IX.B FINANCIAL INFORMATION MONTH WISE EXPENDITURE FROM 1ST JAN 2014 TO 31ST August 2014 S. No Month Total salary of teaching staff Total salary of non teaching staff Total salary of hospital staff expenditure on purchase of new books expenditure 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 and other expenditure 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December Total GRAND TOTAL OF EXPENDITURE from 1ST JAN 2014 TO 31ST August 2014 TOTAL INCOME from 1ST JAN 2014 TO 31ST August 2014
Available / Not available Available / Not available 4. Labour Room with attached toilet and bath room 5. Neonatal care room 6. Central sterlisation/autoclave unit 7. Scrub room 8. Two Recovery room 9. Doctor’s duty room with attached toilet and bath room 10. Interns/house officer/resident doctors room with attached toilet and bath room 11. Nursing staff room with attached toilet and bath room Panchakarma Block 200 350 1. Snehana Kaksha (Male) Available / Not available Available / Not available 2. Snehana Kaksha (Female) 3. Swedana Kaksha(Male) 4. Swedana Kaksha(Female) 5. Shirodhara Kaksha(Male) 6. Shirodhara Kaksha(Female) 7. Vamana Kaksha(Male) 8. Vamana Kaksha(Female) 9. Virechana Kaksha(Male) 10.Virechana Kaksha(Female) 11.Basti Kaksha(Male) 12.Basti Kaksha(Female) 13.Rakta Mokshana, Jalaukavacharana, Agnikarma, Pracchanna etc Kaksha 14.Panchakarma therapist/Physician’s room 15.Panchakarma store room 16. Four attached toilet-baths for males and four for females with wash basin and geyser facility in each. These will be in addition to the toilets of wards. Physiotherapy Unit 75 150 1.Physiotherapy Room Available / Not available Available / Not available 2.Physiotherapist room Central Laboratory: 100 150 Well equipped and spacious area of two hundred square meter with separate sections for Pathology, Biochemistry and Micro-biology. Attached toilet shall be there for collection of urine samples. Other diagnostic tools for ECG or TMT etc. shall be provided. Available / Not available Available / Not available Radiology or Sonography Section :- 50 100 Radiologist chamber, X-ray room, Dark room, film drying room, store room, patients waiting and dressing room, reception or registration or report room. Available / Not available Available / Not available Hospital Kitchen and Canteen: 100 150 Stores/Mortuary: 25 50 Sitting arrangement for internees/students in Various Out Patient Department Available/ Not Available
ANNEXURE-V 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 ANNEXURE-VI PROFORMA TO FURNISH THE DETAILS OF HOSPITAL STAFF (Including Part Time Modern Medical 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 ANNEXURE-VII A. DETAILS OF DRUG DISTRIBUTION IN OPD & IPD (from 1st JAN. 2013 to 31st. DEC. 2013) S.No. Name and Quantity of Drugs obtained from own Pharmacy Name and Quantity of Drugs purchased from market Name and Quantity of utilized along with balance Ayurvedic Drugs Modern Drugs Ayurvedic Drugs Modern Drugs Utilized Balance Utilized Balance Note:-*If required additional sheet be attached in the prescribed format. ANNEXURE-VII. B
S.No. OPD Registration Number IPD Registration Number Name of Patients Age Sex M/F Bed Number Diagnosis Date of Admission Name of treating Doctor Note:-*Details of IPD patients of each department shall be annexed separately. If required additional sheets be attached in the prescribed format.
ANNEXURE-III PROFORMA TO FURNISH THE DETAILS OF TEACHING STAFF S. No. Name of the Teacher Father's Name Date of Birth UG Qualification (University & year) PG Qualification with subject (University & year) Date wise details of Experience in chronological (1st appointment to till date) Department (Subject of ) Nature of present appointment (regular/ contractual/ deputation/ part time/ adhoc) Local Residential Address Permanent Address Name of State Board & Registration Number Salary Account Number , Name of Bank& Branch Telephone Number & Mobile Number of Teacher Photograph of Teacher (Attested by the Principal) Signature of Teacher ( At the time of visitation) Duration (dd/mm/yyyy) Designation Name of the college Sur Name First Name Middle name Note: Please download a copy of Annexure III in MS Format (.xls) from the Website of CCIM i.e. www.ccimindia.org and fill up the details and annex the same as softcopy in the form of CD/DVD as Annexure XIII. Enclose a Printed / hard copy of the same as ANNEXURE III and attach the certified copies of UG, PG & Registration Certificates, experience certificates, joining Report, Relieving Order, Form No. 16 and all other relevant documents and original notarized affidavit (Annexure-IV)of newly appointed teachers after the las t visitation. If any teaching is promoted after submitting notarized affidavit he/she may submit a new affidavit along with necessary documents and get duly verified by the visitors.