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CENTRAL COUNCIL OF INDIAN MEDICINE
CENTRAL COUNCIL OF INDIAN MEDICINE
NEW DELHIVISITATION PROFORMA FOR ASSESSMENT OF AVAILABLE FACILITIES OF TEACHING AND PRACTICAL TRAINING OF UNANI COLLEGE Section A-General Information Name of the College with Complete Address (mentioning taluka, distt. and other details)
Information of communication Contact No. of College
Contact No. of Hospital
Fax
Information of Principal Name
Office Tel No.
Resident Tel No.
Mobile No.
Information of President of Society of College (For private college)
Name & Address
Office Tel No.
Residence Tel No.
Mobile No.
Information of Secretary of Society of College
(For private college)
Name & Address
Office Tel. No.
Residence Tel No.
Mobile No.
Information of concerned Health Secretary/Ayush Secretary dealing with the education of Unani Name & Address
Office Tel No.
Residence Tel No.
Mobile No.
Information of the State Govt. Director/Commissioner of Unani / Ayush Name & Address
Office Tel No.
Residence Tel No.
Mobile No.
Important information of connectivity Name of Nearest Airport & Distance (km)
Name of Nearest Railway station & Distance (km)
1.
2.
3.
Fee Structure For Management seats
For Government seats
Name of the fee fixation authority
Name of competent authority conducting entrance examination for Govt. seats Name & Address
Telephone Number
Name of competent authority conducting entrance examination for Management seats Name & Address
Telephone Number
Name of the other Unani Colleges within radius of 50 km 1.
2.
3.
Name and year of 1st affiliation of University Name
Year of 1st affiliation
Year of 1st permission of State Govt.
DETAILS OF LAND
To be filled up by college
Verification by Visitors as Correct/Not correct
Total area of land with Society/Trust (in acres)
Ownership of land (Own/Lease/Rented)
In the name of the Society/Trust
In the name of President/Secretary
Whether entire land is in one plot or more than one. If more than one, then size and distance between these plots
Whether the land available with the Society/Trust is entirely for Unani College and attached Hospital or for any other Institute also, if so, details thereof.
Information regarding other institutions/colleges runs by the same society/trust. Whether they are in same campus or anywhere else.
Total area of land allotted to the Unani college (in acres)
Total area of land allotted to the Unani hospital (in acres)
Total area of land allotted to the hostels (in acres)
Name of other institutions running in the campus of Unani College
TOTAL CONSTRUCTED AREA OF COLLEGE
Note: Please furnish details in Annexure-I
TOTAL CONSTRUCTED AREA OF HOSPITAL
Note: Please furnish details in Annexure-I
TOTAL CONSTRUCTED AREA OF HOSTEL (Sq.ft.)
Area for Girls Hostel
Area for Boys Hostel
Number of Staff Quarters available
INFORMATION OF ADMITTED STUDENTS
Name of the Course
Admission Capacity
Student admitted in the year 2009-10
Date of last admission of the student
Verification by Visitors as correct/Not correct
Govt. quota
Management quota
UG
PG (Subj. Wise)
*Detail information of total number of subject wise Post Graduate students passed from college till date be furnished as per annexure -II
*List of students admitted in the Year 2009-10 be furnished as per Annexure-III
SECTION B
FINANCIAL INFORMATION
Total income of college
TOTAL EXPENDITURE IN THE YEAR 2008 FROM JAN. TO DEC.
Total Salary of teaching staff
Total Salary of non teaching staff
Total Salary of hospital staff
Total Expenditures on purchase of new books
Total Expenditures on furniture & fixtures
Total Expenditure on equipments & instruments
Total Purchase of raw drugs
Total Purchase of prepared medicines
Total Purchase of Lab Chemicals
others
Total
Verification by Visitors as correct / Not correct
Year 2008
MONTH WISE EXPENDITURE IN THE YEAR Jan. to Dec. 2009
S. No.
Month
Total Salary of teaching staff
Total Salary of non teaching staff
Total Salary of hospital staff
Total Expenditures on purchase of new books
Total Expenditures on furniture & fixtures
Total Expenditure on equipments & instruments
Total Purchase of raw drugs
Total Purchase of prepared medicines
Total Purchase of Lab Chemicals
Others
Verification by Visitors as correct / Not correct
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
13
Total
14
Grand Total expenditure of the year 2009
15
TOTAL INCOME OF THE YEAR 2009
DETAILS OF MUSEUM
Name of the Department
Number of Charts, Models & Specimens Available (To be filled up by college)
Verification by Visitors as correct / Not
Correct
Charts
Models
Specimens
Charts
Models
Specimens
1. Kulliyat
2. Tashreehul Badan
3. Ilmul Advia wa-Saidla
4. Tahaffuzi wa Samaji Tib
5. Niswan wa Atfal
6. Moalajat
7. Jarahat
INFORMATION ABOUT VARIOUS SECTIONS IN COLLEGE
To be filled up by college
Verification by Visitors as correct / Not correct
LIBRARY
-
-
1. Number of books available
Unani -
Modern -
Others -
Total -
2. Seating arrangement in reading room
3. Number of computers with internet facility
HOSTEL
-
-
1. Total number of room available for Boys
2. Total number of rooms available for Girls
3. Seats available for Boys
4. Seats available for Girls
5. Mess facility for Boys available/not available
6. Mess facility for Girls available/not available
HERBAL GARDEN
-
-
Number of Plants
Number of species
Irrigation facility- Available/Not available
NAME & DETAILS OF SPORTS AND GAMES FACILITY
TRANSPORT FACILITY Exists /Not
PHARMACY- Functioning/Non Functioning
*If, Yes, details of Pharmacy be furnished as per
Annexure-IV
SECTION CINFORMATION OF TEACHING & PRACTICAL TRAINING (Jan. to Dec. 2009) FOR UG S.No.SubjectNumber of Classes held (to be filled up by college)Verification by Visitors as correct / Not correct
Theory
Practical/
Clinical
Theory
Practical
1. Tashreehul Badan
2. Munafeul Aza
3. Umoore Tabiya
4. Mantiq, Falsafa & Haiyat
5. Arabic
6. Tarikhe Tib
7.
Ilmul Advia I
(Kulliyat & Mufradat)
8.
Ilmul Advia II
(Murakkabat & Saidala)
9.
Ilmul Amraz & Sareeriyat
10.
Ilmus Samoom & Tibbe Qanooni
11.
Tahaffuzi wa Smamji Tib
12.
Moalajat- I
13.
Moalajat- II
14.
Jarahiyat
15.
Amraz Ain, Uzn, Anf wa Halaq
16.
Qabalat, Niswan wa Atfal
17.
Number of educational tours conducted for teaching & practical purpose in the year 2009
For PG S.No.SubjectNumber of classes & practical/clinical held (to be filled up by college)Verification by Visitors as correct / Not correct
Theory
Practical
Theory
Practical
1.Kulliyate Umoore Tabiya
2.Munafeul Aza
3.Ilmul Advia
4.
Ilmus Saidla
5.
Tahaffuzi wa Samaji Tib
6.
Ilmul Atfal
7.
Moalajat
8.
Ilmul Amraz
9.
Ilaj Bit Tadbeer
10
Amraze Jild o Zohrawiya
11.
Tashreehul Badan
12.
Ilmul Jarahat
13.
Amraze Uzn, Anf wa Halaq
14.
Qabalat wa Amraze Niswan
NUMBER OF EXISTING TEACHING STAFF (where seven Deptt. exists)
S.
No.
Department
Number of Teachers as per CCIM Norms (to be filled up by college)
No. of Existing Teachers
Verification by Visitors as Correct/Not correct
P
R
L
P
R
L
P
R
L
1.
Deptt. of Kulliyat
For UG
1
1
1
Additional for PG course
1
or 1
2
2.
Deptt. of
Tashreeh-ul-Badan
For UG
1
2
2
Additional for PG course
1
or 1
2
3.
Deptt. of Ilmul Advia wa-Saidla
For UG
1
1
2 one in each subj.
Additional for PG course
1
or 1
2
4.
Deptt. of Tahaffuzi-wa Samaji Tib
For UG
1
1
2
Additional for PG course
1
or 1
2
5.
Deptt. of Moalajat
For UG
1
2
2
Additional for PG course
1
or 1
2
6.
Deptt. of Niswan-wa- Atfal
For UG
1
2
2
Additional for PG course
1
or 1
2
7.
Deptt. of Jarahat
For UG
1
1
2
Additional for PG course
1
or 1
2
Total Number of teachers
Professor-
Readers-
Lecturers -
NUMBER OF EXISTING TEACHING STAFF (where fourteen Deptt. exists)
S.
No.
Department
Number of Teachers as per CCIM Norms (to be filled up by college)
No. of Existing Teachers
Verification by Visitors as Correct/Not correct
P
R
L
P
R
L
P
R
L
1.
Kulliyat
For UG
1
1
1
Additional for PG course
1
or 1
2
2.
Tashreehul Badan
For UG
1
1
1
Additional for PG course
1
or 1
2
3.
Munafeul Aza
For UG
1
1
1
Additional for PG course
1
or 1
2
4.
Ilmul Advia wa-Saidla
For UG
1
1
1
Additional for PG course
1
or 1
2
5.
Ilmul Amraz-
For UG
1
1
2
Additional for PG course
1
or 1
2
6.
Tibbe Qanooni wa Ilmus Samoom
For UG
1
1
1
Additional for PG course
1
or 1
2
7.
Tahaffuzi-wa Samaji Tib
For UG
1
1
2
Additional for PG course
1
or 1
2
8.
Moalajat
For UG
1
1
2
Additional for PG
1
or 1
2
9.
Niswa wa Atfal
For UG
1
1
1
Additional for PG
1
or 1
2
10.
Ilmul Qabalat
For UG
1
1
1
Additional for PG
1
or 1
2
11.
Jarahiyat
For UG
1
1
1
Additional for PG
1
or 1
2
12.
Ain, Uzn, Anf, Halaque
For UG
1
1
1
Additional for PG
1
or 1
2
13.
Amraze Jild wa Amraz Zohrawiya
For UG
1
1
1
Additional for PG
1
or 1
2
14.
Ilaj Bid Tadbeer
For UG
1
1
1
Additional for PG
1
or 1
2
Total Number of teachers
Professor-
Readers-
Lecturers -
SALARY INFORMATION*
To be filled up by college
Verification of information by Visitors as correct / Not correct
Pay Scale of teachers
As per State Govt./UGC
(If none of these please mention reason thereof )
1. Mode of payment through BankYes/No (If none please mention reason thereof )
2. GPF & CPF is deducted from the salaryYes/No (If none please mention reason thereof)
3. Teachers promotion policy as per norms of CCIM/Govt./UGC.Yes/No (If none please mention reason thereof)
4. Existing pay scale of teaching staff ( State Govt./UGC/others)
[Pl. tick whichever applicable]Pay Scale of Professor
Pay Scale of Reader
Pay Scale of Lecturer
INFORMATION OF NON TEACHING STAFF OF VARIOUS DEPARTMENTS
S.No.
Department
No. of Existing Non-Teaching Staff
( To be filled up by college)
Verification by Visitors as correct / Not correct
Lab. Tech.
Lab Asstt.
Muse. Keeper
Peon
Lab Tech.
Lab Asstt.
M. Keeper
Peon
1.
Kulliyat
-
1
-
1
2.
Tashreeh- ul-Badan
2 Tec
1
1
1
3.
Ilmul Advia wa-Saidla
1 lab
Attnd
-
1
4.
Tahaffuzi-wa Samaji Tib
-
1
1
1
5.
Moalajat
1
--
--
1
6.
Niswa-wa- Atfal
--
--
--
1
7.
Jarahat
--
--
--
1
Note: Housekeeping may be from out sources with minimum three sweepers
NOTE: DETAIL INFORMATION OF TEACHING STAFF BE FURNISHED AS PER ANNEXURE-V
NOTE: DETAIL INFORMATION OF NON TEACHING STAFF ALONG WITH SALARY DETAILS BE FURNISHED AS PER ANNEXURE-VI
STAFF REQUIRED FOR HOSPITAL & VARIOUS DEPARTMENTS
HOSPITAL STAFF
Name of Post
Staff Required as Per Norms of CCIM
Number of Existing Staff
Verification by Visitors as Correct /Not correct
Superintendent (Principal or Dean of the college may also be ex-officio)
1
Deputy Superintendent
1
Hakeem (for OPD for clinical subjects)
Professors, Readers and Lectures of Tibbi College
Medical Specialist
1 Part time
Surgeon
1 Part time
Gynaecologist
1 Part time
Radiologist
1 Part time
Pathologist
1 Part time
Anesthetist
1 Part time/on call
X-ray technician
1
Clinical Registrar
1 for each clinical deptt.
RMO
1
House Officer/PG student
1 for 20 beds
Matron/Nursing Superintendent
1
Staff Nurse
1 for 10 beds (and 1 for general OPD and 1 for Gynae. OPD)
Ward boy/Ayah/ANM
1 for 20 beds ( and 2 for OPD)
Pharmacist
2
Store Keeper
1
Head Clerk
1
Cook
1
Kitchen Attendant/ Cook
1
Plumber
1 on contract basis
Watch Men
3 on contract basis
Lift men for multi-storeyed Building
3 on contract basis
Electrician
1 (part time)
Dark Room Attendant
1
Dressers(for OPD)
2
Operation Theatre
Attendant
1
Labour Room Attendant
2
Safaiwala
2 (outsourcing)
Statistician
part time
Photographer
part time
ILAJ BID TADBEER DEPARTMENT STAFF
-
-
Ilaj bit tadbeer hakeem
1 Male
1 Female
Ilaj bit tadbeer Technician
2
Ilaj bit tadbeer Assistant
1 Male
1 Female
Physiotherapist
1
Safaiwala
1 (outsourcing)
LIBRARY STAFF
-
-
Librarian
1
Asst. Librarian
1
Library Attendant/Peon
1
PHARMACY STAFF
-
-
Deputy Superintendent (M.D. Ilmul Advia/ Saidla)
Machine Operator
Labour (Number)
HERBAL GARDEN STAFF
-
-
1.
2.
NOTE:- DETAIL INFORMATION OF HOSPITAL STAFF ALONG WITH SALARY DETAILS BE FURNISHED AS PER ANNEXURE -VII
SECTION D
FACILITIES AVAILABLE IN THE HOSPITAL
OPD FACILITIES
S. no.
Name of Department
Equipment, Instrument, Furniture etc required as per norms of CCIM
Departmental Equipment, Instrument, Furniture Available or Not (To be filled up by college)
Verification by Visitors as correct / Not correct
1
Moalajat
View Box
BP Instrument
Stethoscope
Examination Table
Thermometer
Tongue depressor
Weighing machine
Torch
Measuring tape
Weight and height measuring stand
Hammer
2.
Ilmul Jarahat
Autoclave/sterilization facilities
Minor OT
Instruments for anorectal examination
Examination Table
BP instrument
Surgical Blades
Suturing material
Rubber catheter
View Box
Stethoscope
Cheetles forceps
Torch
3
Ain, Uzn, Anaf wa Halaq
Sterilization facilities
Tuning fork
Ophthalmoscope/ fundoscope
Auroscope
Tongue depressor
Examination Table
View Box
BP Instrument
Stethoscope
ENT kit
Torch
Bull`s lamp
4
Qabalat wa Amraze Niswan
Sterilization facilities
Weighing machine
Sims speculum
Cuscos speculum
Examination Table
Lamp stand
Torch
View Box
BP Instrument
Stethoscope
Measuring tape
Washbasin
5
Amraze Atfal
Scale
Weighing machine
Torch
View Box
BP Instrument
Stethoscope
6
Ilaj bit tadbeer
As per Moalajat
7
Emergency
Facilities available (Equipment, Instrument, Furniture etc)
8
Minor OT
Facilities available (Equipment, Instrument, Furniture etc)
Note: Every Deptt. shall have proper seating arrangements for internees/students
NUMBER OF PATIENTS ATTENDED OPD (Jan. to Dec. 2009)
S.No.
Month
Moalajat
including
Ilaj bit tadbeer
Jarahat
including Ain, Uzn, Anaf wa Halaq
Qabalat wa Amraze Niswan
Amraze Atfal
Tahaffuzi wa Samaji Tibb
Verification by Visitors as correct / Not correct
1.
Jan.
2.
Feb.
3.
March.
4.
April
5.
May
6.
June
7.
July
8.
August
9.
Sept.
10.
Oct.
11.
Nov.
12.
Dec
Total
Grand total
DETAILS OF IPD PATIENTS (Jan. to Dec. 2009)
1. Total Number of Patients Admitted in the Year 2009
S .No.
Month
Moalajat
Jarahat
Ain, Uzn, Anaf wa Halaq
Qabalat wa Amraze Niswan
Amraze Atfal
Ilaj bit tadbeer
Verification by Visitors as correct / Not
1.
Jan.
2.
Feb.
3.
March.
4.
April
5.
May
6.
June
7.
July
8.
August
9.
Sept.
10.
Oct.
11.
Nov.
12.
Dec
Total
Grand Total
2. Total Number of Bed Days Occupied
S.No.
Month
Moalajat
Jarahat
Ain, Uzn, Anaf wa Halaq
Qabalat wa Amraze Niswan
Amraze Atfal
Ilaj bit tadbeer
Verification by Visitors as correct / Not correct
1.
Jan.
2.
Feb.
3.
March.
4.
April
5.
May
6.
June
7.
July
8.
August
9.
Sept.
10.
Oct.
11.
Nov.
12.
Dec
Total
Grand total
Note: To calculate the total number of bed days occupied of the months, please calculate the date wise total number of patients, remained on bed at midnight.
IPD SECTIONS WITH BED STRENGTH
Name of the Department
% of Bed Distribution as per CCIM norms
Number of Existing Bed strength (To be filled up by college)
Verification by Visitors as correct / Not
(i) Moalajat and Ilaj bit tadbeer
40%
(ii) Jarahat
10%
(iii) Ain, Uzn, Anaf wa Halaq
10%
(iv) Qabalat wa Amraze Niswan
20%
(v) Amraze Atfal
05%
(vi) Others
15%
Total Number of Beds
DETAILS OF DRUG DISTRIBUTION IN OPD & IPD (Jan. to Dec.2009)
Note:-Detail Information be furnished as per Annexure-VIII
INFORMATION ABOUT VARIOUS SECTIONS IN THE HOSPITAL
To be filled up by college
Verification by Visitors as correct / Not correct
LABOUR ROOM- Functional/Non Functional
Antenatal Room with attached Toilet-Functional/Non Functional
Facilities for Neonatal care - Available/Not Available
Other Available Facilities, Equipments, Instruments
Note:- Details be furnish as per annexure-IX
Number of Deliveries performed during the year 2009
OPERATION THEATRE- Functional/Non Functional
Air conditioning- Exist/Not
Pre Operative Room with attached toilet- Exist/Not
Sterilization room Exist/Not
Changing and wash room with attached toilet - Exist/Not
Total Number of operations done during the year 2009
Details of Available equipments, Instruments and other facilities in Operation theatre
Note:- Details be furnished as per annexure-X
Fumigation Details
AMBULANCE - Available/Not Available
OTHER FACILITIES AVAILABLE IN THE HOSPITAL
-
-
Pathological tests
Total number of Pathological tests/
investigations done in the year 2009
X-Ray
Total number of X-rays done in the year 2009
ECG
Total number of ECG done in the year 2009
USG
Total number of USG done in the year 2009
INFORMATION OF ILAJ BIL TADBEER DEPARTMENT
Name of the Instrument
Number of Instruments Available (To be filled up by college)
Verification by Visitors as correct / Not
correct
Apparatus needed for -
Hajamat (Cupping Set)
Dalk Table
Riyazat
Taleeq (Aquarium for leeches)
Fasd (Venesection Set)
Hamam
Other
TADABEER BEING CARRIED OUT
TOTAL NUMBER OF REGIMENS CARRIED OUT IN THE YEAR 2009 (To be filled up by college)
VERIFICATION BY VISITORS AS CORRECT / NOT CORRECT
Fasad
Hajamat
Dalk
Riyazat
Taleeq
Hamam
Others
DETAILS OF MEDICAL CAMPS CONDUCTED BY COLLEGE IN THE YEAR 2009
S.No.
TO BE FILLED UP BY COLLEGE
VERIFICATION OF INFORMATION BY VISITORS AS CORRECT / NOT CORRECT
NATURE OF THE CAMP
DATE
PLACE
NUMBER OF PATIENTS
* If required additional sheet be attached in the prescribed format.
ANNEXURE -I
DETAILS OF AREA OF COLLEGE AND HOSPITAL
DETAILS OF AREA OF COLLEGE::
TOTAL CONSTRUCTED AREA
NAME OF DEPARTMENT & SECTIONS
To be filled up by college
Verification by Visitors as correct / Not correct
1. Administrative wing
2. Kulliyate Tib
3. Munafeul Aza
4. Tashreeh-ul-Badan
5. Ilmul Advia wa saidla
6. Ilmul Amraz
7. Moalajat
8. Niswan wa Atfal
9. Ilmul Qabalat
10. Jarahat
11. Ain Uzn, Anaf wa Halaq
12. Ilaj Bil Tadber
13. Tahaffuzi wa Samaji Tib
14. Library+ reading room
15. Pharmacy
16. Herbal Garden
17. Auditorium
18. Staff Room
19. Common Room
20. Canteen
21. Class Rooms
22. Tutorial room for PG
23. Area of Dissection Hall
24. Munafeul Aza Lab.
25. Saidla lab
AREA OF MUSEUMS
1. Tashreehul badan
2. Munafeul Aza
3. Ilmul advia
4. Ilmul Amraz
5. Jarahat
6. Tahaffuzi wa Samaji tib
7. Kulliyate Tibb
OTHERS
1.
2.
Total Constructed Area
Cont..
AREA OF VARIOUS SECTIONS AVAILABLE IN THE HOSPITAL
TOTAL CONSTRUCTED AREA OF HOSPITAL
VARIOUS SECTIONS IN THE HOSPITAL
Sections If Exist please mention Area (To be filled up by college)
Verification by Visitors as correct / Not correct
ADMINISTRATIVE BLOCK-
-
-
1. Reception
2. Registration counter
3. Office of Medical Superintendent/ Medical Deputy Superintendent
4. RMO Room
5. Store Room
6. Total area of IPD wards
OPD SECTIONS -
-
-
1. Moalajat including Ilaj Bit Tadbeer
2. Jarahat including Ain, Uzn, Anaf, Halaq-wa-Asnan
3. Qabalat-wa-Amaz-e-Niswan
4. Amraz-e-Atfal
5. Emergency
6. Tahaffuzi-wa-Samaji Tib
7. Minor OT
Clinical Pathology & Biochemistry Lab
Area of store room of Drugs
Dispensary
Record Room
Labour room
Operation Theater
Recovery Room
OTHERS
-
-
1.
2.
Total Constructed Area
ANNEXURE-II
NUMBER OF POST GRADUATE STUDENTS PASSED FROM COLLEGE FROM INCEPTION TO TILL DATE
S.No.
NAME OF PG SUBJECT
TOTAL NUMBER. OF PG STUDENTS PASSED OUT FROM COLLEGE FROM BEGINNING TO TILL DATE (To be filled up by College)
1. Kulliyat-Umoor-e-Tabiya
2. Munafeul Aza
3. Ilmul Advia
4.
Ilmus Saidla
5.
Tahaffuzi-wa-Samaji Tib
6.
Ilmul Atfal
7.
Moalajat
8.
Ilmul Amraz
9.
Ilaj Bil Tadbeer
10.
Amraze Jild o Zohrawiya
11.
Tashreehul Badan
12.
Ilmul Jarahat
13.
Amrazee Uzn, Anf wa Halaq
14.
Qabalat wa Amraze Niswan
GRAND TOTAL
LIST OF STUDENTS ADMITTED IN THE YEAR 2009-10
S.No.
To be filled up by college
Verification of information by Visitors as correct/Not correct
Name of the Students
Fathers Name
Date of Admission
Residential Address
Govt. Quota /Management Quota
* If required additional sheet be attached in the prescribed format.
ANNEXURE-IV
DETAILS OF SAIDLA (PHARMACY)
DETAILS OF EQUIPMENT & INSTRUMENTS
Essential Equipment and Instruments
Available Number of Equipment and Instruments (to be filled up by College)
Verification by Visitors as Correct/Not correct
1. Pulveriser
2. Grinder
3. Mixer
4. Filtering Machine
5. Tablet Making Machine
6. Pill making machine
7. Heating machine
8. Capsule Filling Machine
9. Air Tight Desiccators
10. Moisture absorbing machine etc.
11. Tablet coating pans & fitting press
12. Granulator drying chamber
13. Projector Overhead and Slide
14. Distillation apparatus/Qara Ambiq
15. Weighing Machine
16. Pestle and Mortar
17. Others
DETAILS OF PREPARED MEDICINES IN THE YEAR 2009
NAME OF PREPARED MEDICINE
QUANTITY OF PREPARED MEDICINE
VERIFICATION BY VISITORS AS CORRECT / NOT CORRECT
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
* IF REQUIRED ADDITIONAL SHEET BE ATTACHED
TOTAL EXPENDITURE ON PURCHASE OF RAW MATERIALS IN THE YEAR 2009
NAME OF THE COMPANY
DATE
VOUCHER NUMBER
AMOUNT
VERIFICATION BY VISITORS AS CORRECT/ NOT CORRECT
1.
2.
3.
4.
5.
* IF REQUIRED ADDITIONAL SHEET BE ATTACHED
TOTAL EXPENDITURE ON PURCHASE OF COMPOUND FORMULATION IN THE YEAR 2009
NAME OF THE COMPANY
DATE
VOUCHER NUMBER
AMOUNT
VERIFICATION BY VISITORS AS CORRECT/ NOT CORRECT
1.
2.
3.
4.
5.
* IF REQUIRED ADDITIONAL SHEET BE ATTACHED
ANNEXURE-V
PROFORMA TO FURNISH THE DETAILS OF TEACHING STAFF
Note: Information to be filled up by college as per proforma and be verified by Visitors
S. No.
Name of the Teacher
Father's Name
Date of Birth
UG Qualifi. (Univ. & year)
PGQualif.with subject (Univ. & year)
Nature
of appoin.
Date wise details of Experience in chronological order
Department (Subject)
Present Working Address
Permanent Address
State Board Registration No.
Bank Account Number
Verification by Visitors as correct / Not correct
Duration
(d/m/y)
Designation
Name of the college
Sir Name
First Name
Second name
Note: Please attach the certified copies of Under-graduate and Post-graduate degree, Registration certificate, experience certificates and reliving order along with original affidavit as per prescribed format of all teaching staff. The provisional certificates will be considered only for two years after passing the examination.
ANNEXURE-VI
PROFORMA TO FURNISH THE DETAILS OF NON TEACHING STAFF
S.No.
Name of Employee
Fathers Name
Qualification
Date of Appointment
Nature of Appointment (regular/ contractual/
Part time)
Designation
Name of working department
Pay Scale
Verification of information by Visitors as correct / not correct
ANNEXURE-VII
PROFORMA TO FURNISH THE DETAILS OF HOSPITAL STAFF
S.NO.
NAME OF EMPLOYEE
FATHERS NAME
QUALIFICATION
DATE OF APPOINTMENT
DESIGNATION
NAME OF DEPARTMENT
VERIFICATION BY VISITORS AS CORRECT / NOT CORRECT
PROFORMA TO FURNISH THE POST WISE EXPENDITURE ON SALARY OF HOSPITAL STAFF
S.NO.
NAME OF THE POST
NO. OF PERSONS
PAY SCALE
REGULAR/
CONTRACTUAL/
PART TIME
TOTAL EXPENDITURE INCURRED IN THE YEAR 2009
VERIFICATION BY VISITORS AS CORRECT / NOT CORRECT
ANNEXURE-VIII
DETAILS OF DRUG DISTRIBUTION IN OPD & IPD (JAN. TO DEC. 2009)
S.No.
Name & Quantity of Drugs obtained from own Pharmacy
Name & Quantity of Drugs purchased from market
Name & Quantity of utilised Drugs along with balance
Verification by Visitors as correct / Not correct
Unani Drugs
Modern Drugs
Unani Drugs
Modern Drugs
Utilised
Balance
Utilised
Balance
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
* If required additional sheets be attached in the prescribed format
ANNEXURE IX
DETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR LABOUR ROOM
S.No.
Essential Equipment and Instruments
Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/not correct
1.
Well equipped labour room with attached oxygen tent.
2.
Incubator
3.
Suction Machine - 1
4.
Oxygen Cylinder - 1
5.
Pulse Oxymeter
6.
Others
ANNEXURE X
DETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR OPERATION THEATRE
S.No.
Essential Equipment and Instruments
Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/not correct
1.
Necessary Instruments relating to the subject be kept in hospital. Instruments used in Operation theatre Latest instrument for operation,
Leeching,
Cupping,
Venesection &
Autoclave
2.
Oxygen Cylinder
3.
Suction Machine
4.
Enema
5.
X-ray View Box
6.
Pulse oxymeter
7.
Anaesthesia machine
8.
Others
ANNEXURE XI
DETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR DEPARTMENT OF TASHREEHUL BADAN (ANATOMY)
S. No.
DISSECTION HALL
To be filled up by college
Verification of information by Visitors as correct/not correct
1.
Nubmer of tables
2.
Preservative tank- Exists/Not
3.
No of cadavers available at the time of visitation
4.
No of cadavers dissected/demonstrated in the year 2009
ANNEXURE XII
DETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR PHYSIOLOGY LABORATORY
S.NO.
Essential Equipment and Instruments
Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/not
correct
1.
Microscope
2.
Microtome
3.
Haemocytometer
4.
Haemoglobinometer
5.
Tissue Slide
6.
Refrigerator
7.
BMR Apparatus
8.
Spirometer
9.
BM Instruments
10.
Stethoscope
11.
Kymograph Instruments including electrometer
& accessories
12.
Albuminometer
13.
Urino meter
14.
Centrifugal machine
15.
Distillation apparatus
16.
Glassware for urine examination &
other necessary accessories
17.
Dissecting trays
18.
Necessary chemical etc.
19.
Sphygmomanometer
20.
Tonometer
ANNEXURE XIII
DETAILS OF EQUIPMENT AND INSTRUMENTS REQUIRED FOR MAHIYATUL AMRAZ LABORATORY
S.No.
Essential Equipment and Instruments
Number of Instruments & Equipments available (to be filled up by college)
Verification of information by Visitors as correct/not
correct
1.
Pathological and Biochemical laboratory well equipped for all types of routine and histological examination should be attached with hospital and necessary accommodation for this laboratory also be provided.
2.
Others
ANNEXURE XIV
PROGRESS MADE BY INSTITUTION IN LAST TWO YEARS ON SALIENT POINTS
S.No.
Important Information of College
Progress made by college (To be filled up by college)
1.
Construction of college & hospital building
2.
Appointment of Teaching staff
3.
Number of Seminar organized by the college/attended by teaching staff
4.
ROTP attended by the staff
5.
Research work carried out by teaching staff
6.
Publication of teachers
7.
Quality of work presented/published (National /International journals)
8.
Any contribution/ innovation made by the college/faculty for the System
9.
Conduct of examination in time ort not
10.
Appointment of Non-Teaching staff
11.
Appointment of Paramedical and other Hospital staff
12.
Expansion of Various
Departments of College
13.
Expansion of Herbal Garden, Plantation of New Plants
14.
Development of Pharmacy
15.
Progress in Hospital OPD
16.
Progress in Hospital IPD
17.
Progress of Ilaj Bil Tadbeer Department
ANNEXURE XV
NOTARISED AFFIDAVIT TO BE FILLED UP BY TEACHER IN THE GIVEN FORMAT.
S.No
Information of Teacher
To be filled up by Teacher
1.
Name of the Teacher (Sir Name- First Name- Second name)
2.
Date of Birth (d/m/y)
3.
UG Qualification (University & year)
4.
PG Qualification with subject (University & year)
5.
Post wise details of Experience in chronological order (* Date, Month and Year wise experience should be mentioned)
Duration
(d/m/y)
Designation
Name of the college
6.
Present working Department (Subject)
7.
Present Working Address
8.
Permanent Address
9.
State Board Registration No.
10.
Bank Account Number
11.
Contact Number a. Mobile-
b. Residence
c. Permanent Res.
Signature of Teacher
LIST OF ANNEXURES TO BE SUBMITTED BY COLLEGE
S.No.
Annexure Number
Name of the Annexure
1.
Annexure -I
Details of area of College and Hospital
2.
Annexure-II
Number of Post Graduate students passed out from college from beginning to till date
3.
Annexure-III
List of students (UG and PG) admitted in the year 2009-10
4.
Annexure-IV
Details of Saidla (Pharmacy)
5.
Annexure-V
Proforma to furnish the details of Teaching Staff
6.
Annexure-VI
Proforma to furnish the details of Non Teaching Staff
7.
Annexure-VII
Proforma to furnish the details of Hospital Staff
8.
Annexure-VIII
Details of Drug distribution in OPD & IPD (Jan. to Dec. 2009)
9.
Annexure IX
Details of Equipment and Instruments required for Labour Room
10.
Annexure X
Details of Equipment and Instruments required for Operation Theatre
11.
Annexure XI
Details of Equipment and Instruments required for Tashreehul Badan
12
Annexure XII
Details of Equipment and Instruments required for Munafeul Aza (physiology) Laboratory
13
Annexure XIII
Details of Equipment and Instruments required for Mahiyatul Amraz Laboratory
14
Annexure XIV
Progress made by Institution in last two years on salient points
15
Annexure XV
Notarised affidavit to be filled up by Teacher in given format. (in respect of all teaching staff)
Note: Teachers of Govt. colleges/University constituents colleges who have already submitted affidavits need not to submit again. However, these colleges should submit the affidavit of newly appointed teachers.
*****
***
*
CENTRAL COUNCIL OF INDIAN MEDICINE
NEW DELHI
Guidelines/Instructions to fill up the Visitation Proforma as well as regarding submission of annexures:-
1. Please read the proforma carefully before fill up.
2.Attested copy of UG & PG Certificates, Experience Certificates, Joining report, Relieving Certificate and Affidavit (as per annexure-XV) in respect of each teacher should be attached as per serial number of the list of teaching staff. (as per annexure V) Note: Teachers of Govt. colleges/University constituent colleges who have already submitted affidavits need not to submit again. However, these colleges should submit the affidavit of newly appointed teachers.
3. Copy of Form No. 16 issuing for purpose of income tax should be submitted in respect of all the teaching staff. (Not admissible for Govt./University constituent colleges)
4. In absence of complete documents the teacher will be treated as ineligible.
5. If any teacher found in duplicity the necessary action will be taken against the management, Principal of the college and concern teacher under IPC.
6. Attested copy of salary bills of Jan, June, Nov. & Dec., 2009 should be submitted in respect of Teaching, Non teaching & Paramedical staff along with Bank statements. (Not admissible for Govt./University constituent colleges)
7. Page-wise Index of all annexures should be provided.
8. Financial information should be filled up in prescribed format of proforma only. (Balance sheet should not be attached).
9. The column (namely Verification of information by visitors as Correct/Not correct) will be filled up only by visitors after verification at the time of visitation of the college.
10. The college should filled up the information strictly as per prescribed format. Any change in the prescribed format will not be accepted by CCIM.
11. Please mention constructed area in Sq. ft. only and land area in acres. Any other measurement strictly be avoided.
12. The information should be based on present facts and complete information should be provided in the prescribed format.
Pass Port Size Photograph (To be attested by Principal)
Proforma (U) 2010-11 4
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