LIBRARY - Central Council of Indian Medicine::...
Transcript of LIBRARY - Central Council of Indian Medicine::...
LOICENTRAL COUNCIL OF INDIAN MEDICINE
NEW DELHI
PROFORMA TO BE FILLED UP BY THE VISITORS FOR INCREASE INTAKE CAPACITY IN UNDER GRADUATE/POST-GRADUATE COURSE IN
AYURVED COLLEGES
(Additional sheet may be enclosed as and where required)
PART –I
Section ‘A’
Date of visitation
Purpose of Visitation
Name of the College
Full Address with pin codeName of the State/UT Telephone No./Fax/E-mail
Name of the Managing BodyWith full addressTelephone No./Fax/E-mail
Whether Government/Grant-in-aid/private/ Statutory college of university
Year of Establishment of Society/Trust
Year of Establishment of College
Date & Year of the permission of the State Govt.
Whether permission of State Government is continuing, If yes please enclose the proof, otherwise college authorities may give a certificate in the form of affidavit regarding continuation of permission of State Government.(Proforma enclosed) Name of affiliating University
1Intake Capacity Proforma
Date & Year of affiliation
Whether affiliation of the University is Continuing, if yes please enclose the proof otherwise college authorities may give a certificate in the form of affidavit regarding continuation of affiliation of the University. (Proforma enclosed)
(Yes/No)
Date of last inspection by the University
Date and year of first permission of CCIM with intake capacity Name of the Principal with Qualifications and Experience Time Table (copy to be enclosed)
Presently the College, Hospital and Hostels are on its own land or lease, details be furnished as mentioned below :
Total Area of Land (in acres)
Total area of land allotted to the college (in acres)
Total area of land allotted to the hospital (in acres)
Total area of land allotted to the hostels (in
acres)
Girl’s
Boy’s
*Constructed Area of the college (in Sq.ft.)
*Constructed Area of the Hospital (in Sq.ft.)
*Constructed Area of the Hostel is (in Sq.ft.)
Financial Information
Year Total income receipt during last three years
Total expenditure receipt of last three years
2008-09
2009-10
2010-11
Attested audited Report to be enclosed
2Intake Capacity Proforma
Details of the following to be provided: Previous Year (1st Jan- 31st Dec)
1. Salaries of teaching and non teaching Staff
2. Salaries of the Hospital Staff
3. Expenditure on Drugs
4. Expenditure on raw material for drugs
Administrative Block
Total Area in Sq. ft.
S.No. Name Area of the Space1. Office of the Principal2. Committee Room3. Account Section4. Administrative Section 5. Central Store Room
Status of the College with intake capacity(Courses being conducted)
UG:
PG:
3Intake Capacity Proforma
Departments required as per norms of CCIM with area and Available Infrastructure for Teaching and Training
MAULIK SIDDHANT DEPARTMENT
Total Area of Dept. in sq. ft. ____________________________________________________
Details of Teaching staff
Designation Sitting space in Sq.ft.
Name Qualification Experience
Professor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationTypist/ Clerk
Peon
Details of Space in Sq.ft.
S.No. Name Available area in Sq.ft.1. Departmentall Library *(PG)2. Tutorial Room
No of books available in in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
4Intake Capacity Proforma
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________________________________________________________
2. RACHANA SHARIR
Total Area of Dept. in sq. ft.
Details of Teaching staff
Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationMuseum keeper
Typist
Peon
Lifter
Safaiwala
5Intake Capacity Proforma
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Libarary (PG)
3. Museum
4. Dissection hall
5. Cadaver tank/ room
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Number of specimens of human organs available(List be enclosed)Number of Dissection tablesNumber of Cadavers Available(Enclose Proof)Number of Cadavers dissected previous year
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________________________________________________________
6Intake Capacity Proforma
3. KRIYA SHARIR
Total Area of Dept. in sq. ft.
Details of Teaching staff Designation Sitting space Name Qualification Experience Professor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationLab Assistant
Typist
Peon
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Departmentall Library (PG)2. Laboratory
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
7Intake Capacity Proforma
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
4. DRAVYAGUNA
Total Area of Dept. in sq. ft. Details of Teaching staff Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer.
Details of Non-teaching staff
Designation Name QualificationLab Assistant
Museum keeper
Peon
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
3. Museum
8Intake Capacity Proforma
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
5. RASASHASTRA & BHAISHAJYA KALPANA
Total Area in sq. ft.
Details of Teaching staff
Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer.
Details of Non-teaching staff
Designation Name QualificationLab Assistant
Museum keeper
Typist
Peon
9Intake Capacity Proforma
SafaiwalaDetails of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
3. Museum
4. Laboratory
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
6. ROG NIDAN
Total Area in sq. ft.
Details of Teaching staff
Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
10Intake Capacity Proforma
Details of Non-teaching staff
Designation Name QualificationLab Assistant
Typist
Peon
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
3.. Laboratory
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
11Intake Capacity Proforma
7. SWASTHAVRITTA
Total Area in sq. ft.
Details of Teaching staff Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationMuseum keeper
Peon
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
2. Museum
3. Yoga Hall
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine
12Intake Capacity Proforma
5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
8. AGAD TANTRA & VIDHI AYURVED
Total Area of Dept. in sq. ft.
Details of Teaching staff Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer.
Details of Non-teaching staff
Designation Name QualificationMuseum keeper
Peon
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
13Intake Capacity Proforma
2. Departmental Library (PG)
2. Museum
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
9. PRASUTI & STRIROGA
Total Area of Dept. in sq. ft.
Details of Teaching staff
Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationTypist
Peon
14Intake Capacity Proforma
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
2. Museum
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
10. KAUMARBHRITYA
Total Area of Dept. in sq. ft.
Details of Teaching staff Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer1.2.
15Intake Capacity Proforma
3.
Details of Non-teaching staff
Designation Name QualificationTypist
Peon
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
16Intake Capacity Proforma
11. KAYACHIKITSA
Total Area of Dept. in sq. ft.
Details of Teaching staff
Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationLab Assistant
Typist
Peon
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha
17Intake Capacity Proforma
4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
12. SHALYA
Total Area of Dept. in sq. ft.
Details of Teaching staff
Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationTypist
Peon
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
18Intake Capacity Proforma
3. Museum
4. Ksharsutra Laboratory
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
13. SHALAKYA
Total Area of Dept. in sq. ft.
Details of Teaching staff
Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
Details of Non-teaching staff
Designation Name QualificationTypist
Peon
19Intake Capacity Proforma
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
3. Museum
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
14. PANCHKARMA
Total Area of Dept. in sq. ft.
Details of Teaching staff Designation Sitting space Name Qualification ExperienceProfessor
Reader
Lecturer
20Intake Capacity Proforma
Details of Non-teaching staff
Designation Name QualificationTypist
Peon
Safaiwala
Details of Space in Sq. ft.
S. No. Name Available Area in Sq. ft.
1. Tutorial Room
2. Departmental Library (PG)
2. Museum
No of books available in Departmental Library
1. Ayurved2. Unani3. Siddha4. Modern Medicine5. Other
Observation of the visitor about establishment of the department, furniture, chart model, equipments/instrument,____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
__________________________________________________________________________________
21Intake Capacity Proforma
Number of existing teaching staff fo|eku f’k{kd oxZ dh l[;k
S.No.dze l[;k
DEPARTMENTfoHkkx
Professorizk/;kid
Readerizokpd
LecturerizoDrk
1. Samhita, Sanskrit & Siddhanta (one should be a Sanskrit Lecturer lafgrk] lLd`r ,oa fl)kar (,d laLd`r dk izoDrk gksuk pkfg,)
2. Rachana Sharira jpuk ’kkjhj
3. Kriya Sharira fdz;k ’kkjhj4. Dravyaguna
nzO; xq.k5. Rasashastra & Bhaishajyakalpana
jl ’kkL= ,oa HkS"kT; dYiuk6. Rognidana
jksxfunku7. Swastha Vritta
LoLFko`Rr8. Agadtantra & Vidhi Ayurved
vxnrU= ,o fod`fr foKku9. Striroga & Prasuti
izlwfr ,oa L=h jksx10. Kaumarbhritya
dkSekj Hk`R;11. Kayachikitsa
dk;fpfdRlk12. Shalya
’kY;13. Shalakya
’kkykD;
22Intake Capacity Proforma
14. PanchkarmaiapdeZ
* Information of teaching staff appointed after last visitation be furnished separately as per enclosed profomra. Deletion should also be mentioned separately
Pay Scale of teachersf’k{kdksa ds osru
as per State govt. Yes/No UGC Yes/No
1. Professor izk/;kid
2. Reader izokpd
3. Lecturer izoDrk
Mode of Payment vnk;xh dh fof/kWhether PF/GPF scheme is existing or not D;k Hkfo"; fuf/k@lkekU; Hkfo"; fuf/k gS ;k ugha Promotion policy inksUufr uhfrNumber of teachers possessing Graduate Qualification but working as teachers prior to 1.7.89.Lukrd vgZrk/kkjh f’k{kdks dh la[;k
Number of teachers possessing Post-graduate Qualification. LukrdksRrj vgZrk/kkjh f’k{kdks dh la[;k Number of UG teachers appointed after 1.7.89 1-7-89 ds i'pkr~ fu;qDr Lukrdh; f’k{kdksa dh la[;kPayment of Pay and Allowances through bank/cash (please enclose proof)
23Intake Capacity Proforma
deZpkfj;ksa dks fn, tkus okys osru ,oa HkRrsa dh fdLe cSad vFkok uxn (izek.k izLrqr djsa)
24Intake Capacity Proforma
PROFORMA TO FURNISH THE DETAILS OF TEACHING STAFF
S.No.
Name of teacher
Father’s Name Date of Birth
Designation Qualifications UG & PG level along with details of Awarding body & speciality of Post-graduate Course
Date ofAppointmen
t
Nature of appointment :
Regular/ reemployed
Details of experience inchronological order
iwoZ es izkIr vuqHko dk dzekuqlkj fooj.k
Department in which
teacher has been
appointed
Whether the appointment is in subject concerned
or in Allied subject as per CCIM norms
dz0la0
f’k{kd dk uke
firk@ifr dk uke
tUe frfFk in vgZrk,aiznk; fudk; ,oa
LukrdksRrjikB~;dzze ds fo"k; lfgr LukrdLukrdksRrj dh
vgZrk,a A
fu;qfDr frfFk
Duration
Designation
Name of the
college
foHkkx ftlesa f’k{kd
fVIi.kh dk dzekuqlkj fooj.k dh fu;qfDr
gqbZ gS A
Note: 1. Details of contractual teacher should also be furnished as per Proforma separately with documentary proof.
2. Please attach the verified copy of Under-graduate and Post-graduate degrees.d`i;k Lukrd ,oa LukrdksRrj mikf/k;ksa dh lR;kfir izfr layXu djsa A
3. Full name of the teacher and fathers should be mentioned.
25Intake Capacity Proforma
PROFORMA TO FURNISH THE SALARY DETAILS OF TEACHING STAFF
1. S.No.
2.Name of teacher
3. Designation
4. Pay Scale
5. Basic Pay
1. DA & Other allowances
2. DeductionGPF /CPF / IT
8. Gross Pay 9. Net pay 10. Contact No.
26Intake Capacity Proforma
PROFORMA TO FURNISH THE DETAILS OF OTHER STAFF (Other than teaching staff)
Name of Employee
Father’s Name Qualification Date of appointment Designation Name of Department
1 2 3 4 5 6
27Intake Capacity Proforma
PROFORMA TO FURNISH THE SALARIES DETAILS OF OTHER STAFF (Other than teaching staff)
1. S.No. 2. Name of the employee
3. Designation 4. Scale of pay
5. Basic Pay 6. DA & Other allowances
7. Deduction 8. Gross Pay 9. Net pay
28Intake Capacity Proforma
29Intake Capacity Proforma
LIBRARY iqLrdky;
Area of Library (in Sq.ft.)
1. Number of Rooms/Halls
Number of books available miyC/k iqLrdksa dh la[;k(List of books be enclosed)
a)Ayurved Unani Siddha d½ vk;qosZn
;wukuh fl)[k) Modern vk/kqfudx) Others vU;Total dqy 2. Journals/Magazines being subscribed vfHknRr if=dk@eSxt+huAyurvedic/Unani/Siddha vk;qosZn@;wukuh@fl)Modern Medicine vk/kqfud fpfdRlkOther vU;3. Seating arrangements in reading room iBu d{k esa cSBus dk izcU/k4. Working hours
5. Staff dkfeZd
Librarian iqLrdky;k/;{kAsst. Librarian iqLrdky; ifjpj@vuqlsodLibrary Attendant/Peon iqLrdky;
6. Purchase of books in last academic year Number and cost of the books (List to be enclosed)7. Facilities available in the library
a. E-library – number of computerswith printer and internet facility
b. Photocopying machine and printer
c. Drinking (Filtered) water facility
30Intake Capacity Proforma
d. Separate toilet for boys & girls
e. Separate reading room for Faculty members
8. Any other Remarks vU; dksbZ fVIi.kh
Students Hostel Nk=kokli) Building Hkou Own/Rented/lease
futh@fdjk, dk Constructed area of boys hostel
Constructed area of girls hostel
No. of rooms available for Boys
No. of rooms available for Girls
ii) Number of seats available in Boys hostel
Nk=kasaa ds Nk=kokl esa miyC/k LFkkuiii) Number of seats available in Girls
hostel Nk=kvksasaa ds Nk=kokl esa miyC/k LFkku
iv) Mess facility available Yes/NojlksbZ vkfn dh lqfo/kk gS@ugh
v) Reading room
vi) Any other remarks vU; dksbZ fVIi.kh
PHARMACY
Building Area in Sq.ft. Own/Lease
Staff Name of the post Name QualificationSuperintendent (HOD
31Intake Capacity Proforma
Rasashastra)Deputy Superintendent (M.D. Rasashastra /Bhaisajya kalpana/ Dravya guna)Machine Operator
Labour (Number)
Attach the list of equipments
List of Prepared Medicines with quantity during last year
Brief description of Pharmacy of the college about its functioning including various preparations, raw materials, turnover and annual budget etc. ikB~;fooj.k ds vuqlkj fofHkUu feJ.k rS;kj djus dh O;oLFkk ds lEcU/k es egkfo|ky; dh vkS"k/k fuekZ.k iz;ksx’kkyk dk laf{kIr fooj.k
HERBAL GARDENoukS"kf/k m|ku
i) Area {ks=Qy (in acre)ii) Number of Plants with name and
number of species (List to be enclosed)
iii) Plant Nursery details
iv) Available Irrigation facility
v) Staff dkfeZd (List to be enclosed)
(i) _________________________(ii) _________________________(iii) _________________________(iv) __________________________
vi) vi) Remarks fVIi.kh
CLASS ROOMS
32Intake Capacity Proforma
Class Room Area in Sq.ft. Seating capacity Available facilities
AuditoriumArea in Sq. ft.
Seating capacity
Available facilities
Staff Room
Area in Sq. ft.
Available facilities
Girls Common Room
Area in Sq. ft.
Available facilities
Boys Common Room
Area in Sq. ft.
Available facilities
Sports and Games Facility
1. Indoor Games Facilities
2. Outdoor Games Facility
33Intake Capacity Proforma
3. Play ground (Area in Sq. ft.)
4. Store Room (Area in Sq. ft.)
Canteen
Area in Sq. ft. Seating capacity
Transport Facility :
1. Students own/hired
2. Staff own/hired
Section ‘C’
HOSPITAL vLirky
1. Reception and Enquiry
2. Registration counter
3. Office of Medical Superintendent/ Medical Deputy Superintendent
4. RMO Room
OPD Section
2.. Name of OPD Sections
S. no.
Name of Department
Area (Sq. ft.)
Facility Available (Equipment, Instrument, Furniture etc)
Number
1. Kayachikitsa View Box BP Instrument Stethoscope Sitting arrangement for
internees/students
34Intake Capacity Proforma
Examination Table Thermometer Tongue depressor Cotton balls Torch
Measuring tape Weight and height
measuring stand Hammer
2. Shalya Hand washing facility Drainage facility Minor OT Instruments for anorectal
examination Examination Table BP instrument Surgical Blades Cotton balls Gauze pieces View Box Stethoscope Sitting arrangement for
internees/students Cheetle’s forceps Torch
3. Shalakaya Tuning fork Ophthalmoscope/
fundoscope Auroscope Examination Table View Box BP Instrument Stethoscope Sitting arrangement for
internees/students ENT kit Torch Bull`s lamp
4. Prasuti & Sri Roga
Weighing machine Sim’s speculum Cusco’s speculum Examination Table Lamp stand Torch View Box BP Instrument Stethoscope Sitting arrangement for
internees/students
35Intake Capacity Proforma
Measuring tape5. Bal Roga Scale
Weighing machine Torch View Box BP Instrument Stethoscope
Sitting arrangement for internees/students
6. Panchkarma As per kayachikitsa
NUMBER OF PATIENTS ATTENDED OPD (Jan. 2011 onward)(Note:- Patients of Medical Camp OPD should not be included)
S.No. Month Information to be filled up by college Verification of information by Visitors as correct / Not
Kayachikitsa Shalya Shalakya Prasuti & Stri Roga
Bal Roga
Panchkarma Swasthya Rakshan
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. 2011 onward)
1. Total Number of Patients Admitted January 2011 onwardS .No. Month Information to be filled up by college Verification of information by
Visitors as correct / NotKayachikitsa Shalya Shalakya Prasuti & Stri Roga
Bal Roga
Panchkarma
1. Jan. 2. Feb.3. March.4. April5. May6. June7. July8. August9. Sept.10. Oct.11. Nov.12. Dec
36Intake Capacity Proforma
Total Grand total
2. Total Number of Bed Days OccupiedS.No. Month Information to be filled up by college Verification of information
by Visitors as correct / NotKayachikitsa Shalya Shalakya Prasuti & Stri Roga Bal Roga Panchkarma
1. Jan. 2. Feb.3. March.4. April5. May6. June7. July8. August9. Sept.10. Oct.11. Nov.12. DecTotal Grand total
Note:- To calculate 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 STRENGTHName of the Department % of Bed Distribution
as per CCIM normsNumber of Existing Bed strength (To be filled up by college)
Verification of information by Visitors as correct / Not
(i) Kayachikitsa & Panchkarma 40%
(ii) Shalya 10%
(iii) Shalakya 10%
(iv) Prasuti & Striroga 10%
(v) Bal Roga 10%
(vi) Others 20%
Total Number of Beds
Note: Visitors while verifying the information of fully functional hospital along with 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.
37Intake Capacity Proforma
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
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 roster
38Intake Capacity Proforma
5. 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
1. Casualty
Area (Sq. ft.)
No. of Beds Facility Available (Equipment, Instrument, Furniture etc)
2. Yoga Section (Swasth Rakhshan)
Area (Sq. ft.) Facility Available (Equipment, Instrument, Furniture etc)
3. Minor OT
Area (Sq. ft.) Facility Available (Equipment, Instrument, Furniture etc)
DISPENSARY
Area of Store room of Drugs in sq. ft Area of dispensary Details of quantity with name of drugs dispensed during last year1.
39Intake Capacity Proforma
2.3.4.
Medical Record Room (Area in Sq.ft.)
IPD Sections with bed strength
Name of the Department Bed strength(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
Total
No. of wards/ Hall/ rooms in IPD
Total number of patients admitted in IPD during previous year**Average bed occupancy during previous year
(1st Jan, 2011 to till date)Other Available facilities in IPD Section (Enclose List) **(Bed occupancy should be calculated on formula i.e.Number of bed days occupied x 100Total Number of Beds x 365
Hospital Staff (OPD and IPD)
STAFF
S.No. Name of the Post Name Qualification1 Superintendent (Principal or Dean
of the college may also be ex-officio) v/kh{kd ()
2 Deputy Superintendentmi v/kh{kd
40Intake Capacity Proforma
1 Physician All Professors, Readers & Lecturers of Clinical Subjects
2 Vaidya (for OPD) (6)3 Casualty Medical Officer (3)
4 Pharmacist(for OPD) (2)5 Nurse (for OPD) (2) + (1for Gynae OPD)6 Dressers(for OPD) (2)7 Ward Boy/Attendents (for OPD) (2)8 Clerk (for OPD) (2)9 Safaiwala (for OPD) (2) or on contact basis
IPD Number available in the Hospital
Medical Specialist (cardiologist)
1 Part time
1 Surgeon 1 Part time2 Gynaecologist 1 Part time3 Radiologist 1 Part time4 Pathologist 1 Part time5 Anesthetist 1 Part time/on
call6 X-ray technician 1 7 Clinical Registrar 1 for each clinical
deptt.8 RMO 19 House Officer/PG
student 1 for 20 beds
10 Matron/Nursing Superintendent
1
11 Asstt. Matron 1 for 100 beds12 Staff Nurse 1 for 10 beds13 Ward boy/Ayah/ANM 1 for 10 beds
14 Pharmacist 215 Store Keeper 116 Head Clerk 117 Cook 1 for 50 beds18 Kitchen Attendant/
Cook 1 for 25 beds
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19 Plumber On contract basis 20 Watch Men 4 or on contract
basis21 Lift men for
multistoried building
4 or on contract basis
22 Electrician 1 (part time)23 Dark Room Attendant 124 Operation Theatre
Attendant2
25 Labour Room Attendant
2
26 Safaiwala 1 for 25 beds or on contract basis
27 Statistician part time28 Photographer part time
NOTE:- DETAIL INFORMATION OF HOSPITAL STAFF BE FURNISHED AS PER ANNEXURE –VII
***Note: To ascertain the availability of actual numbers of Hospital Staff/other 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 Personal file Duty Roster Attendance of Hospital 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. 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 teachers 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 is having _______ number of hospital staff.
42Intake Capacity Proforma
Signature of CCIM visitation team
Clinical Pathology & Bio Chemistry Lab
Area (Sq. ft.) Facility Available (Equipment, Instrument, Furniture etc)
Details of investigations performed
Other facilities available in the Hospital
X-Ray please mention the M.A.ECGUSG
Number of X-Rays, ECG and USG done during previous year (Ist Jan. to 31st Dec.)(Enclose the supporting Document)
Panchkarma Department
S.No. Staff Name Qualification
1. Panchkarma Specialist Teachers of the subject
2. Panchkarma Vaidya 1 Male
1 Female
3. Panchkarma Nurse 2
4. Panchkarma Technician 2
5. Panchkarma Assistant 2 Male
2 Female
6. Physiotherapist 1
7. Safaiwala 2
Poorv Karma
43Intake Capacity Proforma
Snehan
Swedan
Main Karma`s being carried out
Total no. carried out during previous year (Ist Jan. to 31st
Dec.)
Vaman oeuVirechana fojspuVasti ofLrNasya uL;Rakta Mokshana jDr eks{k.kAgni Karma vfXudeZ
Details of Instruments:;a=ksa dk C;kSjk
Number of Instruments;a=ksa dh la[;k
Droni nzks.kh (2)
Vastiyantra ofLr;a= (6)
Hot Plates gkWV IysV (2)
Gyser xhtj (2)
Avgahan Yantra voxkgu ;a=(2)
Swedan Yantra Losnu ;a= (2)
Shirodhara Yantra f’kjks/kkjk ;a=(2)
b- Brief description laf{kIr fooj.k ____________________________
Labour Room
Area (600 Sq.ft.)
44Intake Capacity Proforma
Waiting Room with attached Toilet
Labour Room
Facilities for Neonatal care
Other Available Facilities, Equipments, InstrumentsNumber of Deliveries performed during previous year (1st Jan, 2011 to till date) (Enclose list)
Operation Theatre
Area (in Sq. ft.)
Air conditioning
Pre operative Room with attached toilet
Sterilization room – ASV
Changing and wash room with attached toilet
Exit/Not
Operation theater (Area in Sq.ft.)
Recovery Room (Area in Sq.ft.)
Number of operations done during the previous year (1st Jan, 2011 to till date)(Enclose list)Number of patients treated by Kshar Sutra
application (Enclose list)
Details of Available equipments, Instruments and other facilities in Operation theatreFumigation Details
Ambulance
Shortcomings informed by Govt. of India
Compliance submitted by the college
Observations of the visitors
45Intake Capacity Proforma
Overall observations of the visitors1. About Teaching staff
2. About Non-Teaching staff
3. About Departments
4. About Dissection Hall
5. About Physiology Lab
46Intake Capacity Proforma
6. About Pathology Lab
7. About Rasashastra
Bhaishajya Kalpana Lab
8. About Pharmacy
9. Hospital OPD
10. About IPD
11. About OT
12 About Panchkarma
47Intake Capacity Proforma
13 About Khsharsutra
14. About Labour room
15 Hospital in General
16 College in General
17. Condition of building
(a) College
(b) Hospital
18. Financial capability to
meet out the additional expenditure for increase intake capacity of UG/PG Course in Ayurved Collegesa) Cash in hand (in
figure)
48Intake Capacity Proforma
b) Funds available with the Society for establishment of Ayurved College particularly ( figure)
c) Details other Assets of any form for the purpose
a. whether the Ayurved college for increasing intake capacity be in a position to offer the minimum standards of medical education as prescribed by the Central Council
(d)
D;k izLrkfor fpfdRlk egkfo|ky;] tks izos’k {kerk c<+kus dk bPNqd gS] dsUnzh; ifj"kn }kjk ;Fkkfofgr fpfdRlk f’k{kk ds U;wure ekudksa dks izLFkkfir djus dh fLFkfr esa gksxk rdZ lfgr%
b. whether necessary facilities in respect of staff, equipment, accommodation, training, hospital or other facilities to ensure proper functioning of the medical college for proposed increasing intake capacity have been provided or would be provided within the time-limit specified in the scheme with justification;
([k)
D;k deZpkfjo`Un] miLdj] okl&lqfo/kk] izf’k{k.k] vLirky dh ckcr vko’;d lqfo/kk,a ;k fpfdRlk egkfo|ky; ds mfpr dk;Zdj.k ;k of?kZr izos’k {kerk ds mfpr izca/k dks lqfuf’pr djus ds fy, vU; lqfo/kk,a miyc/k djkbZ xbZ gSa ;k Ldhe esa fofufnZ"V le;&lhek ds Hkhrj miyC/k djk nh tk,axh rdZ lfgr %
c. whether adequate hospital facilities, having regard to the number of students likely to attend such medical college or course of study or training have been provided or would be provided within the time-limit
49Intake Capacity Proforma
specified in the scheme with justification;
(x) D;k ,sls fpfdRlk egkfo|ky; ;k ikB~;dze ;k izf’k{k.k esa izos’k ysus okys laHkkfor Nk=ksa dh la[;k dks /;ku esa j[krs gq, vLirky dh Ik;kZIr lqfo/kk,a miyC/k djkbZ xbZ gSa ;k Ldhe esa fofufnZ"V le; &lhek ds Hkhrj miyC/k djkbZ tk,xh rdZ lfgr% %
d. whether any arrangement has been made or programme drawn to impart proper training to students likely to attend medical college or the course of study or training by persons having recognized medical qualifications with justification;
(?k)
D;k fpfdRlk egkfo|ky; ikB~;dze ;k izf’k{k.k esa ekU;rkizkIr fpfdRlk vgZrkizkIr O;fDr;ksa }kjk izf’k{k.k esa Hkkx ysus okys laHkkfor fo|kfFkZ;ksa dks leqfpr izf’k{k.k nsus ds fy, dksbZ bartke fd;k x;k gS ;k dksbZ dk;Zdze rS;kj fd;k x;k gS rdZ lfgr% %
e. whether the applicant fulfils the eligibility and qualifying criteria;
(M+)
D;k vkosnd ik=rk vkSj vgZd ekun.Mksa dks iwjk djrk gS A
f. whether the applicant has a feasible and time bound expansion programme to provide additional beds and infrastructure facilities as specified by the Central Council, by way of up-gradation of the existing Hospital or by way of establishment of new Hospital in the same College campus or both so as to collectively provide the specified bed complement within a stipulated period
(p) fd vkosnd fo|eku vLirky ds mUu;u vFkok egkfo|ky; ds izkax.k esa gh u;k vLirky LFkkfir djus vFkok nksuksa ds ek/;e ls dsUnzh; ifj"kn~
50Intake Capacity Proforma
}kjk fofufnZ"V vfrfjDr ’k;~;kvksa rFkk volajpfud lqfo/kkvksa dks vuqekfur le; esa iwjk djus ’kD; rFkk le;c) dk;Zdze j[krk gS A
g. whether the applicant has necessary managerial and financial capabilities to proposed increasing intake capacity and to maintain the same with ancillary facilities including a teaching Hospital;
(N)
fd vkosnd ds ikl izLrkfor egkfo|ky; dks LFkkfir djus ,oa cuk, j[kus ds fy, vko’;d izcU/kh; ,oa foRrh; {kerk rFkk f’k{k.k vLirky lfgr lgk;d lg;ksxh lqfo/kk,a gSa A
h. whether the applicant has a feasible and time bound programme for recruitment of faculty and staff as per prescribed norms of the Central Council and that the necessary posts stand created to additional requirement for proposed increasing intake capacity
(t) fd vkosnd ds ikl izLrkfor izos’k {kerk dh vfrfjDr vko’;drkuqlkj dsUnzh; ifj"kn }kjk fofgr ekun.Mksa ds vuq:i ladk; vkSj LVkQ dh HkrhZ ds fy, mfpr vkSj le;c) dk;Zdze gS A
i. whether the applicant has not admitted any students against the proposed increasing intake capacity prior to permission. If so, details thereof;
(>)
fd vkosnd us izLrkofr izos’k {kerk dh o`f) gsrq fdlh Nk= dks izos’k fn;k gS ;k ugh A ;fn fn;k gS rks mldk fooj.k A
j. deficiencies, if any, in the infrastructure or faculty. (be pointed out indicating whether these are remediable or not)
(¥) volajpuk vFkok ladk; esa D;k dksbZ dfe;ka gSa (vkSj ;g Hkh bafxr djsa fd os
51Intake Capacity Proforma
nwj gksus ;ksX; gSa ;k ugha )
(1) For issue of Letter of Intent to increase intake capacity, following are pre-requisites for the applicant/college:-
(a) Action has been initiated to increase the bed strength to maintain student bed ratio i.e. 1:2 of hospital with all requisite instruments, equipment etc.
(b) Action has been initiated to appoint the additional teaching and other staff for additional seats as per requirement of CCIM.
(c) Construction of hospital and college building to provide additional accommodation for hospital teaching and other staff, class room, laboratories, dissection hall, library and requirements of equipment, instrument etc. to meet the additional requirements.
(d) Action has been initiated for rational increase of hostel accommodation.
(e) Action has been initiated to increase the number of books in the Library.
Name of Visitors Signature1.
2.
4.
Place LFkku …………………………….
Date frfFk ……………………………..***********
52Intake Capacity Proforma