CENTRAL COUNCIL OF INDIAN MEDICINE NEW · PDF file1 Proforma 13(c) for Siddha Colleges 2008 CENTRAL COUNCIL OF INDIAN MEDICINE NEW DELHI PROFORMA TO BE FILLED UP BY THE SIDDHA

1 Proforma 13(c) for Siddha Colleges 2008

CENTRAL COUNCIL OF INDIAN MEDICINE

NEW DELHI

PROFORMA TO BE FILLED UP BY THE SIDDHA COLLEGES

(Additional sheet may be enclosed as and where required)

PART –I

Section ‘A’

Name of the College

Full Address with pin code

Name of the State/UT

Telephone No./Fax/E-mail

Name of the Managing Body

With full address

Telephone No./Fax/E-mail

Whether Government/Grant-in-aid/private/

Statutory college of university (Enclose document as annexure -1)

Year of Establishment of Society/Trust (Enclose Registration certificate and copy of bye-laws as

annexure-2)

Year of Establishment of College

Date & Year of the permission of

the State Govt. (Enclose Certificate as annexure-3)

Whether permission of State Government is

continuing, If yes please enclose the proof,

otherwise college authorities may give a certificate

in the form of affidavit regarding continuation of

permission of State Government. (Proforma enclosed)

Name of affiliating University


Date & Year of affiliation (Enclose Certificate as annexure-4)

Whether affiliation of the University is

Continuing, if yes please enclose the proof

otherwise college authorities may give a certificate

in the form of affidavit regarding continuation of

affiliation of the University. (Proforma enclosed)

(Yes/No)

Date of last inspection by the University (Enclose the Copy of compliance of the shortcomings point

out by the University, if any)

Date and year of first permission of CCIM with

intake capacity

Name of the Principal with Qualifications and

Experience

Time Table

(Copy to be enclosed)

Presently the College, Hospital and Hostels are on its own land or lease, details be furnished as

mentioned below:

Total Area of Land (in acres)

Total area of land allotted to the college (in acres)

Total area of land allotted to the hospital (in acres)

Total area of land allotted to the hostels (in acres) Girl`s

Boy`s

*Constructed Area of the college (in Sq.ft.)

*Constructed Area of the Hospital (in Sq.ft.)

*Constructed Area of the Hostel is (in Sq.ft.)

*Area certificate of layout plan in blue print with details of Departments should be attached duly singed by the Govt. Authorized

Engineer/Architect.

Ownership of land

If it is in the regional language, then attach Certified

English/Hindi translation duly attested by Gazetted

Officer.(Enclose Certificate)

In the name of the Society/Trust

In the name of President/Secretary


Whether land is on ownership by registry or lease

basis If on lease basis, then period of lease

Whether entire land is in one plot or more than one.

If more than one, then size and distance between

these plots* (Government Authorized Engineer’s certificate to be attached)

Whether the land available with the Society/Trust is

entirely for Siddha College and attached Hospital or for

any other Institute also, if so, details thereof. (Proforma Enclosed )

Financial Information

Year Total income receipt

during last three years

Total expenditure receipt of last three years

2006-07

2007-08

2008-09

Attested audited Report to be enclosed

Details of the following to be provided: Previous Year (1st Jan- 31

st Dec)

1. Salaries of teaching and non teaching Staff

2. Salaries of the Hospital Staff

3. Expenditure on Drugs

4. Expenditure on raw material for drugs

Administrative Block

Total Area in Sq. ft.

S.No. Name Area of the Space

1. Office of the Principal

2. Committee Room

3. Account Section

4. Administrative Section

5. Central Store Room

Status of the College (Courses being conducted)

UG:

PG:


Section ‘B’

Graduate Course Number of students admitted during the last five

years

Year

Intake permitted by CCIM

Admitted in First Professional

Passed in Third Professional

Percentage Passed in Third Professional

2004-2005

2005-2006

2006-2007

2007-2008

*2008-2009

* List of student admitted during 2008-09 to be enclosed.

Details information details of Post-graduate Course of previous year: S.

No,

Name of the Subject Intake permitted by CCIM/Govt.

of India

Number of

scholars

admitted

Number of passed

students previous

year

1. Maruthuvam

2. Gunapadam

3. Sirappu Maruthuvam

4. Kuzhanthai Maruthuvam

5. Noi Nadal

6. Nanjunoolum Maruthuvam

Neethinoolum


*Departments required as per norms of CCIM with area and Available

Infrastructure for Teaching and Training

1. TAMIL LANGUAGE (If required)

Total Area in sq. ft.

Details of Teaching staff

Designation Sitting space in

Sq.ft.

Name Qualification Experience

Professor

Reader

Lecturer

Details of Non-teaching staff

Designation Name Qualification

Clerk/ Typist

Peon

Sweeper cum cleaner

Details of Furniture

Detailed list of Charts


2. SIDDHA MARUTHUVA ADIPPADAI THATHUVANGALUM VARALARUM



Designation Sitting space

in Sq.ft.


Professor

Reader

Lecturer



Typist/ Clerk

Peon

Sweeper cum cleaner

Details of Space in Sq. ft.

S. No. Name Available Area in Sq. ft.

1. Departmental Library (PG)

2. Tutorial Room (PG)

Number of books available in Departmental library 1. Siddha 2. Ayurveda

3. Unani 4. Modern Medicine 5. Other


Detailed list of Equipments & Instruments

Detailed list of Models


Others


3. UDAL KOORUGAL

Total Area of Dept. in sq. ft.



Sq.ft.


Professor

Reader

Lecturer



Museum keeper

Typist

Peon

Lifter

Sweeper cum cleaner



1. Museum

2. Dissection hall

3. Cadaver tank/ room





Number of specimens of human organs available (List be enclosed)

Number of Dissection tables

Number of Cadavers Available (Enclose Proof)

Number of Cadavers dissected previous year

Others


4. UDAL THATHUVAM




Sq.ft.


Professor

Reader

Lecturer



Lab Assistant

Typist/ clerk

Peon

Sweeper cum Cleaner





Number of books available in Departmental library 1. Siddha 2. Ayurveda 3. Unani 4. Modern Medicine 5. Other






5. UYIR VEDHIYAL

Total Area of Dept. in sq. ft.



Sq.ft.


Professor

Reader

Lecturer



Lab Assistant

Museum keeper

Peon

Sweeper cum Cleaner



1. Biochemistry Laboratory






6. GUNAPADAM




Sq.ft.


Professor

Reader

Lecturer



Sweeper cum Cleaner

Peon

Sweeper cum Cleaner





3. Museum







7. NOI NADAL




Sq.ft.


Professor

Reader

Lecturer



Lab Assistant

Typist

Peon

Sweeper cum Cleaner





3. Pathology Laboratory

Number of books available in Departmental library 1. Siddha 2. Ayurveda

3. Unani 4. Modern Medicine 5. Other






8. MARUTHUVA THAVARA IYAL




Sq.ft.


Professor

Reader

Lecturer



Lab. Assistant

Typist

Peon

Sweeper cum Cleaner



1. Museum

2. Laboratory

List of single crude drugs as per Syllabus






9. NUNNUYIR IYAL




Sq.ft.


Professor

Reader

Lecturer



Lab Assistant

Typist/clerk

Peon

Sweeper cum Cleaner



1. Laboratory

2. Museum





Others


10. NOI ANUGAVIDHI OZHUKKAM




Sq.ft.


Professor

Reader

Lecturer



Lab Assistant

Typist/clerk

Peon

Sweeper cum Cleaner



1. Museum





Others


11. SATTAM SARNTHA MARUTHUVAMUM, NANJU NOOLUM




Sq.ft.


Professor

Reader

Lecturer



Museum keeper

Peon





3. Museum







12. MARUTHUVAM –POTHU




Sq.ft.


Professor

Reader

Lecturer



Typist

Peon

Sweeper cum Cleaner





3. Museum







13. SIRAPPU MARUTHUVAM INCLUDING YOGA & VARMAM




Sq.ft.


Professor

Reader

Lecturer



Typist

Peon

Sweeper cum Cleaner





3. Museum







14. ARUVAI MARUTHUVAM INCLUDING ENBUMURIVU AND PALMARUTHUVAM




Sq.ft.


Professor

Reader

Lecturer



Typist

Peon

Sweeper cum Cleaner

Number of books available in Departmental library 1. Siddha

2. Ayurveda

3. Unani

4. Modern Medicine

5. Other






15. SOOL, MAGALIR AND KUZHANTHAI MARUTHUVAM




Sq.ft.


Professor

Reader

Lecturer



Typist

Peon

Sweeper cum Cleaner





3. Museum







NUMBER OF EXISTING TEACHING STAFF S.No.

Department

Professor

Reader

Lecturer

1. Siddha Maruthuva Adippadai

Thathuvangalum Varalarum

2. Tamil language 3. Uyir Vedhiyal 4. Udal Koorugal 5. Udal Thathuvam 6. Gunapadam 7. Noi Nadal 8. Maruthuva Thavara Iyal 9. Nunnuyir Iyal 10. Noi Anugavidhi Ozhukkam 11. Sattam Sarntha Maruthuvamum, Nanju

Noolum

12. Maruthuvam –Pothu 13. Sirappu Maruthuvam Including Yoga &

Varmam

14. Aruvai Maruthuvam Including Enbumurivu

And Pal Maruthuvam

15. Sool, Magalir And Kuzhanthai

Maruthuvam

Pay Scale of teachers Designation Pay Scale as per State Govt

(Yes/No)

Pay Scale as per UGC

(Yes/No)

1. Professor

2. Reader

3. Lecturer

Mode of Payment

Whether PF/GPF scheme is existing or not

Promotion policy

Number of teachers possessing Graduate

Qualification but working as teachers prior

to 13-10-2006

Number of teachers possessing Post-graduate

Qualification.

Number of UG teachers appointed after 13. 10. 06

Payment of Pay and Allowances through

bank/cash (please enclose proof)

21

Proform

a 13(c) for Siddha Colleges 2008

PROFORMA TO FURNISH THE DETAIL

S O

F TEACHIN

G STAFF

S.No

.

Nam

e of

teacher

Father’s Nam

e Date of

Birth

Designation

Qualifications UG &

PG level along with

details of Awarding

body &

speciality of

Post-graduate Course

Date of

Appointm

en

t

Nature of

appointm

ent :

Regular/

reem

ployed

Details of experience in

chronological order

Departm

ent

in which

teacher has

been

appointed

Whether the

appointm

ent is in

subject concerned

or in Allied

subject as per

CCIM

norm

s

Dura

tion

Designa

tion

Nam

e

of the

college

Note:

i) Details of contractual teacher should also be furnished as per Proform

a separately with documentary proof.

ii) Please attach the verified copy of Under-graduate and Post-graduate degrees.

iii) Full nam

e of teacher and father’s should be mentioned.

22

Proform


PROFORMA TO FURNISH THE SALARY DETAIL

S O

F TEACHIN

G STAFF

S.No.

Nam

e of teacher

Designation

Nam

e of the

Board or Council

where teacher is

registered

Registration No.

along with date.

Pay Scale

Basic Pay

DA &

Other

allowances

Deduction

GPF/CPF/IT

Gross

Pay

Net pay

Contact

No.

1

2

3

4

5

6

7

8

9

10

11

12

23

Proform


PROFORMA TO FURNISH THE DETAIL

S O

F O

THER STAFF (Other than teaching staff)

Nam

e of Employee

Father’s Nam

e

Qualification

Date of appointm

ent

Designation

Nam

e of

Departm

ent

1

2

3

4

5

6

24

Proform


PROFORM

A T

O F

URNIS

H T

HE SALARIE

S DETAIL

S O

F O

THER S

TAFF (Oth

er than tea

chin

g staff)

1. S.No. 2. Nam

e of

the

employee

3. Designation 4. Scale

of pay

5.

Basic

Pay

6.

DA

&

Other

allowances

7. Deduction

8. Gross Pay

9. Net pay


LIBRARY

Area of Library (in Sq.ft.)

1. Number of Rooms/Halls

Number of books available (List of books be enclosed) a) Siddha Ayurved Unani

b) Modern

c) Others

Total

2. Journals/Magazines being subscribed a) Siddha/Ayurved/ Unani

b)Modern Medicine

c)Other

3. Seating arrangements in reading room

4. Working hours

5. Staff

Librarian

Asst. Librarian

Library Attendant/Peon

6. Purchase of books in last academic year

Number and cost of the books (List to be enclosed)

7. Facilities available in the library

a. E-library – number of computers

with printer and internet facility

b. Photocopying machine and printer

c. Drinking (Filtered) water facility

d. Separate toilet for boys & girls

e. Separate reading room for Faculty

members

8. Any other Remarks


STUDENTS HOSTEL

i) Building Own/Rented/Lease a. Constructed area of boys hostel

b. Constructed area of girls hostel

c. No. of rooms available for Boys

d. No. of rooms available for Girls

ii) Number of seats available in Boys

hostel

iii) Number of seats available in Girls

hostel

iv) Mess facility available Yes/No

v) Reading room

vi) Any other remarks

PHARMACY

Building Area in Sq.ft. Own/Lease

Staff

Name of the post Name Qualification

Superintendent

(HOD Gunapadam)

Deputy Superintendent

(M.D Gunapadam)

Machine Operator

Labour (Number)

Attach the list of equipments


HERBAL GARDEN

i) Area (in acre)

ii) Number of Plants with name and

number of species (List to be enclosed)

iii) Plant Nursery details

iv) Available Irrigation facility

v) Staff (List to be enclosed) (i) _________________________

(ii) _________________________

(iii)_________________________

(iv) __________________________

vi) vi) Remarks

CLASS ROOMS

Class Room Area in Sq.ft. Seating capacity Available facilities

AUDITORIUM

Area in Sq. ft.

Seating capacity

Available facilities

STAFF ROOM

Area in Sq. ft.


GIRLS COMMON ROOM


Area in Sq. ft.


BOYS COMMON ROOM

Area in Sq. ft.


SPORTS AND GAMES FACILITY

1. Indoor Games Facilities

2. Outdoor Games Facility

3. Play ground (Area in Sq. ft.)

4. Store Room (Area in Sq. ft.)

CANTEEN

Area in Sq. ft. Seating capacity

TRANSPORT FACILITY

1. Students own/hired

2. Staff own/hired


Section ‘C’

HOSPITAL

1. Reception and Enquiry 2. Registration counter 3. Office of Medical Superintendent/

Medical Deputy Superintendent

4. RMO Room OPD SECTION:

Name of OPD Section

S.

no.

Name of

Department

Area

(Sq. ft.)

Facility Available (Equipment,

Instrument, Furniture etc)

Number

1. Pothumaruthuvam

(General Medicine)

• Hand washing facility

• Drainage facility

• View Box

• BP Instrument

• Stethoscope

• Sitting arrangement for

internees/students

• Examination Table

• Thermometer

• Tongue depressor

• Cotton balls

• Torch

• Measuring tape

• Weight and height

measuring stand

• Hammer

2. Sirappumaruthuvam

(SpecialMedicine)



• View Box

• BP Instrument

• Stethoscope


internees/students


• Thermometer

• Tongue depressor

• Cotton balls

• Torch

• Measuring tape

• Weight and height

measuring stand

• Hammer


3. Aruvai Marutuvam

Including

Enbumurivu and

Palmaruthuvam

(Surgery)



• Instruments for anorectal

examination


• BP instrument

• Surgical Blades

• Cotton balls

• Gauze pieces

• View Box

• Stethoscope


internees/students

• Cheetle’s forceps

• Torch

3.

Sool, Mahalir and

Kuzhanthai

Maruthuvam

(Gynae, Obs. &

paeds)



• Weighing machine

• Sim’s speculum

• Cusco’s speculum


• Lamp stand

• Torch

• View Box

• BP Instrument

• Stethoscope


internees/students

• Measuring tape

• Scale

• Baby Weighing machine


internees/students

5. Puramaruthuvam

(External Treatment)


internees/students

• Scale

• Weighing machine


CASUALTY

Area

(Sq. ft.)

No. of Beds Facility Available (Equipment, Instrument, Furniture

etc)

MINOR OT

Area (Sq. ft.) Facility Available (Equipment, Instrument, Furniture etc)

NUMBER OF PATIENTS ATTENDED OPD

i) Total no. of OPD patients during

previous year (1st Jan to 31

st Dec.)

ii) Daily average of patients in all sections

of OPD during previous year

(1st Jan to 31

st Dec.)

DISPENSARY

Area of Store room of Drugs

in sq. ft

Area of dispensary in sq. ft

Details of quantity with name of drugs dispensed during last year

1.

2.

3.

4.

5.

6.

Medical Record Room (Area in Sq.ft.)


IPD SECTIONS WITH BED STRENGTH

Name of the Department Bed strength

(i)

(ii)

(iii)

(iv)

(v)

(vi)

(vii)

Total

No. of wards/ Hall/ rooms in IPD

Total number of patients admitted in IPD

during previous year (1st Jan to 31

st Dec.)

¶ Average bed occupancy during previous

year (1st Jan to 31

st Dec.)

Other Available facilities in IPD Section

(Enclose List)

¶ Bed occupancy should be calculated on formula i.e.

Total number of beds occupied during previous year x 100

Total Number of Beds x 365


HOSPITAL STAFF (OPD AND IPD)

STAFF

S.No. Name of the Post Name Qualification

1 Superintendent (Principal or Dean

of the college may also be ex-officio)

2 Deputy Superintendent

1 Physician(AllProfessors, Readers &

Lecturers of Clinical Subjects)

2 Doctods for OPD (6)

3 Casualty Medical Officer (3)

4 Pharmacist for OPD (2)

5 Nurse for OPD (2) + 1for Gynae OPD

6 Dressers for OPD (2)

7 Ward Boy/Attendants for OPD (2)

8 Clerk for OPD (2)

9 Sweeper cum Cleaner for OPD (2) or

on contact basis

IPD

Number available in the Hospital

1 Physician Specialist 1 Part time

2 Surgeon 1 Part time

3 Gynaecologist 1 Part time

4 Radiologist 1 Part time

5 Pathologist 1 Part time

6 Anesthetist 1 Part time/on

call

7 X-ray technician 1

8 Clinical Registrar 1 for each

clinical deptt.

9 RMO 1

10 House Officer/PG

student

1 for 20 beds

11 Matron/Nursing

Superintendent

1

12 Asstt. Matron 1 for 100 beds

13 Staff Nurse 1 for 25 beds


14 Ward

boy/Ayah/ANM

1 for 25 beds

15 Pharmacist 2

16 Store Keeper 1

17 Head Clerk 1

18 Cook 1 for 50 beds

19 Kitchen Attendant/

Cook

1 for 25 beds

20 Plumber On contract basis

21 Watch Men 3 or on contract

basis

22 Lift men for

multistoried

building

2 or on

contract basis

23 Electrician 1 (part time)

24 Dark Room

Attendant

1

25 Operation Theatre

Attendant

2

26 Labour Room

Attendent

2

27 Sweeper cum

Cleaner

1 for 25 beds or

on contract

basis

28 Statistician part time

29 Photographer part time

CLINICAL PATHOLOGY & BIO CHEMISTRY LAB

Area (Sq. ft.) Facility Available (Equipment,

Instrument, Furniture etc)

Details of investigations

performed

OTHER FACILITIES AVAILABLE IN THE HOSPITAL

X-Ray please mention the M.A. ECG USG Number of X-Rays, ECG and USG done during previous year (Ist Jan. to 31

st

Dec.)(Enclose the supporting Document)


PARTMENT OF PURAMARUTHUVAM

STAFF

S.No. Staff Name Qualification

1. Puramaruthuvam Teachers of the

subject

2. Puramaruthuvam vaid 1 Male

1 Female

3. Puramaruthuvam Nurse 2

4. Puramaruthuvam Technician 1

5. Puramaruthuvam Assistant 1 Male

1 Female

6. Thokkanum therapist 1 Male

1 Female

7. Sweeper cum Cleaner 2

Facilities Available

Massage Tables (2)

Steam bath Facility 1 Male

1 Female

Splint

Required utensil for Thokkanum

therapy.

Details of the Instruments------- (Enclose List)


LABOUR ROOM

Area (600 Sq.ft.)

Waiting Room with attached Toilet

Labour Room

Facilities for Neonatal care

Other Available Facilities, Equipments,

Instruments

Number of Deliveries performed during

previous year (1st Jan to 31

st Dec.)

(Enclose list)

OTHER INFORMATION

Fumigation Details

Ambulance


Certificate

It is certified that all above said information is correct to the best of

my knowledge. If any furnished information is found false, the

undersigned shall be liable for necessary action against.

*Signature of the Authorized Competent Signature of the Principal of

authority of the Trust/Society the college

(with seal) (with seal)

* it is applicable for the private colleges and grant in aid colleges only.

*****

***

*


Documents

CENTRAL COUNCIL OF INDIAN MEDICINE NEW · PDF file1 Proforma 13(c) for Siddha Colleges 2008 CENTRAL COUNCIL OF INDIAN MEDICINE NEW DELHI PROFORMA TO BE FILLED UP BY THE SIDDHA