College Infrastructure Form

College Infrastructure Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0. 2. If you have not yet downloaded the Annexure templates to be uploaded in various sections of the Visitation form. Please click here to download the template applicable to your college (i.e. Ayurveda or Siddha or Unani).

of 50 College Infrastructure Details

Institution Name Ajmal Khan Tibbiya Institution Id : UNI0313 : College, AMU, Aligarh. Institution Visitation Id : A00144 Unani Course : College Council and Website Details

*Is College Council available? Yes No *Is there a College website available? Yes No Progress made by the institution in the last two years on salient points

Note Please give a descriptive (not one word) answer. :

S.NO Important Information of College Progress made by college

*1 Construction of college and hospital building

*2 Appointment of Teaching staff

*3 Appointment of Non-Teaching staff

*4 Appointment of Paramedical and other Hospital staff

*5 Expansion of various departments of college

*6 Expansion of Herbal Garden, Plantation of New Plants

*7 Development of Pharmacy

*8 Hospital OPD

*9 Hospital IPD

*10 Any national/international/state level seminars, ROTP, CME etc.

*11 Publication by college and teaching staff

*12 Research activities if any

*13 Awards won by teaching staffs and students

*14 Progress of Ilaj Bit Tadbeer Department

Constructed Area Of College

Details of various components of College other than teaching dept

Available Area S.NO Particulars (in Sq. mtr.) Page 2 of 50 Page 3 of 50 College Departments Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

College Departments Form

Ajmal Khan Tibbiya Institution Id : UNI0313 Institution Name : College, AMU, Aligarh. Visitation Id : A00144 Institution Course : Unani

For UG

No. of Lectures / Practicals / Clinicals *No. of Dept. Museum S.N Departm*Computer/Printer carried out since last Library o. ent Availability visitation Books *No. of *No. of No. of *Practical / *Theory Charts Models Specimens Clinical 1 Kulliyat --Select--

Tashree 2 h ul --Select-- badan Munafe 3 --Select-- ul Aza Ilmul 4 --Select-- Advia Ilmul 5 --Select-- Saidla Mahiyat 6 ul --Select-- Amraz Tahaffu zi wa 7 --Select-- Samaji Tib

8 Moalajat --Select--

Niswan 9 wa --Select-- Qabalat Ilmul 10 --Select-- Atfal

11 Jarahat --Select--

12 Ain- --Select-- Uzn- Anf- Halaq wa Page 4 of 50 Asnan Amraze Jild wa 13 --Select-- Tazeeni yat Ilaj bit 14 --Select-- Tadbeer

*Number of educational tours conducted for teaching & practical purpose since last visitation For PG

No. of Lectures / Practicals / Clinicals carried out since last visitation S.No.Subject *Theory *Practicals / Clinicals *Seminars

1 Ilmul Qabalat-wa-Amraz-e-Niswan

2 Moalijat

3 Ilmul Advia

4 Kulliyat-Umoor-e-Tabiya

5 Tahaffuzi-wa-Samaji Tib

6 Ilmul Jarahat

*Number of educational tours conducted for teaching & practical purpose since last visitation

of 50 College Financial Details Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

College Financial Details

Institution Name Ajmal Khan Tibbiya College, Institution Id : UNI0313 : AMU, Aligarh. Institution Visitation Id : A00144 Unani Course :

Financial Details

Expenses on Salary *Non-Teaching Staff S.No.Month *Teaching Staff Salary *Hospital Staff Salary Salary

1 January

2 February

3 March

4 April

6 June

7 July

8 August

9 September

10 October

11 November

12 December

13 Total

Expenses on Purchase

S.No.Month *New Books *Raw Drugs *Prepared Medicine *Lab Chemicals

1 January

2 February

of 50 3 March

4 April

6 June

7 July

8 August

9 September

10 October

11 November

12 December

13 Total

Miscellanous Expenses *Equipments and S.No.Month *Furniture and Fixture *Building Construction & Others Instruments

1 January

2 February

3 March

4 April

6 June

7 July

8 August

9 September

10 October

11 November

12 December

13 Total

Grand Total of Expenditure since last visitation

*Total Income since last

of 50 visitation

of 50 Student Details Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0. 2. If you have not yet downloaded the Annexure templates to be uploaded in various sections of the Visitation form. Please click here to download the template applicable to your college (i.e. Ayurveda or Siddha or Unani).

Student Details

Ajmal Khan Tibbiya College, AMU, Institution Id : UNI0313 Institution Name : Aligarh. Visitation Id : A00144 Institution Course : Unani

*Information of Admitted Students

Year of Admissi 2014-15 2013-14 2012-13 2011-12 2010-11 on No of Students admitted for UG Course with Govt Quota No of Students admitted for UG Course with

of 50 Managem ent Quota No of Students admitted for PG Course with Govt Quota No of Students admitted for PG Course with Managem ent Quota Students admitted by order of Order of AYUSH Deptt. (GOI) AYUSH Dept. (GOI)/Co urt order Name of the Last Student Admitted Date of Admissio n of the last Student

of 50 Documents to be Uploaded

*Please upload Annexure-I to furnish the list of students admitted in UG course in the last 5 academic years here

*Please upload Annexure-II A to furnish the list of students admitted in PG course in the last 5 academic years here

*Please upload Annexure-II B to furnish the list of PG students allotted to individual guide in the last 5 academic years here

*Information of Passed out Students

Academic Year 2014-15 2013-14 2012-13 2011-12 2010-11 No of Final Year students appeared for exams for UG Course No of Final Year students passed out in exams for UG Course No of Final Year students appeared for exams for PG Course No of Final Year students passed out in exams for PG Course

of 50 College Staff Information Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

Teaching Staff Information

Non-Teaching Staff Information

Institution Id : UNI0313 Institution Name : Ajmal Khan Tibbiya College, AMU, Aligarh. Visitation Id : A00144 Institution Course : Unani

Teaching Staff Details

Information of Teaching Staff

*No of Existing Teachers * S.No. Department *Associate Professors / *Assistant Professors / Total *Professor Readers Lecturers

1 Ain-Uzn-Anf-Halaq wa Asnan

2 Amraze Jild wa Tazeeniyat

3 Ilaj bit tadbeer

4 Ilmul Advia

5 Ilmul Atfal

6 Ilmul Saidla

7 Jarahat

of 50 8 Kulliyat

9 Mahiyatul Amraz

10 Moalajat

11 Munafeul Aza

12 Niswan-wa-Qabalat

13 Tahaffuzi-wa Samaji Tib

14 Tashreehul badan

Note Tibbe Qanooni wa Ilmul Samoom is merged in deptt. of Tahafuzi wa Samji Tib. :

*No of Communication Skills Teachers :

*No of Arabic Teachers :

Salary Information

S.No. Salary Details *Provide Appropriate Information Please mention the Reason for No

1 Is the mode of payment through Bank? Yes No

2 Is GPF & CPF deducted from the salary? Yes No

3 Is the teachers promotion policy as per norms of CCIM? Yes No

of 50 4 The existing pay scale of teaching staff is as per

5 Pay Scale and Grade pay of Professor

6 Pay Scale and Grade pay of Reader/Associate Professor

7 Pay Scale and Grade pay of Lecturer/Assistant Professor

Other Relevant Information of Teachers *Associate Professors / *Assistant Professors / S.No. Information of Teachers *Professors *Total Readers Lecturers 1 Total number of teachers retired from the college since last visitation

Total number of teachers transferred/left from the college since last 2 visitation Total number of teachers newly appointed in the college since last 3 visitation Total number of teachers re-employed after retirement from Govt. or 4 Grant In Aid colleges since last visitation

Version9.01.00

College Staff Information Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

of 50 Teaching Staff Information

Non-Teaching Staff Information Non-Teaching Staff Details

Details of Technical and Other Staff in the College

S.No. Department Post *Available Staff

Librarian/Assistant Librarian 1 Library Library Attendant or Peon

2 College Office Clerical staff for administrative accounts services

3 Kulliyat Attendant

Laboratory Technician 4 Tashreehul Badan Museum Keeper

Laboratory Technician 5 Munafeul Aza Museum Keeper

Laboratory Technician 6 Ilmul Advia Museum Keeper

7 Saidla Dawasaz/Pharmacy Attendant

8 Mahiyatul Amraz Laboratory Technician

9 Niswan wa Qabalat Attendant

10 Ilmul Atfal Attendant

of 50 11 Tahaffuzi wa Samaji tib Attendant

12 Moalajat Attendant

13 Jarahat Attendant

14 Amraze Ain, uzn, Anf wa Halaq Attendant

15 Ilaj bit Tadbeer Attendant

16 Amraze Jild wa Tazeeniyat Attendant

Gardener 17 Herbal Garden Multipurpose worker

Total -

Note Kindly use Internet Explorer(version 7+), Mozilla Firefox (version 14+) or Google Chrome(version 20+) to fill in the form : Use Mouse to move between fields for entry of data instead of using Tab Key Fields marked with*are mandatory. Please allow pop-ups in your browser whenever asked. Please fill all the forms by selecting the tab name in the header. If you have not yet downloaded the Annexure templates to be uploaded in various sections of the Visitation form. Please click here to download the template applicable to your college (i.e. Ayurveda or Siddha or Unani). For any issues, Clarifications please contact CCIM Helpdesk Email-Id: [email protected] or Mobile Numbers: 9654401726, 9654401763 Please download the user manual for filling the Part 1 visitation proforma here

Note Click on the below "Add College Teaching staff Information" button to add all the College Teaching staff Information one by one. : Add College Teaching staff Information Refresh

FirstName FatherName Department Teacherid CurrDesignation

of 50 No data available in table Account 0 to 0 of 0 entries 1

Note Kindly use Internet Explorer(version 7+), Mozilla Firefox (version 14+) or Google Chrome(version 20+) to fill in the form : Use Mouse to move between fields for entry of data instead of using Tab Key Fields marked with*are mandatory. Please allow pop-ups in your browser whenever asked. Please fill all the forms by selecting the tab name in the header. If you have not yet downloaded the Annexure templates to be uploaded in various sections of the Visitation form. Please click here to download the template applicable to your college (i.e. Ayurveda or Siddha or Unani). For any issues, Clarifications please contact CCIM Helpdesk Email-Id: [email protected] or Mobile Numbers: 9654401726, 9654401763 Please download the user manual for filling the Part 1 visitation proforma here

Note Click on the below "Add College Non Teaching staff Information" button to add all the College Non Teaching staff Information one by one. : Add College Non-Teaching staff Information Refresh

Name of Date of Employee ID Full Name Designation Working Appointment(dd/MMM/yyyy) Department

No data available in table Account 0 to 0 of 0 entries 1

of 50 Hospital Infrastructure Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

of 50 Hospital Infrastructure

Ajmal Khan Tibbiya College, Institution Id : UNI0313 Institution Name : AMU, Aligarh. Institution Course : Unani Visitation Id : A00144

*Statutory Requirements compliance for the teaching hospital

*Does the teaching hospital of the college fulfill the Statutory Requirements of the concerned State/Union Territory/Local Authority to establish and run the hospital? Yes No Not Required

*Hospital Administration Block

S. No. Name of the Departments Available Area (in Sq. mtr.)

1. Superintendent room

2. Deputy Superintendent room

3. Medical officers ( for 2 Resident Medical Officer/Resident Surgical Officer)

4. Matron room

5. Assistant Matron room (for 2)

6. Reception and Registration

Total Constructed Area in Admin Block (in Sq. mtr)

*Hospital OPD Block

of 50 S.No Name of the Departments Available Area (in Sq. mtr.) Hospital OPD and IPD Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0. 2. If you have not yet downloaded the Annexure templates to be uploaded in various sections of the Visitation form. Please click here to download the template applicable to your college (i.e. Ayurveda or Siddha or Unani).

of 50 Hospital OPD and IPD Details

Ajmal Khan Tibbiya College, Institution Id : UNI0313 Institution Name : AMU, Aligarh. Institution Course : Unani Visitation Id : A00144

*No. of OPD (Out Patients Department) Patients in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

S.No Name of the Departments Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Dept Tot

1. Moalajat

2. Amraze Jild wa Tazeeniyat

Jarahat & Ain-Uzn-Anf-Halaq wa 3. Asnan

4. Qabalat wa Amraze Niswan

5. Amraze Atfal

6. Tahaffuzi wa Samaji Tibb

Month Total

*Grand Total

*Details of Total Bed Days Occupied in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

S.No. Name of the Departments Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Dept Tot Moalajat including Ilaj bit 1. tadbeer and Amraz-e-Jild wa Tazeeniyat Jarahat including Ain, Uzn, Anaf 2. wa Halaq

4. Amraze Atfal

Month Total

*Grand Total

Note To calculate total number of bed days occupied of the months please calculate the date wise total number of patients, remained on bed at midnight.

*No. of IPD (In Patients Department) Patients in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

S.No Name of the Departments Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Dept Tot Moalajat including Ilaj bit Tadbeer & Amraze 1. Jild wa Tazeeniyat

2. Jarahat & Ain-Uzn-Anf-Halaq wa Asnan

4. Amraze Atfal

of 50 Month Total

*Grand Total

*Total Number of Beds Existed in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

Additional Bed For No. of Existing beds for S.No. Name of the Departments existing PG(Clinical Total no of available beds UG Dept) : bed ratio 1:4 Moalajat including Ilaj bit tadbeer and Amraz-e-Jild 1. wa Tazeeniyat

2. Jarahat including Ain, Uzn, Anaf wa Halaq

3. Qabalat wa Amraze Niswan wa Atfal

*Total Number of Beds Existed in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

*Bed Occupancy in %

of 50 Other Hospital Details Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0. 2. If you have not yet downloaded the Annexure templates to be uploaded in various sections of the Visitation form. Please click here to download the template applicable to your college (i.e. Ayurveda or Siddha or Unani).

Other Hospital Details

Ajmal Khan Tibbiya College, AMU, Institution Id : UNI0313 Institution Name : Aligarh. Visitation Id : A00144 Institution Course : Unani

*Labour Room

*Is Labour Room functional? Yes No *Is Antenatal Room with attached Toilet functional? Yes No *Are Facilities for Neonatal care available? Yes No *Are other facilities, Equipments, Instruments available? Yes No *Total number of Deliveries performed in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014) *Number of other procedures conducted in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

*Operation Theatre

*Is Minor Operation Theatre Available? Yes No

of 50 *Does Air Conditioning exists? Yes No

*Does Pre Operative Room with attached toilet exists? Yes No

*Does Sterilization Room exists? Yes No

*Does Changing and wash room with attached toilet exists? Yes No

*Are other facilities, Equipments, Instruments available? Yes No

*Is Fumigation facility available? Yes No *Total Number of operations done in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

*Investigations

Investigations done in the last calendar year (i.e.1st Jan 2014 - S.No. Number 31st Dec 2014) 1. Total number of X-rays done

2. Total number of ECG done

3. Total number of USG done

*Central Laboratory

Investigations done in the last calendar year (i.e.1st Jan 2014 - S.No. Number 31st Dec 2014) 1. Total Number of Hematological Tests

2. Total Number of Bio-Chemical Tests

3. Total Number of Serological Test

of 50 4. Total Number of Microbiological Tests

Total number of Investigations done in the last calendar year (i.e.1st Jan 5. 2014 - 31st Dec 2014)

*Details of Tadabeer in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

S.No. Tadabeer Carried Out From OPD From IPD Total

1. Fasad

2. Hajamat

3. Dal'k

4. Riyazat

5. Taleeq

6. Hamam

7. Others

*Details of Medical Camps conducted in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014)

*Please upload Annexure III details of Medical Camps conducted by college in the last calendar year (i.e.1st Jan 2014 - 31st Dec 2014) here

of 50 Hospital Staff Details Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

of 50 Hospital Staff Details

Institution Name Ajmal Khan Tibbiya Institution Id : UNI0313 : College, AMU, Aligarh. Institution Visitation Id : A00144 Unani Course : Hospital Staff

No. of Available S.NO Post Staff

*1 Hospital Superintendent

*2 Deputy Medical Superintendent

*3 Consultants

Resident Medical Officers/ Resident Surgical *4 Officer/Medical Officers (RMO/RSO/MO)

*5 Matron/Nursing Superintendent

*6 Assistant Matron

*7 Staff nurses for In Patient Deptt.

*8 Ward Boy or Ayah

*9 Pharmacists

*10 Dresser

*11 Store Keeper

Office Staff (for registration, record maintenance, *12 data entry etc.)

*13 Dark-room Attendant

*14 Operation Theater Attendant

*Total

Modern Medical Staff

No. of Available S.NO Post Staff

*1 Medical Specialist

*2 Surgical Specialist

*3 Obstetrician and Gynecologist

*4 Pathologist

*5 Anesthesiologist

of 50 Page 29 of 50 Note Kindly use Internet Explorer(version 7+), Mozilla Firefox (version 14+) or Google Chrome(version 20+) to fill in : the form Use Mouse to move between fields for entry of data instead of using Tab Key Fields marked with*are mandatory. Please allow pop-ups in your browser whenever asked. Please fill all the forms by selecting the tab name in the header. If you have not yet downloaded the Annexure templates to be uploaded in various sections of the Visitation form. Please click here to download the template applicable to your college (i.e. Ayurveda or Siddha or Unani). For any issues, Clarifications please contact CCIM Helpdesk Email-Id: [email protected] or Mobile Numbers: 9654401726, 9654401763 Please download the user manual for filling the Part 1 visitation proforma here

Note : Click on the below "Add Hospital Staff Information" button to add all the Hospital Staff Information one by one. Add Hospital Staff Information Refresh

Name of Employee ID Full Name Designation Working Department

No data available in table Account 0 to 0 of 0 entries 1

of 50 Instruments And Equipments For Dissection Hall, Physiology and Teaching Pharmacy Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

Instruments Details

Institution Name Ajmal Khan Tibbiya Institution Id : UNI0313 : College, AMU, Aligarh. Institution Visitation Id : A00144 Unani Course : DISSECTION HALL

Number of Instruments S.NO Essential Equipment and Instruments and Equipments available

*1 Bone Cutters of various types and sizes

*2 Forceps of various types

*3 Chisels

*4 dissecting scissors of various types and sizes

*5 Tagging

*6 Knifes of various types

*7 Needles of various types

*8 Dissection tables (full size)

*9 Dissection table ( half size)

*10 Laboratory trays

*11 Glass jars with cover for specimen

*12 Embalming machine

*13 Rocking pump/foot sprayer

*14 Disinfecting machine

*15 Buckets

*16 Formaldehyde solution

*17 Carbolic acid

*18 Sodium acetate

*19 Potassium acetate

of 50 *20 Disinfecting solution

*21 Glycerin

*22 Dummy cadaver and models of body parts

Whole body skeleton, bones, dissected/preserved body *23 organs etc

*Total

SAIDLA LABORATORY (TEACHING PHARMACY LAB)

*1 Pestle and Mortar-Small

*2 Pestle and Mortar-Medium

*3 Pestle and Mortar-Porcelain

*4 Pestle and Mortar-Iron

*5 Heating Device-Gas Stove

*6 Heating Device-Electric stove

*7 Heating Device-Hot plate

*8 Heating Device-Chulla (Charcoal)

*9 Vessels-Frying Pan

*10 Vessels-Steel Vessel

*11 Vessels-Spatula

*12 Vessels-Ladles & Spoons

*13 Vessels-Knife

*14 Vessels-Plates

*15 Vessels-Tongs

*16 Measuring Equipments Different Size (Glass)

*17 Big Vessels & Containers-Brass

*18 Big Vessels & Containers-Copper

*19 Big Vessels & Containers-Steel etc.

*20 Balance (Different Capacities) -Physical

of 50 *21 Balance (Different Capacities) -Chemical

*22 Pounding Apparatus

*23 Sieves (Assorted Nos. & Size)

*24 Wet Grinder

*25 Mixi

*26 Juice Extractor

*27 Putas (Different kind)

*28 Pyrometer

*29 Thermo meter

*30 Pressure Cooker

*31 Crucibles

*32 Refrigerator

*33 Jars (Porcelain) Fermentation Purpose

Distillation Apparatus including traditional methods such as *34 Qara Ambiq, Nal Bhabka etc.

*35 Enamel Trays

*36 Spirit Lamp

*37 Microscope

*38 Earthen Vessels-Pots

*39 Almirahs & Racks for storage

*Total

PHYSIOLOGY (Munafeul Aza) LABORATORY

*1 Microscopes with oil immersion

*2 Westergren's pipette for ESR

*3 Haematocrit Tube

*4 Sahli's Haemoglobinometer

*5 Haemocytometer

*6 Sphygmomanometer

of 50 *7 Stethoscopes

*8 Clinical Thermometer

*9 Knee Hammer

*10 Tuning forks

*11 Electrocardiograph

*12 Stop watches

*13 Water Distillation still

*14 Thermometers, balances, Microslides,

*15 Cover slips, glassware

*16 Centrifuge with speed control

*17 Colorimeter (photoelectric)

*18 pH meter Electric

*19 pH comparator with disc

*20 Refrigerator

*21 Newton's colour wheel In a batch

*22 Spirometer

*23 Tonometer

*24 Hydrometer

*25 Viscometer

*26 Osmometer

*27 Stalagmometer

*28 Sterilizer

*Total

of 50 Instruments And Equipments For PHARMACOGNOSY ,PATHOLOGY and MEDICAL BOTANY Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

Instruments Details

Institution Name Ajmal Khan Tibbiya Institution Id : UNI0313 : College, AMU, Aligarh. Institution Visitation Id : A00144 Unani Course : PHARMACOGNOSY LABORATORY

Number of Instruments Essential Equipment and S.NO and Equipments Instruments available

*1 Field magnifier

*2 Compound microscope

*3 Dissecting Microscope

*4 Microscope

*5 Slides box with cover slips,

*6 Blotting/filter papers

*7 Electronic balance

*8 Dissection Box

*9 Enamel Trays

*Total

Reagents

S.NO Reagents/Liquids/Others Availability

*1 Chloroform

*2 Alcohol.

*3 HCL

*4 Sulphuric acid

*5 Sodium, potassium hydroxide

*6 Benedict solution

*7 Sodium nitrate

of 50 *8 Potassium nitrate

*9 Citric acid

*10 Iodine

*11 Ethyl Alcohol

*12 Potassium Iodide

*13 Xylol/pure xylene (slide preparation)

MAHIYATUL AMRAZ LABORATORY (PATHOLOGY LABORATORY)

Number of Instruments Essential Equipment and S.NO and Equipments Instruments available

*1 Binocular microscope

*2 X-ray view box

*3 Sterile disposable lancer/needle

*4 Sahli's Square tube

*5 Hb pipette

*6 Dropper

*7 Glass rod

*8 WBC Pipette

*9 Improved Neubauer chamber

*10 Cover slip

*11 Red cell pipette

*12 Cleaned slides

*13 Incubator

*14 Wintrobe's tube

*15 Pasteur's pipette

*16 Centrifuge Graduatee machine

*17 Westregrens pipette

*18 Rubber teat

*19 Westergrens's stand

*20 Litmus paper

of 50 *21 pH indicator paper strips

*22 Urinometer

*23 Multi stix

*24 Bunsen burner

*25 Test tube

*26 Test tube holder

*27 Filter paper

*28 Steel almirah

*29 Steel rack

*30 Glass Jars with lid of different sizes

*31 Glass view rack

*32 Magnifying lens

*33 Autoclave

*34 Water bath

*35 Separating funnels of various sizes

*36 Stop watch

*37 Ultraviolet lamp

Monocular microscope with oil emersion *38 lens20(e)

*39 Capillary Tubes

*40 Hot air oven

*41 Microscope with oil immersion

*42 Refrigetors

*43 Sterile vessels/bottle to collect samples

*44 BP Apparatus

*45 Stethocope

*46 Thermometer

*47 Tongue depressor

*48 Torch

*49 Knee hammer

*50 Measuring Tape

*51 ENT examination set

of 50 *52 Reflectors(Mirrors)

*53 Weighing machine

*54 Tuning Forks

*55 Nasal speculum

*56 Laryngoscope

*57 Catheters

*58 Probes

*59 Disposable Gloves

*60 Physical balance

*61 Syringe needle destroyer

*62 HBs Ag kit

*63 HIV kit - Tridot (method by T Mitra)

*64 CT and BT kit

*65 Cell counter (haemoautoanalyser)

Renal profile, LET kit, Lipid profile, Blood *66 Sugar kit

*Total

OPD and Labour Room Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

of 50 OPD Details

Labour Room Details

Instruments and Equipments for OPD

Moalajat

*Number of Equipments and S.No.Equipments, Instruments, Furniture Instruments available 1 X-Ray View Box

2 BP Apparatus

3 Stethoscope

4 Examination Table

5 Thermometer

6 Tongue depressor

7 Cotton balls

8 Torch

9 Measuring tape

10 Weight and height measuring stand

11 Knee Hammer

12 Washbasin

Jarahat

*Number of Equipments and S.No.Equipments, Instruments, Furniture Instruments available

1 Hand washing facility

2 Drainage facility

3 Minor OT.

4 Instruments for anorectal examination

of 50 5 Examination Table

6 BP Apparatus

7 Thermometer

8 Surgical Blades

9 Cotton Balls

10 Gauze pieces

11 X-ray viewing Box

12 Stethoscope

13 Cheetle's forceps

14 Torch

Ain-Uzn-Anf-Halaq wa Asnan

1 Tuning forks

2 Ophthalmoscope/fundoscope

3 Auroscope

4 Examination Table

5 X-Ray Viewing Box

6 BP Apparatus

7 Stethoscope

8 Thermometer

9 ENT kit

10 Torch

11 Bull's lamp

Qabalat wa Amraze Niswan

1 Weighting machine

2 Sim's speculum

of 50 3 Thermometer

4 Cusco's speculum

5 Examination Table

6 Lamp stand

7 Torch

8 X-Ray Viewing Box

9 BP Apparatus

10 Stethoscope

11 Measuring tape

12 Washbasin

Amraze Atfal

1 Scale

2 Weighing machine

3 Torch

4 View Box

5 Thermometer

6 BP Apparatus

7 Stethoscope

8 Examination Table

Ilaj bit Tadbeer

1 X-Ray View Box

2 BP Apparatus

3 Stethoscope

4 Examination Table

5 Thermometer

of 50 6 Tongue depressor

7 Cotton balls

8 Torch

9 Measuring tape

10 Weight and height measuring stand

11 Knee Hammer

12 Washbasin

Massage table, Glass tank for Leeches, Cupping sets, 13 Venesection set etc.

Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

OPD Details

Labour Room Details Instruments and Equipments for LABOUR ROOM

of 50 *Number of Equipments and S.No.Essential Equipments and Instruments Instruments available

1 Shadowless Lamp

2 Suction Machine (Neonatal)

3 Oxygen Cylinder and Mask

4 Foetal Toco Cardiograph

5 Radient Warner

6 Phototherapy Unit

7 Weighing Machine (Paediatric)

8 Patient trolley

9 Anaesthesia trolley

10 Infantometer

11 Vacuum extractor

12 Foetal Doppler

13 Low cavity forceps

14 Steriliser

15 Machintosh rubber sheet

16 Catguts and Thread

17 Speculum - Sim's

18 Speculum - Cuscos

Instruments for labour and Episiotomy (Scissors, forceps, needle 19 holders etc.)

20 Baby tray

21 Draw Sheets

22 Plastic Aprons

23 HIV kit for emergency patients

24 Plain and Hole towels

25 Gloves

26 Nebuliser

27 Foetoscope

28 Auto Clave

29 Drums

of 50 30 Instrumental Trolley

31 OT tables and head Up and head low facility

32 Double dome Shadowless lamp

33 Pulse Oxymeter

34 Oxygen Cylinder

35 Resuscitation kit

36 Boyle's apparatus

37 Electro Cautery

38 MTP Suction Machine

39 Anaesthesia Kit

40 Blunt and Sharp Curettes

41 Dilators set (Hegar's, Hawkins)

42 Anterior Vaginal Wall retractor

43 Uterine sound

44 Volsellum

45 MTP Suction Curette

46 Needles

47 Needle holders

48 Sponge holding forceps

49 Towel Clips

50 Retractors abdominal (Doyne's etc.)

51 Green armytage forceps

52 Uterus holding forceps

53 Kocher's forceps

54 Artery forceps (Long, short, Mosquito)

55 Scissors- different sizes

56 Forceps obstetrics

57 Tongue depressor

58 Endotracheal tubes

59 B.P. apparatus

60 HSG Cannula

of 50 61 Cord Cutting appliances

62 I.U.C.D. removing hook

63 Bladder Sound

Version9.01.00

of 50 Operation Theatre Form Important Instructions : 1. If any of the value is not available or not applicable then please put it as 0.

Institution Details

Instruments and Equipments for Operation Theatre

JARAHAT

*Number of Equipments and S.No.Essential Equipments and Instruments Instruments available

1 Spot light (Shadowless ceiling fitted)

2 Needle holding Forceps (big-medium-small)

3 Aprons

4 Specimens Jar

5 Dressing drums of Assorted size

6 Drum stand

7 IV Stand

8 X-ray View Box (double)

9 Surgeon's gown

10 Mask and caps

11 Gauze, cotton and Bandage

12 Gloves of different size

13 Cheetles Forceps

14 Towel Clips

15 Mosquito forceps

16 Scissors straight (Tailor)

17 Scissors curved of different sizes

18 Stitch removal Scissors

19 Dissection forceps

of 50 20 Sinus forceps

21 Probes - Assorted size

22 Pointed scissors

23 Gastric and Intestinal clamps (occlusive and crushing)

24 Abdominal Retractors

25 Tissue Forceps

26 Bob Kock's Forceps

27 Kocher's forceps

28 Urethral Dilators

29 Rubber catheters of Assorted size

30 Metal Catheters

31 Corrugated Rubber drain

32 Suturing Needle (straight/curved) of Assorted size

33 Surgical Thread

34 Sponge holding forceps

35 Right Angle cholecystectomy Forceps

36 Stone holding forceps

37 Proctoscope with or without illuminator

38 Bougies (Megars)

39 Allies Forceps small

40 Allies Forceps Big

41 Pile holding forceps

42 Artery Forceps small

43 Artery Forceps big

44 Artery Forceps Medium

45 Sigmoidoscope Rigid/flexible

46 Barron Pile's Gun

47 Laryngoscope Pediatric/Adult

48 Boyles Apparatus

49 Multiparameter Monitor

50 Ambu Bag

of 50 51 Suction machine Electrical/Manual

52 Generator (Minimum 30 KV)

53 Emergency light

54 Fire Extinguisher

55 Skin grafting knife with handle

56 Surgical blades of different size

57 BP Handle of different size

58 Vertical BP Instrument

59 Self Retaining Retractor

60 Bone Drill Machine

61 Bone cutter

62 Giggly Saw

63 Scoop

64 Periosteum elevator

65 Maggler Forceps

66 E.T. Tubes of different sizes

67 High Pressure Autoclave

68 Fumigator

69 Refrigerator

70 Nitrous Oxide Cylinder

71 Exhaust Fan

72 X.ray view box

73 Auto linen Washing Machine

74 Hydrolic Operation Table

75 Shadow less lamp ceiling

76 Anaesthesia Trolley/Boyle's Apparatus

77 Instrument Trolley

78 Endotracheal Tube

79 Ambu Bag

80 Proctoscope with or without illumination

81 Revolving Stool

82 Gabriel Syringe

of 50 Version9.01.00

of 50 Declaration Important Instructions : 1. The declaration form at the end to be Submitted once all the forms are completed.

Declaration

Payment Information of Digitisation Fee

Note Digitisation Fee in the form of DD to be handed over to visitation team at the time of visitation :

*Digitisation Fee Payment *Bank Name Transaction Type

*Digitisation Fee Draft Bank Branch /Transaction Code Reference No.

*Digitisation Fee *Bank City Paid Amount

*Digitisation Fee Payment Date Declaration by Principal

I, Dr. Saud Ali Khan Principal, Ajmal Khan Tibbiya College, AMU, Aligarh. solemnly writing that if any information provided by me in proforma and Annexures found false, I shall be held responsible in the matter. I shall have no objection if any legal action is taken by the CCIM against me.

I Agree (Principal)

Note This is an electronic form and requires no signature. Clicking on 'I Agree' by the Institution signifies that the : Principal has agreed to the information submitted for this visitation.

Version9.01.00