaching experience of 3 years in a recognized Institution in the respective discipline
10. Requisite teaching experience Certificate(s) submitted11. Whether recognized/approved by the concerned University12. Having age less than 65 years13. Whether not being superannuated in the mid-session in the
reporting year.14. Copy of Form-16 submitted15. Copy of salary bill/bank statement submitted16. Original Affidavit in prescribed Format submitted
S. No.
PG teacher Yes/No
17.. Whether the teacher deputed /appointed for post graduate teaching possess a degree in Unani Medicine and Post -graduate qualification in concerned discipline/allied subject as per regulations from a recognized institution/University.OR.If a teacher, working in recognized Unani Medical College and appointed prior to 1995 for post of Professor, Reader and Lecturer in the respective discipline without Post-Graduate qualification
18. If Professor, 10 years teaching experience in a recognized Institution or 13 years teaching experience for non-post-graduate Lecturer/ Reader in respective disciplines.
19. If Reader, 5 years teaching experience in a recognized Institution or 8 years teaching experience for non-post-graduate Lecturer/ Reader in respective disciplines.
20. No experience for Lecturer
Unani-Visitation Profr. 2011-12 30
Certification by Visiting Team/CCIM Official
As per above check-list, the teacher named………………………………….. …………………... posted in the Department of…………………………………………………………… is found eligible/not eligible.
The reason for non-eligibility (in case of not found eligible) are as following:
Assessment of teaching staff:-
Signature of Visiting Team/CCIM OfficialDated:
Unani-Visitation Profr. 2011-12 31
Reason of non-eligibility Yes/No
1. Overage (>65 years )2. Previous experience certificates not submitted 3. Found in Duplicity 4. Extra Arabic Teacher5. Submitted false teaching experience 6. Long Gap in teaching7. Affidavit not received or not in prescribed format 8. Non Unani Degree Holder 9. PG diploma holder- not approved by CCIM for teaching10. PG degree not according to schedule 11. Shortage of experience for higher Faculty12. Resigned from College13. Retired from College 14. Superannuation in mid-session
LIST OF ANNEXURES TO BE SUBMITTED BY COLLEGE
S.No. Annexure Number
Name of the Annexure
1. Annexure -I Details of area of College and Hospital
Annexure-II List of Under-graduate students admitted in the year 2010-11
Annexure-III List of post-graduate students admitted in the year 2010-112. Annexure-IV Details of Saidla (Pharmacy)
3. Annexure-V Proforma to furnish the details of Teaching Staff
4. Annexure-VI Proforma to furnish the details of Non Teaching Staff
5. Annexure-VII Proforma to furnish the details of Hospital Staff
6. Annexure-VIII Details of Drug distribution in OPD & IPD (Jan. to Dec. 2010)
7. Annexure IX Details of Equipment and Instruments required for Labour Room
8. Annexure X Details of Equipment and Instruments required for Operation
Theatre
11. Annexure XI Details of Equipment and Instruments required for Tashreehul Badan
12 Annexure XII Details of Equipment and Instruments required for Munafeul Aza (physiology) Laboratory
13 Annexure XIII Details of Equipment and Instruments required for Mahiyatul Amraz Laboratory
14 Annexure XIV Progress made by Institution in last two years on salient points
15 Annexure XV Notarised affidavit to be filled up by Teacher in given format. (in respect of newly appointed teaching staff after last visitation)Note: Teachers of Govt. colleges/ constituents colleges of University who have already submitted affidavits need not to submit again. However, these colleges should submit the affidavit of newly appointed teachers.
16. Annexure XVI Check list for eligibility of individual teacher
*********
Unani-Visitation Profr. 2011-12 32
CENTRAL COUNCIL OF INDIAN MEDICINENEW DELHI
Guidelines/Instructions for Colleges regarding Visitation 1. Please read the proforma carefully before filling up.2. Page-wise Index of all annexures should be provided.3. College should make ready three sets of Visitation proforma duly signed on each page
by the Principal/Dean/Director alongwith all annexures for visitors.4. College should make arrangement of videographer and photographer during visitation
of CCIM for preparing CD and group photographs with Teaching staff and non-teaching staff of College and Medical and non-Medical staff of Hospital with the visitors separately. The name of each staff member is to be written on the bottom of the photograph. It is to be noted that without CD and photograph, the visitation report will not be accepted by CCIM.
5. A soft copy of the details of teaching staff as per Annexure-V is also to be submitted in a CD.
6. Personal file of each teaching staff alongwith other relevant record (educational documents, experience certificate, bank details of salary distribution etc.) should make available to visitors to verify the facts.
7. Attested copy of UG & PG Certificates, Experience Certificates, Joining report, Relieving Certificate and Affidavit (as per annexure-XV) in respect of newly appointed teacher after last visitation should be attached as per serial number of the list of teaching staff including supportive documents in respect of reason of ineligibility of previous year (as per annexure V) Note: Teachers of Govt. colleges/ constituent colleges of University should also submit the affidavit of newly appointed teachers.
8. Copy of Form No. 16 issuing for purpose of income tax should be submitted in respect of all the teaching staff. (Not admissible for Govt./University constituent colleges)
9. Check list for eligibility of individual teacher as per Annexure-XVI should be provided to the visitors to verify the facts.
10. Teachers whose eligibility has been questioned by the Council due to any reason (false experience, duplicity etc.) will not be treated eligible unless cleared by the Central Council of Indian Medicine.
11. In absence of complete documents the teacher will be treated as ineligible.12. Financial information should be filled up in prescribed format of proforma only. 13. The column (namely “Verification of information by visitors as Correct/Not correct”)
will be filled up only by visitors after verification at the time of visitation of the college.
14. The college should filled up the information strictly as per prescribed format. Any change in the prescribed format will not be accepted by CCIM.
15. Please mention constructed area in Sq. ft. only and land area in acres. Any other measurement strictly be avoided.
16. The information should be based on present facts and complete information should be provided in the prescribed format.
17. The College should submit all the relevant information at the time of visitation. No further documents will be accepted by the Council after the visitation in any case.
18. The College shall provide local conveyance including lodging/ boarding (one AC room for each visitor) to the visitors.
Note: If any teacher will be found in duplicity/any record of teacher/any information submitted by the College will be found incorrect, the necessary action will be taken against the concerned teacher/ Principal of College /Secretary/President of the management of the concerned College.
Unani-Visitation Profr. 2011-12 33