Project Report Hospital

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PROJECT REPORT
NEW ERA PATIENT-FRIENDLY

HOSPITAL PRIVATE LIMITED
SHUKUL BAZAR, SULTANPUR,
UTTAR PRADESH, INDIA
Bejon Misra, Managing Director

consumeralert@eth.net
&
Dr. Bidhan Das, Consultant
MBBS, MHA (AIIMS)
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CONTENTS
Page
Executive Summary 3
About the Organization 5
Preamble 7
Introduction 8
Technical Analysis & Justification 12
Health Care Plan 22
Functional Plan and Programs 24
Departmentation 29
Facilities Management 32
Licenses permits and statutory obligations 34
Organisation Structure 36
Staffing Pattern and Qualification 37
Annexures
1. Layout Map of the Facility (Annexure-1) 38
2. List of Equipment and Furniture (Annexure-2) 42
3. List of Drugs (Annexure-3) 50
4. Universal Precautions (Annexure-4) 62
5. Charter of Patient’s Rights as a Consumer (Annexure-5) 64
6. Financial Details (Annexure-6) 66
7. Geographical Map of the Location (Annexure-7) 86
8. Micro Health Insurance 88
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EXECUTIVE SUMMARY
It is rightly said that India lives in its villages. About 78% of the population of the
country lives in rural India.
The country has the dubious distinction of being the 2nd largest populous country
in the world. The flip side is that in spite of being a vast country having a huge
population of 108 crores the health status of the country is very poor.
As evidenced by the World Health Report, the health indicators are far inferior
to its neighboring developing countries. Health being a state subject the
government has a very well structured public health system.
The three tier level of health-care organization with the root at the level of primary
health centers going through CHCs, DHs and tertiary centers like medical colleges
and centers of excellence like AIIMS, PGI etc.
In spite of all this, the reach and acceptance of the facilities particularly in the
PHCs and CHCs is very poor.

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Several studies have revealed that the community prefers to go to a private
provider and pay out of pocket rather than going to a public facility even though it
is free. This is evidenced by the fact that the GDP on account of health is 5.2%.
out of which the share of the Government is only 1.8% and the rest is from the
private providers.
Health care in India is a sunrise sector and the country is witnessing a
mushrooming of corporate hospitals being ironically concentrated at the
Metropolitan cities with a focus on the international health business. At the end the
rural sector is left untouched even if the population is ready to pay.
Govt. has taken a revolutionary step in the form of National Rural Health
Mission (NRHM) and furthered it by laying standards for the same in the form of
IPHS 2006. The results of this program are to be seen in the years to come.
The basic issue is to regain the trust of the community on the public health
facilities.
The areas of concern in order to achieve the trust is
- Accessibility
- Availability
- Affordability
- Affability
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IMPLEMENTING AGENCY: NEW ERA PATIENT-FRIENDLY

OBJECTIVES:
To develop and implement state-of-art health delivery system for providing quality
healthcare facilities at an affordable price for all.
To conduct research and development studies for bringing policy changes in the
healthcare delivery system globally especially in developing countries for the poor
and disadvantaged consumers.
To educate consumers and make them aware on their rights and provide informed
choice in an effective and efficient manner.
New Era Patient-Friendly Hospital Private Limited has ventured into this area
so as to create a model incorporating all the features stated in the NRHM,
National Population – Policy and IPHS 2006.
Located in rural surrounding the place is 70 km off Lucknow in the State of Utter
Pradesh (INDIA) and close to Jagdishpur Industrial Area on the Lucknow to
Sultanpur Highway in a village called Pureshuklan in Shukul Ka Bazar Block,
district Sultanpur.
This initiative will function as a private ‘for profit’ model. The aim is to emulate
and replicate this model to other parts of the country particularly in the
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economically back ward states and in turn help the Government to implement the
NRHM in the real sense of the term.
The facility has been planned and designed as per BIS standards for 30 bedded
hospital as well as IPHS 2006.
It has 30 beds with basic broad specialties, supplemented with diagnostic services
including an ultrasound, ICU and an operating room.
The structural standards have been met with, the process and outcome standards
are being worked upon so as to enable the hospital to be accredited by the National
Accreditation Board for Hospital and health care providers in the days to come.
The concept of Public Private Partnership can very well be applied to this model.
The facility is geared up to handle and support all national health programs,
Counseling services, NGO participation, PRI involvement, preventive health, IEC
services, Sanitation, Hygiene and safe water supply to the community apart from
patient/consumer education and awareness on rights and responsibilities.
The rights of patients and staff are to be respected and the approach will be
market/consumer driven. Governance of the facility will be professionally
managed.
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PREAMBLE
This report has been prepared to formulate the project “commissioning of the New
Era Patient-Friendly Hospital Private Limited at “Pureshuklan” (Post Office
Shukul Bazaar), District Sultanpur in the State of Uttar Pradesh in INDIA.
The report is based on the discussion and data generated, from various meeting
held with the promoters of the project, who are members of the Governing Board
and visits to the sights. Data is also collected for the disease pattern, incidence of
various diseases and other relevant social, cultural and health status indicators. All
the data has been qualified to accommodate the functional requirements of various
departments in this hospital.
The Departmentation plan as listed has been discussed and approved. The hospital
activity has been adopted to be of primary to secondary level of health care, so
as to be in the linen of NRHM and Millennium Development goals (MDG).
The provision in this report has been made for specific purpose of conceptual
proposal and designing of the hospital. In this report, due consideration has been
given to under stand the market needs of the locality, research has been conducted
for various national health programs, national health policy, NRHM, world health
report, IPHS 2006, and BIS standards for 30 bedded hospital.
New Delhi
Dated : 30 August 2006 Bejon Misra &
Dr. Bidhan Das

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INTRODUCTION
Pursuant to the executive summary in the report it has very adequately been
emphasized that the need for a model rural hospital meeting all possible standards
to a reasonable extent be created in order to provide quality health care at the most
affordable cost. However, needless to say that the infrastructure so created shall be
easily replicated all over the country and other developing countries so as to bring
good quality health care to the door step of the community and in turn progress
towards HEALTH FOR ALL and achieving the MDGs.
In order to meet this demand for comprehensive health care services this model
hospital has been named as “New Era Patient-Friendly Hospital Private
Limited” hospital. The hospital shall not only provide and supplement the much
needed beds in this segment but also augment the emergency health care services
and prove to the world that quality health care services can be provided at a very
low capital cost. It will further demonstrate how this model can be financially
viable and sustainable. The hospital addresses the unmet needs of the community
as consumers and therefore empowers them with their right to health and
availability of services for the money paid, so as to appreciate the value for
money. The proposed hospital shall provide a comprehensive medical, surgical,
obstetrics, pediatrics, orthopedics, eye & ENT, Ayurveda, Homeopathy as well as

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all the needed support services. Most importantly it will be functional 24/7 all
through out the year so as to make available emergency medical care round the
clock at a very reasonable cost which the community can afford.
The Mission of the Hospital
“To provide quality health care accessible and affordable to all round the clock”.
Proposal
To commission this multi specialty hospital so as to provide comprehensive
medical, surgical, obstetrics, pediatrics, orthopedic, eye & ENT, Ayurveda,
Homeopathy care as a not for profit venture but a self sustaining model. The
hospital shall be linked with telemedicine to designated centers of excellence in
the country and coupled with a micro insurance model for the community to pay
for their health care needs.
The services provided will be at a very nominal and affordable price. However, for
the underprivileged group a self-financing scheme based on a co-operative model
will be created.
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Objectives
1. To ensure availability of comprehensive quality health care accessible to
all without any discrimination or bias.
2. To provide the services round the clock 24/7.
3. To enable access of the services to the community at an affordable
price.
4. To run the facility in a transparent manner so as to create an
environment of empowerment and ownership of the community.
5. To provide value for money to the consumers of health care.
6. To act as a role model for others to emulate.

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NAME OF THE HOSPITAL
NEW ERA PATIENT-FRIENDLY

“Demand Quality Health Care”
Location: Pureshuklan, District Sultanpur, U.P. India
Size of the Hospital
30 bedded in patient unit with suitable component of out patient unit, Emergency
Department, ICU, OT, and needed support services.
Organisation Owning the Hospital
New Era Patient-Friendly Hospital Private Limited
The Registered office: National Capital Territory of Delhi.
Date of Commencement of Business of the Hospital
January 2007
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Governing Board of the Hospital
1. Dr. Mahendra Pratap Narain Pande, D.O. (Lon)

Chairman
2. Mr. Bejon Misra

S/o Late Satyendra Nath Misra
W018, Regency Park II, DLF Phase IV, Gurgaon
(Professional)
3. Mr. Rajeev Misra

S/o Late Mahesh Misra
C-20, Defence Colony, New Delhi – 110024
(Professional)
4. Dr. Mahendra Jeet Sharma

S/o Late Sh. Gopi Nath Sharma
572/1B, Civil Lines, MGS Gate,
Sultanpur – 22804
Uttar Pradesh
5. Mr. Trtirunillai Krishanan Govindan

S/o Late Sh. T.D. Krishan (Retired)
90C, Pocket L, Mayur Vihar Phase I,
Delhi – 110091
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TECHNICAL ANALYSIS
Located in village for Pureshuklan, surrounded by many mango groves and
farmland. The building is well ventilated and certain portions are air-conditioned.
There is adequate access from the main road on two sides. Approach road is wide
enough for cars, jeeps, vans, Lorries and other means of transport.
The building plan has been considered keeping the location and socio cultural
habits of the community. It is a two storied building having ramps so as to
transport immobile patients to the first floor. The hospital will have an advanced
pathology lab based on semi automation, a good imaging department; emergency
services round the clock, an operating room and an ICU to provide critical care
and life stabilization care for all cases.
Equipped with an ambulance it can provide safe transportation of both stable and
unstable patients to the designated referral hospitals. The nearest tertiary care
hospital is SGPI, Lucknow and KGMC, Lucknow which are approximately 70
kms away with a driving time of 1 ½ hours. It has been envisaged to contain the
cost of health care to bring it within the reach of the population who at present are
not able to afford the cost of health care.

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In addition, we bring out the following points for consideration.
General
1. For selected specialties as stated above the hospital shall provide all
needed services.
2. For all other specialties it shall provide only essential services to
preserve life and stabilize the patient’s condition and evacuate the
patient to an alternative health care facility.
3. The hospital shall maintain its accounts in a very transparent manner,
and make it public.
4. It will accept grants/donations from all concerned and submit the
income/expense statement to the funding organization.
5. Being governed by a collaborative approach it will take the mandates of
the stakeholders in the business in to consideration.
Degree of Specialization
1. The hospital shall provide primary as well as secondary level care
including the preventive, promotive, curative and rehabilitative services
within the ambit of its capacity.
2. The hospital has made provisions for future expansion for size and
adding on departments if need be.
3. It will provide comprehensive intensive care for all types of medical and
surgical cases.
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4. The hospital shall be equipped to provide expert first aid and all services
for resuscitation and preservation of life.
5. It will provide a basic casualty unit, a comprehensive critical and
intensive care unit providing ventilator support, shock therapy, and
backup support for all there services.
6. The various activities as listed above shall be supported by the
following clinical support services.
a. 1 operating room / labor room
b. 1 four bedded ICU
c. Imaging department with
1 portable X-ray machine
1 fixed X-ray machine
1 ultrasound machine
1 theatre sterile supply unit
d. Laboratory services
7. The hospital will have an out sourced laundry service to provide clean
linen. The sterilization of requisite linen shall be carried out in-house.
8. The hospital will also have an organized catering service to provide
regular and therapeutic diets.
9. The hospital shall have relationship with more than 1 hospital at
Sultanpur, Barabanki and Lucknow for casualty evacuation, specialized
investigation and other services not available in-house.

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CATCHMENT AREA
a. Shukla Bazar
b. Jagdishpur
c. Odoria
d. Dadera
e. Munimpur
f. Nindura
g. Banikader
h. Fatehpur
i. Haidergarh
j. Mawai
k. Puredalai
l. Ram Nagar
m. Rudauli
n. Siddhaur
o. Sirauli Gauspur
p. Suratganj
q. Trivediganj
r. Sultanpur
s. Baba Ka Bazar
t. Suleha
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u. Inhauna
v. Rae Bareli
w. Rani Ganj
x. Rudauli
y. Faizabad
z. Barabanki
The hospital will be geared up to cater to the requirement of the population within
a radius of 10 kms from the site.
Work Load
The proposed hospital shall attract adequate number of patients from the
neighboring blocks. Once stabilised it shall also attract patients from neighboring
district.
Population of attachment area - 500,000
Sex ratio - 933 females/1000 males
Growth Rate - 1.46% per year
Broad Age Distribution of Population
Below 15 - 39.77%
15 – 59 - 53.56%
Above 59 - 6.67%
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Health Indicators
Birth Rate - 25.8% / 1000/year
Death Rate - 8.5% /1000/year
General fertility rate - 103.2% /1000/year
Infant Mortality Rate - 710% /1000/year
Expectancy of life at birth - 66.04% year (64.8 for all India)
Proportion of workers to
total population - 34.18% (51.00% for males only)
General morbidity rate - 81.0% once a year
Accident/emergency rate - 7.5% year
Hospital occupancy rate - 18.0% year of population day
Facilities Available
There are primary health centers, community health centers, sub-centers, FRUs
along with district hospital in the catchment area. However, the consumers are not
happy with the services provided by them and avail their health care services from
private providers as evidenced by several studies.
There are certain private providers along with Ayurveda and Homeopathy
practitioners but none of them provide the comprehensive range of services. Hence
this effort of providing all services under one roof is envisaged.

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Disease Profile
Uttar Pradesh
Male Female
1. Infectious & Parasitic Diseases 16.6 14.3
2. Neoplasms 3.0 3.5
3. Endocrine, Nutritional, Metabolic 3.0 3.3

Diseases & Immunity Disorders
4. Diseases of Blood & Blood 2.0 2.8

Forming Organs
5. Mental Disorders 0.1 0.1
6. Diseases of the Nervous System 3.1 3.2

& Sense Organs
7. Diseases of the Circulatory System 23.0 20.8
8. Diseases of the Respiratory System 7.2 7.0
9. Diseases of the Digestive System 5.6 3.5
10. Diseases of the Genito-urinary System 1.6 1.4
11. Complications of Pregnancy 0.0 2.1
12. Diseases of the Skin & Subcutaneous Tissues 0.2 0.2
13. Diseases of the Musculoskeletal System 0.1 0.1

& Connective Tissues
14. Congenital Anomalies 0.5 0.7
15. Certain Conditions Originating in 8.6 9.1

Perinatal Period
16. Symptoms, Signs and ill Defined Conditions 13.9 14.8
17. Injury and Poisoning 11.5 13.1

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The data used has been taken from Health Information of India 2001. Published
in June 2003 by Central Bureau of Health Intelligence, Min. of Health and Family
Welfare, Govt. of India or the previous edition.
JUSTIFICATION
According to the World Health Report 2000 — “while private health expenses in
industrial countries now average only some 25 percent because of universal health
coverage (except in the United States, where it is 56%), in India, families typically
pay 80 percent of their health care costs as "out-of- pocket" expenses when they
receive health care”.
The above table gives an idea about the household spending or out of pocket
expenses in India as per source mentioned in the table.
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The above table reveals that in spite of the huge Government infrastructure in
terms of health care in rural areas it has failed to meet the requirements of rural
masses.
This table clearly reveals that the private providers in health care capture a larger
market share of the health care business in our country.
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This table
elaborates
clearly
that the
private
practition
ers and
smaller
nursing
homes
capture a
larger
share of
the rural
health
care
market.
The figure
explains
the reasons
for
preferring
private
providers
vis-à-vis
govern-
ment
providers
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It has
been made very clear by several studies including the above that majority of the
health care providers in rural India have less than 30 beds.
Studies further reveal that the private for profit hospitals capture most of the
private health care market.
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The above table elaborates that hospitals in rural areas should have met minimum
standards laid down by NABH.
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Projected Work Load of the Hospital
For the population base growing at rate of 1.5% approximately per annum and
hospital beds growing at the rate of 10% per annum.
OPD
From the catchment area - 23,250 per year
Referral Cases - 9,200 per year
Emergency - 1% of total OPD –

325 patients per year
Say 1 patient per day
In Patients
Average length of stay - 5 days
15% of OPD Patients visits x 5 days (average length of stay = 17,520 patients bed
days per year)
Hence total number of bed required will be 47.
All the processes will be very structured so as to bring down the average length of
stay to 3-4 days. Therefore a bed strength of 30 will be sufficient.
Details of Site
Location : Pureshuklan
Size of the Plot : 12,000 sq. ft.
Specific use of Land : Hospital
Permissible floor space index : 30%

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Building Height : 8 meters
Road Access : Available
Public Transport Service : Available
Electric Supply : Available
Water Supply : Available
Sewage Treatment : Will be met with
Refuse Disposal : Will be out sourced & Treated by

Deep Burial
Telephone Lines : 3 lines

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PHYSICAL FACILITY
(All Data are derived from BIS Standards for 30 bedded Hospital, IPHS 2006)
Area
a. Total built up area 8,000 sq. ft.
b. Area of ground floor 4,000 sq. ft.
c. Area of First Floor 4,000 sq. ft.
Building Height - 8 meters
Hospital Engineering Services
a. Load of Electricity - 25 KVA
b. Generator - 10 KVA
c. UPS – 3 KVA
d. Electrical Distribution box and panels
Fire Fighting System - Yes
Solar Heating System - Planned
Telecommunicating System
- EPBAX having 3 incoming and 10 out going
Nurse call system - Yes
Computers - HIS
Water - 2 Sources (Municipality and Bore well)

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HEALTH CARE PLAN
Objective
It is proposed that the hospital positions it self as a center of excellence, providing
health care services to the targeted community and the following services to
capture the market in the society.
a. Pre-marital counseling
b. Registration of young couples
c. Marriage counseling
d. Sex education
e. Ante-natal checking of expecting mothers
f. Natal services for mother and child
g. Post natal monitoring of mother and child upto 3 years including
immunization, child’s growth monitoring and support for birth of the
sibling
h. Care of child in pre-school and school
i. Child counseling
j. Tobacco cessation campaign
k. School health
l. First AID and emergency services
m. Continuing health education to the community
n. Evacuation of patients to tertiary facilities

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o. Specialty clinics
p. Telemedicine facility
q. To co-ordinate with the district health and family welfare department in

implementing all national health programmes in the region.
r. Comprehensive medical records keeping
s. Co-operative based micro health insurance scheme
t. Health Check package
u. Preventive health
v. Health education
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FUNCTIONAL PLAN AND PROGRAMS
1. The hospital shall provide its services on a fee for service basis to
all. However, due consideration will be given to the socio
economic status of the community.
2. Capital cost of plan and building is Rs. 42 lakhs.
3. Projected cost of medical equipments and building utility
equipments will be around Rs. 72 lakhs.
4. The hospital will be self-sustaining financially.
5. The calculations of occupancy rate and break even are enclosed.
6. Depreciations as applicable are adapted.
7. Technology up gradations will be supported by donations
8. Hospital tariff will be so structured that it provides sustainability
along with maintenance of the building, and equipments.
9. Hospital accounts shall be computerized and all taxes shall be
accounted for.
10. The medical superintendent will be the designated authority for
authorizing any incidental expenditure and shall maintained an
account for the same.
11. All patients will be given and information booklets.

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12. Patients shall sign the respective general and informed consent
form.
13. Operations of the hospital will be carried out according to the
laws of the land.
14. The hospital shall provide services as per the following
timetable.
IPD
Ward Rounds Morning 9 1.m. – 12 noon, 7 days a week

Evening 7 p.m. – 9 p.m. 7 days a week
Urgent Consultations On call from the ward sister, 24 hours,
Round the year
Cross Consultations Routine Morning: 9 a.m. – 12 p.m., 7 days a
week
Urgent On call from the ward sister, 24 hours,
Round the year
Diagnostic Services Routine Morning: 8 a.m. – 11 a.m., 7 days a
week
Round the year
All Nursing Procedures,
as required, shall be
provided as per the ward
schedule.
Therapeutic Services Routine Afternoon: 2 p.m. – 5 p.m., 7 days a
(Other than Nursing week
Procedures)
Round the year
Discharge Routine To be initiated during the ward rounds
and all formalities to be completed
and patient discharged by Noon of
same day or next day.
Round the year.
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OPD
Routine 12 hours per day, 6 days a week
Consultations
Special 3 – 4 hours in the afternoon hours,
Clinics after notified lunch interval, 4 days a
week, in Hospital OPD.
Emergency Services
To be provided 24 hours, Round the
year, and will include all other
hospital services that are needed
including emergency surgery.
Surgical Suit Services

Elective As per schedule of the surgical suit, 6
Surgery, days a week after finishing the OT list
Surgical Suit, on 6th, once a week.
Maintenance After Notified lunch interval, 6 days a
Special week
Dressings
Imaging Services
Registration 4-6 hours in the morning hours, upto
of cases notified lunch interval, 6 days a week
Examination 8-11 a.m. 6 days a week
– IPD cases
- OPD Cases 9 a.m. upto notified lunch interval, 6
days a week.
After notified Lunch Interval, 5 days a
week
Delivery of Within 2-4 hours of Examination
Reports
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Laboratory Services
Registration 4-6 hours in the morning hours, upto
of cases notified Lunch Interval, 6 days a week
Collection of 4-6 hours in the morning hours, upto
Samples notified lunch interval, 6 days a week.
For special clinics: 4 days a week in
the clinics.
Delivery of All Stat tests, as soon as possible.
Reports
For all other tests, results shall be
posted to requesting location .
Hard copies shall be delivered in the
notified schedule, 6 days a week.
Ancillary Therapies
Routine As per schedule of the respective
department, 6 days a week
Special On call from the ward sister, 24 hours,
procedures Round the year.
15. There shall be a proper admission and discharge procedure.
16. Patient has to pay for all the medication and surgical supplies.
17. Money to be collected at a central billing and reception area.
18. A discharge summary will be given to all the discharge patients.
19. Fire and emergency drills to be carried out regularly.
20. Casualty Medical Officer shall control the ambulance services
21. Staff in the hospital to be provided health care facilities
according to the policies.
22. Laundry services to be out sourced.
23. Flow diagrams to be displayed at all areas.
24. Care should be taken so as to prevent criss- crossing of traffic.

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25. Medical Superintendent shall conduct periodic staff meetings.
26. All major hospital routines to be documented.
27. The governing board shall designate by a written resolution
authorizing the medical superintendent to give concessions to
patients as an when required.
28. Medical consultants will be on free for service basis.
29. A token amount of 10% from their fees will be deducted as
hospitals share.
30. Free treatment could be given to the underprivileged sections of
the society.
OPD
a. OPD consulting room shall be utilized on a three hours slot basis in four
shifts in two chambers from 8 a.m. to 8 p.m.
b. Female ayahs to be deployed in the OPD.
c. Citizens’ charters to be displayed.

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DEPARTMENTATION
1. Functional Department
a. General Surgery
b. Internal Medicine
c. Gynecology and Obstetrics
d. Pediatrics
e. Orthopedics
f. EYE
g. ENT
h. Ayurveda
i. Homeopathy
j. Physical Medicine and Rehabilitation
k. Anesthesia
l. Radio Diagnosis
m. Laboratory Medicine
n. Emergency Medicine
2. Support Departments
a. Reception and Public relationship
b. Hospital administration
c. Human Resource Development

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d. Finance and Accounts
e. Medical Records
f. Purchase and Store
g. Cafeteria
h. Laundry
i. Maintenance
j. Pharmacy
k. Security
3. Hospital Shall Provide Residential Accommodation for Nurses
4. Functional Areas
a. ICU - 4 beds
b. Observation ward – 2 beds
c. Male ward – 12 beds
d. Female ward – 12 beds
OPD
a. OPD - 2 rooms
b. Casualty – 1 room
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Support Areas
a. Imaging Departments
b. Laboratory
c. Physiotherapy
d. Generator Room
e. Electricity Distribution panel
f. Water Storage
g. Medical Gas Storage Area
h. Cafeteria
i. Pharmacy
FACILITY MANAGEMENT
- Temple
- Public Education Centre
- MSW’s Desk
- Cafeteria
- Pharmacy
- Emergency
- O.P.D.
- Reception
- Distribution Panel/Switch Box
- Generator Room
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- Laboratory
- X-Ray
- Ultrasound Room
- Admin. Area and IT + Accounts
- Accounts / HR
- Observation Room
- Wards (Male + Female)
- Doctors duty room
- Nurses Changing room
- Store and Medical Record Room
- I.C.U.
- O.T. Complex
- Conference room
- Corridors
- Guest Room
- Solar Heating System
LICENSES PERMITS AND STATUTORY OBLIGATIONS
a. Building Permit (Completion Certificate)
b. Registration under MTP Act
c. Registration of the Ultrasound machine under PNDT Act.
d. The Wholesale and Retail Drug-License

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e. The Excise Permit to store Spirit.
f. The permit to store opium and its derivatives under the Narcotic and
Psychotropic Substances Act.
g. No Objection Certificate from the Chief Fire Officer, from the Region.
h. No Objection Certificate under Pollution Control Act.
i. No Objection Certificate under Bio-medical Waste Rules, 1998.
j. The Vehicle Registration Certificates in respect of all vehicles the
hospital owns.
k. Radiation Protection Certificate in respect of All X-ray Equipment from
BARC.
l. PAN Number
m. ESI Registration
n. Indian Medical Council (Professional Conduct, Etiquette and Ethics)
Regulations, 2002: “All hospitals are obliged to provide medical care to
preserve life to all injured citizens brought to hospital”.
o. Pharmacy License
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ORGINASTION STRUCTURE
Governing Body
Medical Superintendent
Consultants Nurses Administration ICU/OT/Casualty
• Surgery o Nursing Supdt IT o Anesthesist

• Medicine o Nurses Receptionist o Technicians
• Gynaecology o Ward Boys Billing & Accounts o TSSU
• Paediatrics o Ayahas MRD o CMO
• Orthopaedics o Sweepers Security
• EYE Drivers
• ENT Maintanance
Store & Purchase
• Lab
• Radiology
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STAFFING PATTERN WITH QUALIFICATION
1. Medical Superintendent - MBBS, DHA, 10 years of experience
2. Nursing Superintendent - Diploma Nursing, 15 years of experience
3. GDMOs - MBBS, BUMS, with 1 year experience
4. Nurses - Diploma Nursing – 1 year experience
5. Receptionist - Graduates
6. IT Manager - 5 years experience in

Software & Hardware
7. Admin./HR - Graduate with MBA
8. Accounts - B.Com.
9. Lab Technician - MLT.
10. X-Ray Technician - Radiography Course
11. OT Technician - ORA Course
12. Electrician - ITI Diploma
13. Plumber
14. Driver - Heavy vehicle License with 5 years exp.
15. M.S.W. - Counselling Course
16. Ward Boys -
17. Sweepers -
18. Ayahas
Page 42
ANNEXURE - 1
LAYOUT MAP OF THE FACILITY

Page 43

Page 44

Page 45

Page 46
ANNEXURE -2
LIST OF SUGGESTED EQUIPMENTS AND FURNITURES

1. Normal Delivery Kit
2. Equipment for assisted vacuum delivery
3. Equipment for assisted forceps delivery
4. Standard Surgical Set (for minor procedures like episiotomies stitching)
5. Equipment for Manual Vacuum Aspiration
6. Equipment for New Born Care and Neonatal Resuscitation
7. IUD insertion kit
8. Equipment / reagents for essential laboratory investigations
9. Refrigerator.
10. ILR/Deep Freezer
11. Ice box
12. Computer with accessories including internet facility
13. Baby warmer/incubator.
14. Binocular microscope
15. Equipments for Eye care and vision testing: Tonometers (Schiotz),
direct opthalmoscope, illuminated vision testing drum, trial lens sets
with trial frames, snellen and near vision charts, Battery operated torch
16. Equipments under various National Programmes
17. Radiant warmer for new born baby

Page 47
18. Baby scale
19. Table lamp with 200 watt bulb for new borne baby
20. Phototherapy unit
21. Self inflating bag and mask-neonatal size
22. Laryngoscope and Endotracheal intubation tubes (neonatal)
23. Mucus extractor with suction tube and a foot operated suction machine
24. Feeding tubes for baby
25. Sponge holding forceps – 2
26. Valsellum uterine forceps – 2
27. Tenaculum uterine forceps – 2
28. MVA syringe and cannulae of sizes 4-8 (2 sets; one for back up in case
of technical problems)
29. Kidney tray for emptying contents of MVA syringe
30. Containers for tissues
31. Torch without batteries – 2
32. Battery dry cells 1.5 volt (large size) – 4
33. Bowl for antiseptic solution for soaking cotton swabs
34. Tray containing chlorine solution for keeping soiled instruments
35. Residual chlorine in drinking water testing kits
36. H2S Strip test bottles

Page 48
Requirements for the Labour Room
1. A labour table
2. Suction machine
3. Facility for Oxygen administration
4. Sterilisation equipment
5. 24-hour running water
6. Electricity supply with back-up facility (generator with POL)
7. Attached toilet facilities
8. An area earmarked for new-born care
9. Emergency drug tray: This must have the following drugs
a. Inj. Oxytocin
b. Inj. Diazepam
c. Tab. Nifedepine
d. Magnesium sulphate
e. Inj. Lignocaine hydrochloride
f. Inj. Methyl ergometrine maleate
g. Sterilised cotton and gauze
10. Delivery kits, including those for normal delivery and assisted
deliveries.
Page 49
PRIVACY of a woman in labour should be ensured as a quality assurance
issue.
List of Equipments for Pap Smear
1. Cusco’s vaginal speculum (each of small, medium and large size)
2. Sim’s vaginal speculum – single & double ended - (each of small,
medium and large size)
3. Anterior Vaginal wall retractor
4. Sterile Gloves
5. Sterilised cotton swabs and swab sticks in a jar with lid
6. Kidney tray for keeping used instruments
7. Bowl for antiseptic solution
8. Antiseptic solution: Chlorhexidine 1% or Cetrimide 2% (if povidone
iodine solution is available, it is preferable to use that)
9. Chittle forceps
10. Proper light source / torch
11. For vaginal and Pap Smears:
a. Clean slides with cover slips
b. Cotton swab sticks
c. KOH solution in bottle with dropper
d. Saline in bottle with dropper
e. Ayre’s spatula
f. Fixing solution / hair spray

Page 50
Requirements of the Laboratory
Reagents
1. For Cyan meth - haemoglobin method for Hb estimation
2. Uristix for urine albumin and sugar analysis
3. ABO & Rh antibodies
4. KOH solution for Whiff test
5. Gram’s iodine
6. Crystal Violet stain
7. Acetone-Ethanol decolourising solution.
8. Safranine stain
9. PH test strips
10. RPR test kits for syphilis
Glassware and other Equipment
1. Colorimeter for Hb estimation
2. Test tubes
3. Pipettes
4. Glass rods
5. Glass slides
6. Cover slips
7. Light Microscope
Page 51
List of Furniture (including surgical)
Examination table 5
Writing tables with table sheets 8
Plastic chairs (for in-patients’ attendants) 10
Armless chairs 12
Full size steel almirah 8
Labour table 1
OT table 1
Arm board for adult and child 4
Wheel chair 1
Stretcher on trolley 1
Instrument trolley 2
Wooden screen 1
Foot step 5
Coat rack 2
Bed side table 30
Bed stead iron (for in-patients) 30
Baby cot 2
Stool 30
Medicine chest 4
Lamp 5
Shadowless lamp light (for OT and Labour room) 2

Page 52
Side Wooden racks 10
Fans 10
Tube light 18
Sundry Articles including Linen:
Buckets 10
Mugs 10
LPG stove 1
LPG cylinder 2
Sauce pan with lid 2
Water receptacle 2
Rubber/plastic shutting 10 meters
Drum with tap for storing water 5
I V stand 16
Mattress for beds 30
Foam Mattress for OT table 1
Foam Mattress for labour table 1
Macintosh for labour and OT table 4 metres
Kelly’s pad for labour and OT table 2 sets
Bed sheets 50
Pillows with covers 40
Blankets 30
Baby blankets 2
Page 53
Towels 30
Curtains with rods 50 metres
ANNEXURES -3
DRUGS
(To be vetted by the Hospital Drug Committee)
Oxygen Inhalation
Local Anaesthetics
Lignocaine Hydrochloride Topical Forms 2-5%
Preoperative Medication and Sedation for Short Term Procedures
Diazepam Tablets 5 mg
Injection 5 mg / ml
Analgesics, antipyretics and Non-Steroidal Anti-inflammatory Medicines,
Non-Opioid Analgesics, Antipyretics and Nonsteroidal Anti-inflammatory
Medicines
Acetyl Salicylic Acid Tablets 300mg & 50 mg
Ibuprofen Tablets 400 mg
Paracetamol Injection 150 mg / ml

Page 54
Syrup 125 mg / 5ml
Antiallergics and Medicines used in Anaphylaxis
Adrenaline Injection
Chlorpheniramine Maleate Tablets 4 mg
Dexchlorpheniramine Maleate Syrup 0.5 mg / 5 ml
Dexamethasone Tablets 0.5 mg
Pheniramine Maleate Injection 22.75 mg / ml
Promethazine Tablets 10 mg, 25 mg
Syrup 5 mg / 5 ml
Capsules 250 mg, 500 mg
Ampicillin Capsules 250 mg., 500 mg
Powder for suspension 125 mg / 5 ml
Injection 500 mg
Benzathine Benzylpenicillin Injection 6 lacs, 12 lacs, 24 lacs units
Benzylpenicillin Injection 5 lacs, 10 lacs units
Cloxacillin Capsules 250 mg, 500 mg
Liquid 125 mg / 5 ml
Procaine Benzylpenicillin Injection Crystalline penicillin
(1 lac units)
+ Procaine penicillin (3 lacs units)
Cephalexin Syrup 125 mg/5 ml
Capsules 250 mg., 500 mg*

Page 55
Ciprofloxacin Injection 200 mg / 100 ml
Hydrochloride Tablets 250 mg., 500 mg
Co-Trimoxazole Tablets 40 + 200 mg, 80 + 400 mg
(Trimethoprim + Sulphamethoxazole) Suspension 40 + 200 mg / 5 ml
Doxycycline Capsules 100 mg
Erythromycin Estolate Syrup 125 mg / 5 ml
Tablets 250 mg, 500 mg
Gentamicin Injection 10 mg / ml, 40 mg / ml
Metronidaozle Tablets 200 mg, 400 mg
Injection 500 mg / 100 ml
Antidotes and Other Substances used in Poisonings
Nonspecific
Activated Charcoal Powder
Atropine Sulphate Injection 0.6 mg / ml
Specific
Antisnake Venom Injection Polyvalent Solution/
Lyophilyzed Polyvalent Serum
Anticonvulsants/Antiepileptics
Carbamazepine Tablets 100 mg, 200 mg
Syrup 20 mg / ml
Phenytoin Sodium Capsules or Tablets 50 mg, 100 mg
Syrup 25 mg / ml
Page 56
Antiinfective Medicines
Anthelminthics
Intestinal Anthelminthics
Mebendazole Tablets 100 mg
Suspension 100 mg/ 5 ml
Albendazole Tablets 400mg
Antifilarials
Diethylcarbamazine Citrate Tablets 150 mg
Antibacterials
Amoxicillin Powder for suspension 125 mg / 5 ml
Capsules 250 mg, 500 mg
Cardiovascular Medicines
Antianginal Medicines
Acetyl Salicylic Acid Tablets 75 mg,100mg,350mg.
Glyceryl Trinitrate Sublingual Tablets 0.5 mg.
Injection 5 mg/ml
Isosorbide 5 Mononitrate Tablets 10 mg.
Propranolol Tablets 10mg,40mg
Injection 1mg/ml.
Antihypertensive Medicines
Amlodipine Tablets 2.5 mg, 5 mg, 10 mg

Page 57
Atenolol Tablets 50 mg,100 mg
Enalapril Maleate Tablets 2.5 mg, 5 mg, 10 mg
Injection 1.25 mg / ml
Methyldopa Tablets 250 mg
Dermatological Medicines (Topical)
Antifungal Medicines
Benzoic Acid +Salicylic Acid Ointment or Cream 6% + 3%
Miconazole Ointment or Cream 2%
Antiinfective Medicines
Framycetin Sulphate Cream 0.5%
Methylrosanilinium
Chloride (Gentian Violet) Aqueous solution 0.5%
Neomycin +Bacitracin Ointment 5 mg + 500 IU
Povidone Iodine Solution and Ointment 5%
Silver Nitrate Lotion 10%
Nalidixic Acid Tablets 250 mg, 500 mg
Nitrofurantoin Tablets 100 mg
Norfloxacin Tablets 400 mg
Tettracycline Tablets or Capsules 250 mg

Page 58
Antileprosy Medicines and Anti-tubecullar medicines as per national
programmes
Antifungal Medicines
Clotrimazole Pessaries 100 mg, 200 mg, Gel 2%
Griseofulvin Capsules or Tablets 125 mg, 250 mg
Nystatin Tablets 500,000 IU
Pessaries 100,000 IU
Antiprotozoal Medicines
Antiamoebic and Antigiardiasis Medicines
Diloxanide Furoate Tablets 500 mg
Metronidazole Tablets 200 mg, 400 mg
Injection 500 mg / 100 ml
Tinidazole Tablets 500 mg
Blood Products and Plasma Substitutes
Plasma Subsitutes
Dextran-4 Injection 10%
Dextran Injection6%
Silver Sulphadiazine Cream 1%
Antiinflammatory and Antipruritic Medicines

Betamethasone Cream / Ointment 0.05%
Dipropionate Calamine Lotion

Page 59
Astringent Medicines
Zinc Oxide Dusting Powder
Medicines Affecting Skin Differentiation and Proliferation

Glycerin Solution
13.6 Scabicides and Pediculicides
Benzyl Benzoate Lotion 25%
Disinfectants and Antiseptics
Antiseptics
Benzoin Compound Tincture
Cetrimide Solution 20% (conc.for dilution)
Chlorhexidine Solution 5% (conc. for dilution)
Ethyl Alcohol 70% Solution
Gentian Violet Paint 0.5%, 1%
Hydrogen Peroxide Solution 6%
Disinfectants
Bleaching Powder Powder
Formaldehyde IP Solution
Potassium Permanganate Crystals for solution
Diuretics
Furosemide Injection, 10 mg/ ml,
Tablets 40 mg
Page 60
Gastrointestinal Medicines
Antacids and other Antiulcer Medicines
Aluminium Hydroxide+ Magnesium Suspension
Hydroxide Tablet
Omeprazole Capsules 10 mg, 20 mg, 40 mg
Ranitidine Hydrocholoride Tablets 150 mg, 300 mg
Injection 25 mg / ml
Antiemetics
Domperidone Tablets 10 mg
Syrup 1 mg / ml
Metoclopramide Tablets 10 mg
Syrup 5 mg / ml
Injection 5 mg / ml
Antispasmodic Medicines
Dicyclomine Hydrochloride Tablets 10 mg,
Hyoscine Butyl Bromide Tablets or 10 mg
Laxatives
Bisacodyl Tablets/ suppository 5 mg
Isphaghula Granules
Medicines used in Diarrhoea

Oral Rehydration Salts Powder for solution As per IP
Page 61
Hormones, other Endocrine Medicines and Contraceptives
Adrenal Hormones and Synthetic Substitutes
Prednisolone Tablets 5 mg, 10 mg
Antidiabetics and Hyperglycaemics
Insulins and Other Antidiabetic Agents
Glibenclamide Tablets 2.5 mg, 5 mg
Insulin Injection (Soluble)
Injection 40 IU / ml
Metformin Tablets 500 mg
For Specific Group of Individuals

Rabies Vaccine Injection
Tetanus Toxoid Injection
Ophthalmological Preparations
Antiinfective Agents
Chloramphenicol Drops/Ointment 0.4%, 1%
Ciprofloxacin Hydrochloride Drops/Ointment 0.3%
Gentamicin Drops 0.3%
Miconazole Drops 1%
Sulphacetamide Sodium Drops 10%, 20%, 30%
Tetracycline Hydrochloride Ointment 1%
Antiinflammatory Agents
Prednisolone Acetate Drops 0.1%
Prednisolone Sodium Phosphate Drops 1%

Page 62
Xylometazoline Drops 0.05%, 0.1%
Local Anaesthetics
Medicines used in Psychotic Disorders
Chlorpromazine Hydrochloride Tablets 25 mg, 50 mg, 100 mg
Syrup 25 mg / 5 ml
Medicines used for Generalized Anxiety and Sleep Disorders

Diazepam Tablets 2 mg, 5 mg, 10 mg
Antiasthmatic Medicines
Aminophylline Injection 25 mg / ml
Beclomethasone Dipropionate Inhalation 50 mg, 250 mg/dose
Salbutamol Sulphate Tablets 2 mg, 4 mg
Syrup 2 mg / 5 ml
Inhalation 100 mg / dose
Theophylline Compounds Antitussives
Codeine Phosphate Tablets 10 mg
Syrup 15 mg / 5 ml
Dextromethorphan Tablets 30 mg
Solutions correcting Water, Electrolyte and Acid-Base Disturbances
Oral
Oral Rehydration Salts Powder for Solution As per IP
Glucose Injection 5% isotonic
50% hypertonic
Glucose with Sodium Chloride Injection 5% + 0.9%

Page 63
Normal Saline Injection 0.9%
Potassium Chloride Injection 11.2% Sol.
Ringer Lactate Injection
Sodium Bicarbonate Injection
Miscellaneous
Water for Injection Injection 2 ml, 5 ml, 10 ml
Vitamins and Minerals
Ascorbic Acid Tablets 100 mg, 500 mg
Calcium salts Tablets 250 mg, 500 mg
Multivitamins Tablets
Page 64
ANNEXURE - 4
STANDARD PRECAUTIONS
The standard precautions should be understood and applied by all medical and
paramedical staff involved In providing health services. The basic elements
include:
1. Hand washing thoroughly with soap and running water.
a. Before carrying out the procedure
b. Immediately if globes are torn and hand is contaminated with blood
or other body fluids.
c. Soon after the procedure, with gloves on and again after removing
the gloves.
2. Barrier precautions: using protective gloves, mask, waterproof aprons
and gowns.
3. Strict asepsis during the operative procedure and cleaning the operative
site. Practise the “no touch technique” which is: any instrument or part
of instrument which is to be inserted in the cervical canal must not touch
anynon-sterile object / surface prior to insertion.
4. Decontamination and cleaning of all instruments immediately after each
use.
Page 65
5. Sterilisation / high level disinfection of instruments with meticulous
attention.
6. Appropriate waste disposal.
Sterilization of Instruments
1. Instruments and linen must be autoclaved.
2. In case autoclaving is not possible, the instruments must be fully
immersed in water in a covered container and boiled for at least 20
minutes.
Sterilisation of Copper T insertion instruments
1. Copper T is available in a pre-sterilised pack
2. Ensure that the instruments and gloves used for insertion are autoclaved,
or fully immersed in a covered container and boiled for at least 20
minutes
Sterilisation and maintenance of MVA equipment
The four basic steps are:
1. Decontamination of instruments, gloves, cannulae and syringes in 0.5%
chlorine solution
2. Cleaning in lukewarm water using a detergent.
3. Sterilisation / High Level Disinfection
4. Storage and re-assembly of instruments.
5. The person responsible for cleaning must wear utility gloves.

Page 66
ANNEXURE - 5
CITIZEN’S CHARTER
Charter of Patients’ Rights for the Hospital
1. Preamble
Hospital exists to provide health care to every citizen of the locality within
the allocated resources and available facilities. The Charter seeks to provide a
framework, which enables citizens to know.
a. What services are available and their charges
b. The quality of services they are entitled to
c. The names through which complaints regarding denial or poor qualities
of services will be addressed.
2. Objective
a. To make available health care services and the related facilities for
consumers.
b. To provide appropriate advice, treatment, referral and support that
would help to cure the ailment to the extent medically possible.
c. To redress any grievances in this regard.
3. Commitments of the Charter
a. To provide access to available facilities without discrimination,

Page 67
b. To provide emergency care, if needed on reaching the hospital
c. To provide adequate number of notice boards detailing the location of
all the facilities and the schedule of camps and other activities.
d. To provide written information on diagnosis, treatment being
administered.
e. To record complaints and respond at an appointed time.
4. Grievance Redressal
a. Grievances that consumers have will be recorded.
b. Aggrieved user after his/her complaint recorded would be allowed to
seek a second opinion at a referral hospital.
5. Responsibilities of the Users
a. Users of hospital would attempt to understand the commitments made in
the charter.
b. Users would not insist on service above the standard set in the charter
because it could negatively affect the provision of the minimum
acceptable level of service to another user.
c. Instructions of the hospital personnel would be followed sincerely, and
d. In case of grievances, the redressal mechanism machinery would be
addressed by users without delay.

Page 68
ANNEXURE - 6
FINANCIAL DETAILS
Total Cost of Project
Cost / Sq. Amount

ft Rate / Sq. ft (Rs.)
Cost of Land 500,000
Cost of Construction 500 8000 4,000,000
(This includes civil Construction, Electrical, Ducting)
Cost of Equipments 7,200,000

Contigency & Working Capital 1,100,000
12,800,000
The Total Cost of the Project is Rs. 1.25 Crores
Pre Operative Expenses Rs. 5,00,000
a. Consultancy
b. Travelling and Logistics
c. Adminitrative Expenses
The pre operative expenses have not been considered in calculating the
viability.
Page 69
Cost of Equipment
No. Price / Unit (Rs.) Amount (Rs.)

Hospital Furniture All 250,000
Fire Fighting Equioments All 50,000
Medical Gases All 100,000
Autoclave 1 75,000 75,000
OT Table 1 200,000 200,000
Boyle's Separators 1 150,000 150,000
Coutery Machine 1 150,000 150,000
Ventilator 1 150,000 150,000
Infusion Pump 1 50,000 50,000
Suction Machine 3 15,000 45,000
Defibrillator, Monitor, Recorder 2 150,000 300,000
Portable Emergency Light 1 50,000 50,000
Laprascope Set 1 1,000,000 1,000,000
Cardiac Monitors 4 50,000 200,000
Pulse Oxy Meter 1 25,000 25,000
Nebulizer 2 2,500 5,000
Ultrasound Machine with 2 Probes 1 600,000 600,000
Portable X - Ray Machine 60 MA 1 75,000 75,000
X - Ray Machine 100 MA 1 150,000 150,000
View Box 5 2,000 10,000
Semi Auto Analyser 1 300,000 300,000
Electrolyte Analyser 1 200,000 200,000
Microscope 1 40,000 40,000
Labarotary Autoclave 1 30,000 30,000
Refrigerator 3 10,000 30,000
Wax Bag 1 5,000 5,000
Short Wave Diathermy 1 25,000 25,000
Ultrasonic Therapy 1 30,000 30,000
ECG Machine 2 40,000 80,000
Opthamology OPD Setup 1 100,000 100,000
HIS & Computers All 1,000,000
OT Light 1 100,000 100,000
Silent Genrator Set 1 700,000 700,000
UPS 1 300,000 300,000
Surgical Instruments & Drums 1 150,000 150,000
Linen All 50,000
Water Pump & Motor All 100,000
Surgical Consumables & Dugs All 300,000
Miscellaneous 25,000
Total Cost of Equipments 7,200,000

Page 70
Revenue Streams
Month Wise
Nov-06 Dec-06 Jan-07 Feb-07 Mar-07
Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)
OPD Consultation 7500 7750 7750 10500 11625

Lab Tests - OPD 15000 15500 15500 19600 21700
Lab Tests - IPD 12000 12400 12400 16800 18600
X - Ray - OPD 6000 6200 6200 5600 6200
X - Ray - IPD 3750 3875 3875 7000 7750
Ultra Sound 18000 18600 18600 16800 18600
Physiotherapy 4500 4650 4650 4200 4650
Counselling 1500 1550 1550 1400 1550
MTP 11250 11625 11625 10500 11625
Delivery 30000 31000 31000 28000 31000
Surgeries 45000 46500 46500 42000 46500
Indoor Stay 9000 9300 9300 12600 13950
ICU 60000 62000 62000 56000 62000
Health Checks 15000 15500 15500 14000 15500
Ambulance 15000 15500 15500 16800 18600
Drugs & Consumables 63000 65100 65100 84000 93000
Total Revenue 316500 327050 327050 345800 382850

Page 71
Revenue Streams
Month Wise
Apr-07 May-07 Jun-07 Jul-07 Aug-07

Lab Tests - OPD 21000 21700 30000 31000 31000
Lab Tests - IPD 18000 18600 36000 37200 37200
X - Ray - OPD 6000 6200 9000 9300 9300
X - Ray - IPD 7500 7750 7500 7750 7750
Ultra Sound 18000 18600 27000 27900 27900
Physiotherapy 4500 4650 6000 6200 6200
Counselling 1500 1550 2250 2325 2325
MTP 11250 11625 11250 11625 11625
Delivery 30000 31000 30000 31000 31000
Surgeries 45000 46500 45000 46500 46500
Indoor Stay 13500 13950 27000 27900 27900
ICU 60000 62000 90000 93000 93000
Health Checks 15000 15500 30000 31000 31000
Ambulance 18000 18600 18000 18600 18600
Total Revenue 370500 382850 501000 517700 517700

Page 72
Revenue Streams
Month Wise
Sep-07 Oct-07 Nov-07 Dec-07 Jan-08

Lab Tests - OPD 30000 31000 36000 37200 37200
Lab Tests - IPD 36000 37200 48000 49600 49600
X - Ray - OPD 9000 9300 12000 12400 12400
X - Ray - IPD 7500 7750 11250 11625 11625
Ultra Sound 27000 27900 36000 37200 37200
Physiotherapy 6000 6200 6000 6200 6200
Counselling 2250 2325 3000 3100 3100
MTP 11250 11625 15750 16275 16275
Delivery 30000 31000 42000 43400 43400
Surgeries 45000 46500 63000 65100 65100
Indoor Stay 27000 27900 36000 37200 37200
ICU 90000 93000 120000 124000 124000
Health Checks 30000 31000 45000 46500 46500
Ambulance 18000 18600 21000 21700 21700
Total Revenue 501000 517700 783750 809875 809875

Page 73
Revenue Streams
Month Wise
Feb-08 Mar-08 Apr-08 May-08 Jun-08

Lab Tests - OPD 34800 46500 45000 46500 45000
Lab Tests - IPD 46400 93000 90000 93000 90000
X - Ray - OPD 11600 15500 15000 15500 15000
X - Ray - IPD 10875 15500 15000 15500 15000
Ultra Sound 34800 46500 45000 46500 45000
Physiotherapy 5800 7750 7500 7750 7500
Counselling 2900 3875 3750 3875 3750
MTP 15225 23250 22500 23250 22500
Delivery 40600 62000 60000 62000 60000
Surgeries 60900 93000 90000 93000 90000
Indoor Stay 34800 69750 67500 69750 67500
ICU 116000 186000 180000 186000 180000
Health Checks 43500 62000 60000 62000 60000
Ambulance 20300 23250 22500 23250 22500
Total Revenue 757625 1143125 1106250 1143125 1106250

Page 74
Revenue Streams
Month Wise
Jul-08 Aug-08 Sep-08 Oct-08 Nov-08

Lab Tests - OPD 46500 68200 66000 68200 75000
Lab Tests - IPD 93000 111600 108000 111600 120000
X - Ray - OPD 15500 21700 21000 21700 27000
X - Ray - IPD 15500 19375 18750 19375 22500
Ultra Sound 46500 65100 63000 65100 72000
Physiotherapy 7750 9300 9000 9300 10500
Counselling 3875 4650 4500 4650 5250
MTP 23250 25575 24750 25575 27000
Delivery 62000 68200 66000 68200 72000
Surgeries 93000 102300 99000 102300 108000
Indoor Stay 69750 83700 81000 83700 90000
ICU 186000 186000 180000 186000 180000
Health Checks 62000 77500 75000 77500 90000
Ambulance 23250 24800 24000 24800 30000
Total Revenue 1143125 1367875 1323750 1367875 1416750

Page 75
Revenue Streams
Month Wise
Dec-08 Jan-09 Feb-09 Mar-09
Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)
OPD Consultation 38750 38750 35000 38750

Lab Tests - OPD 77500 77500 70000 77500
Lab Tests - IPD 124000 124000 112000 124000
X - Ray - OPD 27900 27900 25200 27900
X - Ray - IPD 23250 23250 21000 23250
Ultra Sound 74400 74400 67200 74400
Physiotherapy 10850 10850 9800 10850
Counselling 5425 5425 4900 5425
MTP 27900 27900 25200 27900
Delivery 74400 74400 67200 74400
Surgeries 111600 111600 100800 111600
Indoor Stay 93000 93000 84000 93000
ICU 186000 186000 168000 186000
Health Checks 93000 93000 84000 93000
Ambulance 31000 31000 28000 31000
Drugs & Consumables 465000 465000 420000 465000
Total Revenue 1463975 1463975 1322300 1463975
Assumptions
OPD - 10 Patients per day at a charge of Rs.25 per patient
Lab Tests - 5 Patients of OPD at Rs.100
Lab Tests - 2 Patients of In-house at Rs.200
X-Ray- 2 OPD at Rs.100
X-Ray- 1 OPD at Rs.125
Ultra Sound - 2 at Rs.300
Physiotherapy - 3 at Rs.50
Counselling - 2 at Rs.25
MTP - .5 at Rs.1000
Delivery - .5 at Rs.2000
Surgeries - .5 at Rs. 3000
Indoor Stay - 2 at Rs.150
ICU - 1 at Rs.2000
Health Checks - 1 at Rs.500
Ambulance - 1 at Rs.500
Drugs & Consumables - 4000
No.of Beds – 26 + 4
Page 76
Month Wise
Expenses
Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)
Salary 258,500 258,500 258,500 258,500 258,500

Electricity 10,000 10,000 10,000 10,000 10,000
Water 2,000 2,000 2,000 2,000 2,000
Telephone 5,000 5,000 5,000 5,000 5,000
Transportation 8,000 8,000 8,000 8,000 8,000
Maintainance 10,000 10,000 10,000 10,000 10,000
Drugs & Consumables 53,550 55,335 55,335 67,200 74,400
Marketing & Promotion 25,000 20,000 20,000 15,000 15,000
WebSite Designing &
Maintainance 10,000 15,000 0 0 0
Miscellaneous 15,000 15,000 15,000 15,000 18,000
Total Expenses 397,050 398,835 383,835 390,700 400,900
Month Wise
Expenses
Apr-07 May-07 Jun-07 Jul-07 Aug-07
Salary 258,500 258,500 284,350 284,350 284,350

Electricity 11,000 11,000 11,000 11,000 11,000
Water 2,200 2,200 2,200 2,200 2,200
Telephone 5,500 5,500 5,500 5,500 5,500
Transportation 9,000 9,000 9,000 9,000 9,000
Maintainance 11,000 11,000 11,000 11,000 11,000
WebSite Designing &
Maintainance 0 0 0 0 0
Miscellaneous 18,000 18,000 18,000 18,000 18,000
Total Expenses 397,200 399,600 444,650 442,770 442,770

Page 77
Month Wise
Expenses
Sep-07 Oct-07 Nov-07 Dec-07 Jan-08
Salary 284,350 284,350 314,850 314,850 314,850

Electricity 11,000 11,000 11,000 11,000 12,000
Water 2,200 2,200 2,200 2,200 2,500
Telephone 5,500 5,500 5,500 5,500 6,000
Transportation 9,000 9,000 9,000 9,000 11,000
Maintenance 11,000 11,000 11,000 11,000 12,000
WebSite Designing &
Maintainance 0 10,000 0 0 0
Miscellaneous 18,000 15,000 20,000 20,000 20,000
Total Expenses 439,650 449,770 594,550 601,750 606,550
Month Wise
Expenses
Feb-08 Mar-08 Apr-08 May-08 Jun-08
Salary 314,850 386,875 386,875 386,875 386,875

Electricity 12,000 12,000 12,000 12,000 12,000
Water 2,500 2,500 2,500 2,500 2,500
Telephone 6,000 6,000 6,000 6,000 6,000
Transportation 11,000 11,000 11,000 11,000 11,000
Maintainance 12,000 12,000 12,000 12,000 12,000
WebSite Designing &
Maintainance 0 0 0 0 0
Miscellaneous 20,000 20,000 20,000 20,000 22,000
Total Expenses 592,150 752,975 743,375 752,975 745,375

Page 78
Month Wise
Expenses
Jul-08 Aug-08 Sep-08 Oct-08 Nov-08
Salary 386,875 386,875 386,875 386,875 386,875

Electricity 12,000 12,000 12,000 12,000 12,000
Water 2,500 2,500 2,500 2,500 2,500
Telephone 6,000 6,000 6,000 6,000 6,000
Transportation 11,000 11,000 11,000 11,000 11,000
Maintainance 12,000 12,000 12,000 12,000 12,000
WebSite Designing &
Maintainance 0 0 0 0 10,000
Miscellaneous 22,000 22,000 22,000 22,000 22,000
Total Expenses 754,975 829,375 817,375 829,375 827,375
Month Wise
Expenses
Dec-08 Jan-09 Feb-09 Mar-09
Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)
Salary 386,875 386,875 386,875 386,875

Electricity 12,000 12,000 12,000 12,000
Water 2,500 2,500 2,500 2,500
Telephone 6,000 6,000 6,000 6,000
Transportation 11,000 11,000 11,000 11,000
Maintenance 12,000 12,000 12,000 12,000
Drugs & Consumables 372,000 372,000 336,000 372,000
Marketing & Promotion 5,000 5,000 5,000 5,000
Website Designing &
Maintenance 10,000 10,000 10,000 10,000
Miscellaneous 22,000 22,000 22,000 22,000
Total Expenses 839,375 839,375 803,375 839,375

Page 79
Salary
Nov-06 Dec-06 Jan-07 Feb-07
1.00 1.00 1.00 1.00

Medical Superintendent 15000 15000 15000 15000 15000
Nursing Superintendent 10000 10000 10000 10000 10000
Nurses 5000 80000 80000 80000 80000
Receptionist 4000 12000 12000 12000 12000
IT Manager 6000 6000 6000 6000 6000
Ward Boys / Ayahs 2500 10000 10000 10000 10000
Admin & HR Officer 8000 8000 8000 8000 8000
Accounts Officer 5000 5000 5000 5000 5000
Billing Clerk 2000 2000 2000 2000 2000
Driver 3000 6000 6000 6000 6000
MSW / Counsellors 4000 8000 8000 8000 8000
Lab Technicians 4000 12000 12000 12000 12000
X - Ray Technicians 4000 12000 12000 12000 12000
OT Technicians 4000 12000 12000 12000 12000
Security Guards 2500 12500 12500 12500 12500
Electrician 2000 2000 2000 2000 2000
Plumber 2000 2000 2000 2000 2000
GDMO's 10000 40000 40000 40000 40000
Physiotherapist 4000 4000 4000 4000 4000
258500 258500 258500 258500

Page 80
Salary
Mar-07 Apr-07 May-07 Jun-07 Jul-07
1.00 1.00 1.00 1.00 1.00

Nurses 80000 80000 80000 88000 88000
Receptionist 12000 12000 12000 13200 13200
IT Manager 6000 6000 6000 6600 6600
Ward Boys / Ayahs 10000 10000 10000 11000 11000
Admin & HR Officer 8000 8000 8000 8800 8800
Billing Clerk 2000 2000 2000 2200 2200
Driver 6000 6000 6000 6600 6600
MSW / Counsellors 8000 8000 8000 8800 8800
Lab Technicians 12000 12000 12000 13200 13200
OT Technicians 12000 12000 12000 13200 13200
Security Guards 12500 12500 12500 13750 13750
Electrician 2000 2000 2000 2200 2200
Plumber 2000 2000 2000 2200 2200
GDMO's 40000 40000 40000 44000 44000
258500 258500 258500 284350 284350

Page 81
Salary
Aug-07 Sep-07 Oct-07 Nov-07 Dec-07
1.00 1.00 1.00 1.00 1.00

Nurses 88000 88000 88000 98000 98000
Receptionist 13200 13200 13200 17200 17200
IT Manager 6600 6600 6600 6600 6600
Ward Boys / Ayahs 11000 11000 11000 13500 13500
Admin & HR Officer 8800 8800 8800 8800 8800
Billing Clerk 2200 2200 2200 2200 2200
Driver 6600 6600 6600 6600 6600
MSW / Counsellors 8800 8800 8800 8800 8800
Lab Technicians 13200 13200 13200 17200 17200
OT Technicians 13200 13200 13200 13200 13200
Security Guards 13750 13750 13750 13750 13750
Electrician 2200 2200 2200 2200 2200
Plumber 2200 2200 2200 2200 2200
GDMO's 44000 44000 44000 54000 54000
284350 284350 284350 314850 314850

Page 82
Salary
Jan-08 Feb-08 Mar-08 Apr-08 May-08
1.00 1.00 1.00 1.00 1.00

Nurses 98000 98000 125000 125000 125000
Receptionist 17200 17200 25000 25000 25000
IT Manager 6600 6600 7500 7500 7500
Ward Boys / Ayahs 13500 13500 18750 18750 18750
Admin & HR Officer 8800 8800 10000 10000 10000
Billing Clerk 2200 2200 2500 2500 2500
Driver 6600 6600 7500 7500 7500
MSW / Counsellors 8800 8800 10000 10000 10000
Lab Technicians 17200 17200 20000 20000 20000
OT Technicians 13200 13200 20000 20000 20000
Security Guards 13750 13750 15625 15625 15625
Electrician 2200 2200 2500 2500 2500
Plumber 2200 2200 2500 2500 2500
GDMO's 54000 54000 62500 62500 62500
314850 314850 386875 386875 386875

Page 83
Salary
Jun-08 Jul-08 Aug-08 Sep-08 Oct-08
1.00 1.00 1.00 1.00 1.00

Nurses 125000 125000 125000 125000 125000
Receptionist 25000 25000 25000 25000 25000
IT Manager 7500 7500 7500 7500 7500
Ward Boys / Ayahs 18750 18750 18750 18750 18750
Admin & HR Officer 10000 10000 10000 10000 10000
Billing Clerk 2500 2500 2500 2500 2500
Driver 7500 7500 7500 7500 7500
MSW / Counsellors 10000 10000 10000 10000 10000
Lab Technicians 20000 20000 20000 20000 20000
OT Technicians 20000 20000 20000 20000 20000
Security Guards 15625 15625 15625 15625 15625
Electrician 2500 2500 2500 2500 2500
Plumber 2500 2500 2500 2500 2500
GDMO's 62500 62500 62500 62500 62500
386875 386875 386875 386875 386875

Page 84
Salary
1.00 1.00 1.00 1.00 1.00

Nurses 125000 125000 125000 125000 125000
Receptionist 25000 25000 25000 25000 25000
IT Manager 7500 7500 7500 7500 7500
Ward Boys / Ayahs 18750 18750 18750 18750 18750
Admin & HR Officer 10000 10000 10000 10000 10000
Billing Clerk 2500 2500 2500 2500 2500
Driver 7500 7500 7500 7500 7500
MSW / Counsellors 10000 10000 10000 10000 10000
Lab Technicians 20000 20000 20000 20000 20000
OT Technicians 20000 20000 20000 20000 20000
Security Guards 15625 15625 15625 15625 15625
Electrician 2500 2500 2500 2500 2500
Plumber 2500 2500 2500 2500 2500
GDMO's 62500 62500 62500 62500 62500
386875 386875 386875 386875 386875

Page 85
PROFIT & LOSS ACCOUNT FINANCIAL YEAR 2006 - 2007
Amount
Particulars Amount (Rs.) Particulars (Rs.)
To Salary 1292500 OPD Consultation 45125

To Electricity 50000 Lab Tests - OPD 87300
To Water 10000 Lab Tests - IPD 72200
To Telephone 25000 X - Ray - OPD 30200
To Transportation 40000 X - Ray - IPD 26250
To Maintenance 50000 Ultra Sound 90600
To Drugs & Consumables 305820 Physiotherapy 22650
To Marketing & Promotion 95000 Counselling 7550
Website Designing &
To Maintenance 25000 MTP 56625
To Miscellaneous 78000 Delivery 151000
To Depreciation on Equipments 720000 Surgeries 226500
To Depreciation on Buildings 200000 Indoor Stay 54150
ICU 302000
Health Checks 75500
Ambulance 81400
Drugs & Consumables 370200
Loss Carried forward to

Balance 1189570
Sheet
Total 2891320 2888820

Page 86
PROJECTED STATEMENT OF ACCOUNT FROM 1/4/2007 31/3/2008
Particulars Amount (Rs.) Particulars Amount (Rs.)

Website Designing &
ICU 1251000
Health Checks 427000
Ambulance 236350
Loss Carried forward to

Balance
Sheet 386685
Total 8004385 7999385

Page 87
PROJECTED STATEMENT OF ACCOUNT FROM 1/4/2008 31/3/2009
Particulars Amount (Rs.) Particulars Amount (Rs.)

Website Designing &
ICU 2190000
Profit Carried forward to
Balance Health Checks 927000
Sheet 4232525 Ambulance 316100
Total 15694225 15689225

Page 88
ANNEXURE - 7
GEOGRAPHICAL MAP OF THE LOCATION

Page 89
Page 90
MICRO HEALTH INSURANCE
Once the hospital is commissioned a detailed plan of actions will be created for
a community based co-operative health insurance. This will unable the
beneficiaries to a range of services by the hospital.
However, the following points need consideration:
a. Contribution by the population
b. Subsidy
c. Provider payment mechanism
d. Range of services entitled

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Page 1

NEW ERA PATIENT-FRIENDLY

Bejon Misra, Managing Director

country lives in rural India.

to its neighboring developing countries. Health being a state subject the

government has a very well structured public health system.

and centers of excellence like AIIMS, PGI etc.

PHCs and CHCs is very poor.

Several studies have revealed that the community prefers to go to a private

Health care in India is a sunrise sector and the country is witnessing a

mushrooming of corporate hospitals being ironically concentrated at the

rural sector is left untouched even if the population is ready to pay.

The areas of concern in order to achieve the trust is

IMPLEMENTING AGENCY: NEW ERA PATIENT-FRIENDLY

healthcare facilities at an affordable price for all.

and disadvantaged consumers.

choice in an effective and efficient manner.

so as to create a model incorporating all the features stated in the NRHM,

National Population – Policy and IPHS 2006.

Pradesh (INDIA) and close to Jagdishpur Industrial Area on the Lucknow to

Sultanpur Highway in a village called Pureshuklan in Shukul Ka Bazar Block,

NRHM in the real sense of the term.

hospital as well as IPHS 2006.

including an ultrasound, ICU and an operating room.

Counseling services, NGO participation, PRI involvement, preventive health, IEC

patient/consumer education and awareness on rights and responsibilities.

market/consumer driven. Governance of the facility will be professionally

Era Patient-Friendly Hospital Private Limited at “Pureshuklan” (Post Office

Shukul Bazaar), District Sultanpur in the State of Uttar Pradesh in INDIA.

departments in this hospital.

activity has been adopted to be of primary to secondary level of health care, so

as to be in the linen of NRHM and Millennium Development goals (MDG).

report, IPHS 2006, and BIS standards for 30 bedded hospital.

Dated : 30 August 2006 Bejon Misra &

Dr. Bidhan Das

towards HEALTH FOR ALL and achieving the MDGs.

hospital has been named as “New Era Patient-Friendly Hospital Private

money. The proposed hospital shall provide a comprehensive medical, surgical,

obstetrics, pediatrics, orthopedics, eye & ENT, Ayurveda, Homeopathy as well as

clock at a very reasonable cost which the community can afford.

The Mission of the Hospital

To commission this multi specialty hospital so as to provide comprehensive

medical, surgical, obstetrics, pediatrics, orthopedic, eye & ENT, Ayurveda,

hospital shall be linked with telemedicine to designated centers of excellence in

for their health care needs.

the underprivileged group a self-financing scheme based on a co-operative model

1. To ensure availability of comprehensive quality health care accessible to

all without any discrimination or bias.

2. To provide the services round the clock 24/7.

3. To enable access of the services to the community at an affordable

4. To run the facility in a transparent manner so as to create an

environment of empowerment and ownership of the community.

5. To provide value for money to the consumers of health care.

6. To act as a role model for others to emulate.

NAME OF THE HOSPITAL

NEW ERA PATIENT-FRIENDLY

Location: Pureshuklan, District Sultanpur, U.P. India

Size of the Hospital

Department, ICU, OT, and needed support services.

Organisation Owning the Hospital

New Era Patient-Friendly Hospital Private Limited

The Registered office: National Capital Territory of Delhi.

Date of Commencement of Business of the Hospital

Governing Board of the Hospital