1862014 wus information booklet

8/10/2019 1862014 WUS Information Booklet

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2014-2015Dr. Sunil Thakur, MS, LLB, DMCH

Chief Medical Officer W.U.S. Health Centre

Chhatra MargUniversity of Delhi

Delhi-110007


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INDEX

Contents Page No.

Introduction 3

Organizational Set up 4

List of Medical Officers 5(W.U.S. Health Centre, North Campus)

List of Part-Time Specialists 6

Health Services 7

W.U.S. Health Centre, South Campus 8-9

W.U.S. Health Centre, East & West Campus 10

Eligibility & Membership 11-13

Entitlements of Eligible Members 14

Rates of Health Centre Contribution 15

Guidelines for claim of Reimbursement 16

Medical Fitness Certificates & Medical Boards 17

Annexure I Application Form for All Employees 18-19

Annexure II Application Form for Students (Resident/Non Resident) 20

Annexure III Application for Medical Examination for Fresh/Re-Employment 21-22

Annexure IV Format for No-Dues Certificate 23

Annexure V Approved Hospitals & Diagnostic Centres 24

Annexure VI Form for payment of Investigation Charges Bill 25

Annexure VII Form for payment of Local Purchase Bills through 26Cheque/Cash


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INTRODUCTION

W.U.S. Health Centre was started in March 1955 by World University Service(W.U.S.), a Geneva based international Non-Governmental Organization (NGO).It has been a satisfying experience to serve its beneficiaries for the past 59 yearsand our mission has been to provide personalized services to the members of health

centre & staff. Subsequently, three more Health Centres in East, West, & SouthCampus were commissioned with assistance from University Grant Commission(UGC).

W.U.S. Health Centres have on its roll 20 doctors (including 5 part time medicalofficers), 6 staff nurses (including 3 contract nurses), 41 permanent and 15paramedical employees (on contract) which ensures efficiency in work andwillingness to help the clientele when they need us. W.U.S. Health Centres(North campus and South campus) have fully equipped physiotherapy unit tocater to the beneficiaries.

WUS Health Centre is a Contributory Health Service Scheme and with its fouroperational units in North, South, East and West, it caters to health relatedneeds of the Delhi University employees, their family members and students.The North or the Main Campus unit of the Health Centre is the nodal point andhas a team of 14 Doctors (including 3 medical consultants on contract and threepart-time medical officers), 12 visiting part-time specialists, 30 permanent, 12employees on contract paramedical staff and all major investigative facilities areavailable here. The unit in the South Campus has 04 doctors (including 02 part-time medical officers), 03 visiting part-time specialists and limited investigativefacilities are available here. East and West Health Centres are managed by singledoctor.

This Information Booklet contains collated information about various aspects ofthe Health Centre viz its organization, administration, operational facilities,rules and regulations in a summarized form. This booklet will serve as a guidebook for all Health Centre beneficiaries, doctors and the administrative staff in theUniversity and constituent colleges.

The membership of health centres for employees / teachers is obtained bysubmitting duly filled membership pro forma for which assistance is sought

from the concerned institutions to remit the required subscription of themembers every month regularly along with the requisite information i.e. (i)Name, Token Card No. (ii) Present basic pay, (iii) Amount deducted fromsalary. Regarding the subscription of students, it has to be collected on Annualbasis (for 12 months) at the time of admission and it must be remitted by 31March of the year. The remittance cheque is to be prepared in favour of theRegistrar, University of Delhi for delivery of the same in the Health Centre. Formembers of the WUS Health Centre, South Campus, the remittance cheque is tobe prepared in favour of the Director, University of Delhi South Campus.


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ORGANISATIONAL SET-UP

Interim Governing Council (IGC) The WUS Health Centres in University of Delhi has an Interim Governing Council (IGC)appointed by the Executive Council. The Committee formed on 04.07.2012 is as follows:

Prof. V.K. Chaudhary - (Chairperson, Professor and Head of theDepartment of Bio-Chemistry nominated byVice-Chancellor,)

1. Prof. Anil Tyagi - Professor, Department of Bio-Chemistry(Member)

2. Prof. S.C. Bhatla - Professor and Head, Department of Botany.(Member)

3. Dr. Jolly Rohtagi - Professor of Ophthalmology, UCMS(Member)

4. Prof. T.R. Sheshdri - Professor, Department of Physics(Member)

5. Prof. Rani Gupta - Professor, Department of Micro-Biology(Member)

6. Dr. Sunil Thakur - Chief Medical officer, W.U.S. HealthCentre (Member Secretary)

The Interim Governing Council (IGC) formulates various rules and regulations for the

Health Centres on behalf of the Executive Council. It provides basic functional guidelinesand develops long-term policies for operationalisation of the Health Centres.

Purchase Committee

All purchases for the Health Centres are made through duly constituted purchasecommittees proposed by the Chairperson of the IGC or the Chief Medical Officer/MedicalAdministrator and approved by the Pro-Vice Chancellor on yearly basis.

Being head of the administration, the Chief Medical Officer is responsible for the smoothfunctioning of all the Health Centres. However, Health Centres in the South, West andEast are locally administered by respective Senior Medical Officer-in- Charges.


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WUS HEALTH CENTRE, NORTH - MAIN CAMPUS Chattra Marg, Delhi-110007

Telephone: 27666257

Timings: MONDAY to SATURDAY*

Morning 8 AM to 2 PMEvening 2 PM To 8 PM

Night 8 PM to 8 AM

* Saturday: 2 Doctors work in Morning Shift & 1 Doctor in Evening Shift.

Sunday: 8.30 AM to 10.30 AM Only Except National Holidays,

Night Service: All Days

LIST OF MEDICAL OFFICERS

S.No. Name Qualification Designation

1. Dr. Sunil Thakur MB;BS, MS, L.L.B, DMCH Chief Medical Officer2. Dr. R.K. Gupta M.B;B.S, DCH Sr. Medical Officer3. Dr. (Mrs.) Sheela Jaiswal M.B;B.S, MD (Gynae.) Sr. Medical Officer4. Dr. Dr. S. Karmakar M.B;B.S. Sr. Medical Officer5. Dr. (Mrs.) Neelu Madan M.B;B.S., MD (Gynae.), DNB Sr. Medical Officer6. Dr. S.S. Dugtal M.B;B.S., MD (Med) Sr. Medical Officer7. Dr. (Mrs.) Ritu Tanwar M.B;B.S. Medical Officer8. Dr. Y.P. Singh M.B;B.S, DTCD Medical Officer (Contract)

LIST OF MEDICAL CONSULTANTS (ON CONTRACT)

1. Dr. J.L. Jain M.B;B.S, MBA (HCA), WHO Fellow Sports Medicine (USA)2. Dr. Archana Gupta M.B;B.S, MD (Gynae.)3. Dr. K.K. Kohli M.B;B.S, DTCD

LIST OF PART-TIME MEDICAL OFFICERS (ON CONTRACT)

1. Dr. Sudha Goel M.B;B.S, MD (Gynae.)2. Dr. Neena Paul M.B;B.S3. Dr. M.K. Grover M.B;B.S, DCH


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LIST OF PART-TIME /FULL TIME SPECIALISTS Room N

CARDIOLOGY 1. Dr. Dinesh KumarGupta

MD, DM (Cardio) Tuesday 9:00 A.M. 11:00 A.M.

(HEART) Wednesday 9:00 A.M. 11:00 A.M.Thursday 9:00 A.M. 11:00 A.M.

DENTISTRY 1. Dr. Preeti Mahajan BDS Wednesday 10:00 A.M. 01:00 P.M. 8Saturday 10:00 A.M. 01:00 P.M.Friday 10:00 A.M. 01:00 P.M.

2. Dr. Shalu Pruthi BDS Monday 10:00 A.M. 01:00 P.M.Thursday 10:00 A.M. 01:00 P.M.

3. Dr. Gaurav Kumar Vats BDS Tuesday 10:00 A.M. 01:00 P.M.

E.N.T. 1. Dr. Sunil Thakur MS, L.L.B, DMCH Monday-

Friday

8:30 A.M. 10:30 A.M. 27

(Full time Specialist)

NEUROLOGY 1. Dr. K.S. Anand MD, DM (Neuro) Saturday 3:00 P.M. 5:00 P.M. 5(BRAIN)OPTHALMOLOGY 1. Dr. P.K. Vaish MS (Ophthalm),

DOMSMonday 9:00 A.M. 11:00 A.M. 28

(EYE) Wednesday 9:00 A.M. 11:00 A.M.Friday 9:00 A.M. 11:00 A.M.

ORTHOPAEDICS 1. Dr. R.K. Gupta MS (Ortho) Monday 4:00 P.M. 6:00 P.M. 7(BONE & JOINTS) Wednesday 4:00 P.M. 6:00 P.M.

Friday 4:00 P.M. 6:00 P.M.

PAEDIATRICS 1. Dr. Anjali Gera MD (Ped) Monday 9:30 A.M. 11:30 A.M.(Creche)

(CHILDREN) Friday 9:30 A.M. 11:30 A.M.

2. Dr. Manjoo Gupta MD (Ped) Wednesday 9:30 A.M. 11:30 A.M.(Creche)

Tuesday 9:00 A.M. 11:00 A.M.

PSYCHIATRY 1. Dr. Anandi Lal MD (Psychiatry) Monday 9:00 A.M. 11:00 A.M. 23

DERMATOLOGY 1. Dr. Monika Garg DVD Wednesday 10:00 A.M. 12:00 NOON 25(SKIN) Friday 10:00 A.M. 12:00 NOON

2. Dr. Divya Aggarwal MD (Dermat) Tuesday 8:30 A.M. 10:30 A.M. 25Thursday 8:30 A.M. 10:30 A.M.


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WUS HEALTH CENTRE, SOUTH CAMPUS BENITO JUAREZ ROAD, NEW DELHI-110021.

Telephone: 24110505

FACILITIES AVAILABLE AT W.U.S. HEALTH CENTRE (SOUTHCAMPUS):-

W.U.S HEALTH CENTRE (SOUTH CAMPUS) PROVIDES HEALTH SERVICESFROM MONDAY TO SATURDAY WITH LIMITED INVESTIGATIVESERVICES.

TIMINGS: 09.00 AM to 05.30 PM, MONDAY to FRIDAYSATURDAYS: Emergency services are available from 09:00 AM to 03: 00 P.M.Sunday closed.

LIST OF MEDICAL OFFICERS

S.No. Name Qualification Designation Time

1. Dr. V.P. Garg M.B;B.S, MD (Ped) Sr. Medical Officer 09:00 AM to 03:00 P.M2. Dr. Rinku Mathur M.B;B.S, DMCH Medical Officer 11:30 AM to 05:30 P.M

PART TIME MEDICAL OFFICERS

1. Dr. Aneet Wadhwa M.B;B.S Part-time Medical Officer 02:30 PM to 05:30 P.M.2. Dr. Renu Verma M.B;B.S, MS Part-time Medical Officer 09:00 AM to 12:00 P.M.

Clinical Pathology Laboratory

1. Ms. Nirmala Kumari Technical Assistant

A. Sample collection time 09.30 AM to 11.30 AMB. Routine Blood, Urine, Stool Tests is done on: Monday to FridayC. Blood Sugar Test is done on: - Tuesday & ThursdayD. LFT, KFT, Lipid Profile, RA Factor is done on: Thursday


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DENTAL SERVICES:-

Dr. N.K. Pahwa, BDS Tuesday, Wednesday & Thursday 02:15 PM to 04:15 PM

Root Canal Treatment is available on Tuesday, Wednesday & Thursday

GYNAECOLOGICAL SERVICES:

Dr. Neelu Gandhi, M.B;B.S, MD (Gynae) Monday, Wednesday & Friday09:00 AM to 11:00 AM

EYE SERVICES:-

Dr. Tarun Kapoor, M.B; B.S, MS (Ophthalm) Monday & Thursday03:00 PM to 05:00 PM

PHYSIOTHERAPY SERVICES:-

Ms. Vertika Goel Physiotherapist 09.30 AM to 03.30 PM(Monday to Saturday


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WUS HEALTH CENTRE, EAST

B.R.AMBEDKAR COLLEGE CAMPUS, STAFF QUARTERS-2&3 YAMUNA VIHAR, DELHI-110094

Telephone: 22813870

TIMINGS: 09.00 AM to 03.00 PM, MONDAY to FRIDAYSATURDAYS & SUNDAYS CLOSED

Dr. J.K. Siddhartha, M.B;B.S, DHHM, MBA Sr. Medical Officer 09:00 AM to 03:00 PM

Pathological Testing are available on Tuesday & Thursday from 09:00 AM to 03:00 PM

WUS HEALTH CENTRE, WEST SHIVAJI COLLEGE CAMPUS, RING ROAD, DELHI-110027

Telephone: 25105659

TIMINGS: 09.00 AM to 03.00 PM-MONDAY to FRIDAYSATURDAYS & SUNDAYS CLOSED

Dr. T.K. Chumbak, M.B;B.S Medical Officer 09.00 AM to 03.00 PM

Pathological Testing are available on Monday, Wednesday & Friday from 09:00 AM to03:00 PM


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ELIGIBILTY & MEMBERSHIP

1. All permanent employees of Delhi University and its Constituent Colleges andMembers of their family (as recorded in the service book) are entitled for allapproved facilities of Health Centres.

2. All ad-hoc employees and temporary employees are issued Treatment Cardfor the specified period of employment and entitled only to existing in-housefacilities of the Health Centres. They are not entitled for any form ofreimbursement.

3. Full time students of the University are entitled to become temporary members onyear to year basis.

i. Each eligible member is issued a Health Book or Card bearing a recent passport size photograph. It should be pasted on the inner side of theHealth Book or in the front portion of the Treatment Card.

ii. In case a member does not bring the Treatment Card/ Health Book whileapproaching the Doctor, medicines will not be given for more than 3 days.

iii. Members holding Treatment Card with D (day students) membership areeligible only for the facilities available in the Health Centre. Noreimbursement of any kind will be allowed.

iv. Members holding Treatment Card with R (resident student) and T(temporary members) membership are also not eligible for reimbursementof treatment at other Hospitals either in their OPD or IPD.

v. Investigative laboratory tests, Radiological tests and Medicines readilyavailable in the Health Centre will not be allowed to be done or purchasedfrom the open market. Such bills will not be entertained for reimbursement.

vi. For seasonal/routine ailments, medicines will be issued initially for 3 to 5days before making a long tern treatment plan.

vii. For chronic ailments and long term on-going treatments, medicines can beissued for one full month.


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HOW TO BECOME A MEMBER OF THE WUS HEALTH CENTRE

Health centre facility is available to only eligible members who have enrolledthemselves (teachers, non-teaching, students & retired staff of Delhi University and its

affiliated Colleges) in the health centre.

To obtain membership, a prescribed pro forma has to be filled up by Universityemployees/students along with payment of the prescribed subscription fee. Aspecimen of application form is enclosed (Annexure I-II).

1. University Employee

(a). In service employees

Academic and Non-academic employees are required to submit properly verifiedApplication Form, from their respective department/college alongwith followingdocuments:-

Copy of Appointment Letter Date of Birth Certificate of wife and children(s) Two copies of recent passport size photograph of each book-holder Certificate from the work place of spouse in case s/he is working, mentioning that

s/ she will not avail any medical facility from their organization.

The subscription for membership for one month has to be deposited in cash in the

Health Centre between 10:00 a.m. to 12:30 p.m. along with the application form. Thesubscription for subsequent months will be forwarded by their respectivecollege/department.

(b) Retired employees

A retired employee is required to submit a properly verified Application Form along withfollowing documents:-

No Dues Certificate Two copies of recent passport size photograph of each book-holder

The Pay Band and Grade Pay at the time of retirement must be mentioned clearly on theApplication Form.

10 years subscription is taken as Life Membership only for the Retired Employees, whichis also payable year wise without any break or lump-sum payment at the time of finalretirement. The amount has to be paid in Cash or by Cheque/Demand Draft in favour ofRegistrar, University of Delhi and has to be deposited in the Office of the Health Centre.


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ENTITLEMENTS OF ELIGIBLE MEMBERS

1. All Non-Resident Students will be provided only Emergency Treatment at theHealth Centre as and when required. OPD treatment will be given only to those

Non-resident Students who have paid membership fee of the Health Centre on per session basis. No Reimbursement of any kind will be allowed.

2. All Resident Students (in Halls/Hostels of the University and its affiliated colleges)will be provided OPD treatment with facility for local purchase of reimbursablemedicines if these are not readily available in the Health Centre. No other form ofreimbursements will be allowed.

3. All permanent Employees of the Institute of Economic Growth, C.P.D.H.E.and Agro Economic Centre will be allowed to continue their Membership ofthe WUS Health Centre and avail investigation and treatment facilitiesavailable at the Health Centre. However, all hospitalization related expenses andany other investigation charges will be paid to these employees directly by therespective employers or the funding agencies only.

4. Regular full time employees of Delhi University Co-operative Society, WUS-DU Committee and Delhi University Womens Association will be givenmembership of the WUS Health Centre on payment of Rs. 120/- for each session(August 1 to July 31). The membership will include all eligible members of familyas per University norms. They will be provided only OPD facilities available at theHealth Centre. No reimbursement facility will be allowed.

5. All workers employed on Ad-hoc and contract basis and personnel appointedin time bound Research Projects will be allowed only OPD consultation andtreatment on production of valid identity cards clearly showing the period for whichs/he is engaged in work with the University. No reimbursement facility will beallowed. The facility will be given to individuals only and shall not include anyother members of the family. Rate chargeable for the members will be inaccordance with the rate slabs applicable for drawing other benefits.

6. Visiting Faculty will enjoy full OPD facility including local purchase of medicinesnot available at the Health Centre. All other investigation and in-door treatment billswill be paid by the Sponsor or Donor institution as the case may be.

7. All regular University and affiliated college employees will enjoy theconsultation and treatment at the Health Centre with reimbursement of medicine andtests required for diagnoses by the attending Medical Officer. However,Emergency and hospitalization will be reimbursed by the College/University as thecase may be.


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SUBSCRIPTION FOR HEALTH CENTRE MEMBERSHIP

(w.e.f. 23.06.2009)

(B) Non Resident Students (Day Students)120/- p.m. payable on annual basis from the academic year beginning 2005.

.(C) Resident Student (Hostel)

240/- p.m. payable on annual basis from the academic year 2005.

(D) Ph.D./M.Phil student240/- per academic session.

(E) Junior Research Fellows , Senior Research Fellows, Research Associates:

As per salary slabs applicable to regular employeesNote:

10 years subscription is taken as Life Membership only for the Retired Employees,which is also payable year wise without any break or lump-sum payment at thetime of final retirement. The amount has to be paid in cash or by Cheque/DemandDraft in favour of Registrar, University of Delhi and deposited in the Office of theHealth Centre.

In service employee intending to become member of Health Centre shall have to pay one month subscription in cash in the Health Centre Office and subsequent payments will be deducted from their salary in their respective institutions.

Re-employed employees shall make one time payment in cash for the specified period of re-employment. The amount is to be calculated on the basis of therate of subscription payable at the time of reemployment.

Grade Pay In Service RetiredPer Month

ContributionLife Time

ContributionUpto 1,650/- per month 50/- 6,000/-

1,800/-; 1,900/-; 2,000/-2,400/- ; and 2,800/- per month 125/- 15,000/-

4,200/- per month 225/- 27,000/-

4,600/-; 4,800/-; 5,400/-; and6,600/- per month

325/- 39,000/-

7,600/- and above per month 500/- 60,000/-


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GUIDELINES FOR CLAIM OF REIMBURSEMENT

1) There is no need to obtain reference from the WUS Health Centre for availingtreatment at the hospital.

2) The treatment must be availed only from the Hospitals empanelled by theUniversity. However, in emergency cases, the treatment can be availed from thenearest hospital even if that Hospital is not on the University approved panel. Thenature of Emergency will have to be justified and approved by the MedicalAdministrator for availing reimbursement of expenses.

3) Reimbursement bill ought to be submitted by the beneficiaries directly to theirconcerned College/Department / University in which the beneficiaries areworking. Form (A) for OPD treatments and /Form (B) for Hospitalizationexpenses. The College/University will make the reimbursement as the case may

be. All claims must be made within three months of the treatment .

4) The Retired employee must submit their Hospital /OPD claims directly tothe College/Department / University from where they retired. Thereimbursement will be made by College /University as the case may be.

5) The reimbursement will be as per CGHS approved rates. All extra charges otherthan the CGHS approved rate list will be the responsibility of the incumbent.

Reimbursement of Diagnostics/ X-ray charges

Such reimbursement will be allowed only if such test facilities are not availableor operational in the particular WUS Health Centre. Availability and functionalityof these tests/equipments must be ascertained from the Pathological, Analytical labsand X-ray before getting the investigations done in other laboratories.


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MEDICAL FITNESS CERTIFICATE & MEDICAL BOARDS

1. Medical fitness certificate in case of fresh or re-employment is provided bythe W.U.S. Health Centre as per guidelines illustrated in Annexure-III.

In case of new appointments to the University, Medical Examination shall be donedaily from Monday to Friday from 09:00 AM to 05:30 PM.

Candidates are required to submit 2 passport size photographs duly attestedalongwith the letter of appointment.

2. Any student requiring writer or extension of time during examination should applyto the Principal of the respective college one month in advance. The application isrouted through the Examination Branches at the North or South Campus to theChief Medical Officer WUS Health Centre (MAIN CAMPUS), Chhatra Marg,University of Delhi, Delhi-110007.


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Annexure-IWUS HEALTH CENTREUNIVERSITY OF DELHI

DELHI-110007 Application Form for Membership in the WUS Health Centre (Permanent/Temp./Retd.Employees )

Addition of the name of dependants/ Duplicate

The Chief Medical OfficerWUS Health Centre, Token Card No..University of Delhi,

Dated

Dear Sir,I, (______________________) wish to avail the medical facilities provided at the Health Centre. I agree to abide by the rules

nd regulations of the WUS Health Centre as framed by the Executive Council and also agree to have the necessaryontribution deducted from my salary every month. I undertake that:

. I am not a member of any other Health Centre of University of Delhi.

. Enclose the age proof Birth Certificate/School Certificate for the dependant beneficiaries.

. Enclose copy of University Employee I-Card Two Photograph of each member.

. Certificate from the respective deptt. of spouse that he/she is not availing any medical facilities form his/her

. Office (If he/she is working).

Signature)(To be filled by the Applicant)

Name (in Block Letters)..Age... Sex..........

Designation..Department/College......

Date of Appointment/Date of Retirement.

Residential Address....

.Phone No

No. Name of the family Date of Birth Marital Status Relation Income of the MemberMembers

(To be filled in by the Office of the Applicant)Present Last Pay Scale Grade Pay..

Pay Band Date of increment..

(i) I certify that the particulars filled in by the Applicant and the Office are correct to the best of my knowledge and belief.He/She may be admitted to the Health Centre. The Health Centre Contribution will be deducted from the salary of theapplicant every month according to the rules.

(ii) Certified that the H.C. Contribution in respect of Sh./Ms. ...is being/has beendeducted .p.m. w.e.f. .. and being (regularly)/ has been remitted to theUniversity/Centre vide Ch.No.. dated

Chief Medical Officer Seal of the Institution


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Page 2 of 2Annexure II

Specimen Copy

WUS HEALTH CENTREUNIVERSITY OF DELHI

DELHI-110007

FOR NON RESIDENT/RESIDENT STUDENT

T.C. No. DRApplication for Membership

(To be filled in by the applicant)

Name (in block letters)......Age.Sex...

College/Department...Class...Roll No.......

Home/Hostel Address....................................

.......Phone No............

I...wish to register my name with the W.U.S. Health

Centre to avail a sum of Rs. ____________ as membership fees for the session.(Attach a photocopy of the fee receipt and Photo Copy of Identity Card and Two Passport size photographs.)

I have already paid .at WUS Health Centre Contribution VideR.No.(__________________)Dt (______________________________________) in the Hostel. (Attach a copy of the Receipt)

Signature

Certified that the particulars given above by the applicant are correct to the best of my knowledge. Irecommended him/her for registration in the WUS Health Centre.

Rates of Health Centre ContributionFor Resident student 240/- per academic session.For Non-Resident student 120/- per academic session.For Ph.D./M.Phil student 240/- per academic session.

For Non-Resident Student

Received ______________ for WUS Health Centre fee

Vide R.No.________________ dated__________________

Signature of Cashier/S.O. with stamp Signature and Seal with theOf the Department/Institution Head of theInstitution/Hostel

(FOR HEALTH CENTRE USE)Received a sum of _______________________ vide Receipt No.__________________ Dated_____________

Chief Medical Officer Section Officer


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Page 1 of 2

MEDICAL REPORT

Name Date of Exam.

GENERAL EXAMINATION:

1. Apparent. Age...

2. Build: Thin/Medium/Heavy 3. Nutrition

4. Height. 5. Weight..

6. Chest Normal.. 7. Expanded..

8. Abdominal girth. 9. Eye (External)

10. Vision RE/LE 11. Ear/Nose/Throat/Teeth

12. Pulse Rate/Volume/Rhythm/

13. Heart.. 14. Blood Pressure

15. Lungs. 16. Liver/Spleen

17. Glands

18. Bones/Joints/Muscles..

19. Skin/Hair/Nails

20. Hernia/Hydrocele/Varicose veins

21. Gynae/Obstetric History.

22. E.C.G. ........................

23. Laboratory Investigation:

24. Urine/R/MF

25. Blood HB...Gms/1000

26. Any Special Investigation:

27. Remarks of Examining Medical Officer

CHIEF MEDICAL OFFICER MEDICAL OFFICER


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Page 2 of 2

Annexure IVSpecimen Copy

W.U.S. HEALTH CENTREUNIVERSITY OF DELHI

NO DUES CERTIFICATE

(To be submitted on Retirement/Death/Withdrawal of Membership/Deputation)

1. Name ..... Designation .

2. College/Institute ...Department ..

3. Are you member of Health Centre ? . ..

4. Token Card No. ..

5. Basic Pay + Grade Pay as on to date ..

6. Health Centre Contribution (old rate) deducted .. P.M. from to

7. Health Centre Contribution (new rate) deducted @ . P.M.from ..to

8. Date of Retirement/Death..

9. Health Centre Contribution arrears deducted

The particulars are correct as per office record

Principal/Head/Section Officer(With Seal)

Note: The concerned employee should be directed to surrender the Token Card and all the Treatment Books.----------------------------------------------------------------------------------------------------------------------------------

W.U.S. HEALTH CENTREUNIVERSITY OF DELHI

(Clearance Certificate)

Certified that nothing is to be recovered from Mr./ Ms. Designation....

Working in....Token Card no.

Having Books also surrendered by him/her.

Amount deposited .. for the month of

SECTION OFFICER


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Annexure -V

Please visit University website to see for updated list of approved hospitals and diagnostic centres.


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Annexure VISpecimen Copy

The Chief Medical Officer,University of Delhi,Delhi-110007.

Subject: Payment of investigation Charges Bills

Sir,

I am enclosing herewith bill / bills of investigation charges as detailed below:-

S.No. Name of Hospital Nature of Investigation Amount

1.

2.

3.

4.

Total

Yours Faithfully,

Signature

Name of Employee

Token No. .

Designation

College/Deptt.

Telephone No.

Address..

...

S.B.I. Delhi University Main BranchSaving Bank A/c No.


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Annexure VIISpecimen Copy

The Chief Medical OfficerUniversity of DelhiDelhi-110007.

Subject: Payment of Local Purchase bills through Cheque/Cash

Sir,I am enclosing herewith bill / bills L.P. Medicines charges as detailed below:-

S.No. Cash Memo No./ Date Amount1.

2.

3.

4.5.

6.

7.

8.

9.

10.

Total

Yours Faithfully,

Signature

Name of Employee

Token No. .

Designation

College/Deptt.

Telephone No.Address..

...

S.B.I. Delhi University Main Branch

Saving Bank A/c No

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