Standardized revised 25092017

P^i t iir iNgI4FrqArroN

Dated Chandigarh 7tui lo l 7

No 3781992-3HB-lll- The Covernor ol Haryana is pleased to ordef Standardized and fevised l-lospitaJ jee and charges upto Civil Hospital level- I tri I

S |krnN9__ ]_ _

OPD Parchee fee

2 lndoof Admission fee

l Hospital Bed Chafges Ceneral Ward

4 Hospital Bed Charges Private room

5 MLC Charges

6 Dupiicate copy of MLR

1 Posl Morlem examination Duplicate copyof postrrortent repon

9 Laboratory Investigations (biochem istrypathology amp rulicrobiology) not covefed in assL[ed ]ist of MN1]Y and noo Haryana

Table A Iilpe - ot Teppoea Exempted categorieslFacitry

Civil Hospital SDH FRU CHC

(Sub csntres amp PHCS are exempted)

Civii Hospital SDH FRU CHC

(Sub centres amp PHCs are exempted) Civil Hospiral SDH FRIJ CHC

4

(Sub centres amp PHCs are exempted)


Civil Ilospital SDH FRU CHC

Civil Hospital SDH FRU CHC Civil Hospital SDH FRU Civil Hospital SDH FRU


lChurseRs5- | r BPL of HatiValid for I I 2 Antenatal postnatal woDrcn (Lrpio calerddr yedr | 4i dar s afier oelrver)

Rs l0- for each adlnission

Rs I 0- per day

Rs 250f per day

Rs250- pel MLR

Rs250-

Flee for 1

Rs 100-

lhe lob investigations surgrcat package charges and dental procedLrres charges as pfoposect In MMIY notificalior The charges of investigation aDd

J i I la ls tuplo | )eart RBSK lr| amp DFtrc

| 4 R-fA UncorsoiolLs tJnknown

I 5 Sexral asarh virjnr

J 6 Prisonets court casespolice custodv I mectcatexantnatjon

1 BPL of Haryana 2 Ante atai Postltatal wonle| (pto I

42 days a fier delivery)L Inlbnrs (upto I yeaf) RBSK IBSy i

amp DEIC RTA Unconscious Llnknown j

Sc l cali viri i

6 Prisonltrs cortn caltslntice cultt1 Inedical exantinaion

7 All fanlily plalning procedures lMirrlap Lalr|onpr rL1ir NSV IUCD insejlioD Lrtc )

8 Ali llaryarra Cov(ftJrtnr ntp r pensioners and thejr dependents as per Haryalt6 Civil Sefvice fUles vrlil l lr^^ Dli--r- _ L-- tttyt __tt_-ll1-- None l

I

_--li - trrL oT itaryana i

L Anttat1l losrlrrtat ^ottrn tj J 1we r1-l^ri --

l lrrrls rrpro l 1ea r RlJSl I amp DL JC

L RTA L ncor iorr L n r^sr5 Seurl assa ll ttitn

c()lJl( it ( J)1 t rcr^1 h1-r^

lff lquested by Court of Police

I

ll requested by Courrr or police i

jL BPL of l-lirryana2 Antenatal PostnataJ ontcll

(Lrpto 42 days afier delivef )l Intants (Upto I year)ltUSK l

IBSY amp DEIC]4 RTA UnconsciousUnklorrn

I

5 Sexuai assault victinr 6 Prisoner-s cou cases police I

custodv nredrl Pnrtr^r^

(3

procedures nol All Haryana Cove nlent residents

employees pelsloners arlo tnetr Surgical Civil Hospital covered in MMIY

10

package and SDH FRU as per Annexure I dependenls as Per liaYana

Civil Sefricc fLrles (valid l1n denlal procedure CHC

lndoof Patients onlY)ch4fges nol covered in

asslrred list of MMIY and non-Haryana tesloen$ 1

Service entry Class- lamp Il Rs500f ll medical

examinaion fee Class III Rs200l r Stare of

I

I

Rs 100-Flaryana Class- IV NOlle

Centml Covenllrent elrployee or Rs 500f each i private sectof emploYee

t2 Driving license lee Arms license fee Medical N OieRs 100-

Exarrination fbr students otr

I

adurission ll Birth and death I

As per the provisiotl ofthe Birth and Death Registralion Actcertificaie and I

their copies

OPD registration charges of Ayurvedic College Kurukshetra for the Aniformity is rounded off to Rs 5-

ANNEXURE I

Charges ( )SrNo Name of the Test 5Hemoglobin Estimation (hb)

2 Total Leukocyte Count (TLC) l0 t0

3 Differential Leukocyte Count( DLC) +

Peripheral Blood Film l0

) MP (Slide Method) x 0

l06 ESR

7 Complete Hemogfam 50

Total Eosinophilic Count (TEC) l0 t09 Bleeding Time (BT)

Clotting Time (CT) l0

Prothrombin Time (PTl) 2A

2 PTT-K 60

3 PT-]NR 25

4 BIood Croup (ABO-RH typing) l0

5 Blood Sugar (Fasting PP amp Rardon) 0 each I est

100 6 HbAlc

1 Clucose Tolerance Test (CTT) r00

2A r 8 Blood Urea x

I S Creatinine 20

20 SBilitubin (T) 40

21 SBilirubin (D) + 30

t022 SBilirubin (l)

23 SCOT 30

5024 SCCT l025 soii -

6

___

1

26t 27

28

29

10

ll 32

t3 il 35

16

l7

38

39

40

42

43

45

41

48

49

50

5t

52

SAlkaline Phosphastase

STotal Protein

Sefum Lithium

Serum Protein tAC ratio

S Uric Acid

irgsrglvt Serurn Sodium

Serurr CalciLrrn

Serun Phosphorus _ Serlrm Potassium

serlrJn u tz Assay

Serum lron

Serum Ferritin

Serum lron TIBC amp Serurn Ferritin

Total Lipid profrle

Serum Triglycelides HDL Cholesterol

gr1rrir$f RA factor

C-Reactive Protein

T3

ISH I CPK T

CPK MB I

LDH )53 I FSH

54 ] LH xj5 I Serum Prolactin 56 ] Serum Progestefone

51 Ser um Am lase

58 j Selum Calcium

59 ] Lactate DehydrQgenase (LDH) 60 I Serurn Lrpase

61 I Free PSA (Total FreePSA) 62 I Serum HCC

6r ] fI iT 4 I cA- I5 65 Troponin T or Troponin I

66 I VDRL Rapid Test

67

68

69 70

11

12

13

74 7 5

16

17

78

19

80

8l

6N

HIV Rapid Test

HBSAC (Rapid) Test

HCV

Widai Test

Water exiIninatton (Bacterio loeica_-_Slood culture +r

Fungus CultLrre

AFB Culture

I ) r r

PLs UrjneSernvn Sloor (g1 q-x111 Sputurr for AFB

Urine Microscopy

Urine Biochemistrv

Ljrine Complete Lll1lCl1 rf r) -I

i0 20

20

30

50

l0 25

25

l0 r00

25

t00

t50

rc0

30

l0 l0 100

50

25

80

80

90

]]5 160

60

100

r00

80

200

25

25

50

50

r00

r00

254

250

r00

20

50

50

r00

2A

0

t00

70

50

0

50 per test

0

t0

t0 20

0

)

81 I Lr inarl Berrce Jones Proreirs r BJP)

81 ] Urinary Crearinine r2a Hrs Quanrirarive) d4 | Lrirre Uroortirroger (Qud ra Ve)

8i ] Plerrral Fluid Asciric lluid Microscopy

86 I Pieural FIuidAscitic Fluid Gluscose

8 ] PIeuIal FluidAscitic Fluid Protein

PleuralrFluidAscitic FIuid Protein and SeruqAlbumin88 I

89 ] CSF Clucose

90 I CSF Proteins

9t ] CSF Mjcroscopy

9t I Semen Examination roLltiDe

93 I Stool for Ova and Cyst

94 I Stool for OccUlr Blood q5 Cefvical Pap Snteal

96 I Bone marrow with iron stajn

97 I Bone marrow cytology

ry I Xray x

09 l luro image

1OO IVP

l0l lBariurr Meal

102 Barium Swailow

103 I Barium Enema

104 Mammography

r05

106

107

108 r09

lt0 lll 1l

|3 I 14

I 15

6

I 17

r 18

l I9

120

121

t22

123

)24

125

126

t27

t28

t29

130

r3t

|]2 r33

174

6^

-

Ultrasonography r USC ) i Electr ocardiography (ECC) o

D-Echocard ioaraolrv 1

Stress Echocafdiography

Color doppler

Exercise TMT

ABP (Anlbulatory blood pressure monitoring ) Holtef

EEC

Bone Dersil) Meas rrernerrL Deaacarr

ECT Charges

ABC

ABG Along with Elecrrolytes (Na + K +)

Audiometfy test

Fibroptic Endoscopy

Sclerctherapy without Anaesthesia

Sc)erotherapy with Ceneral ADaesrhesia

Fibroptic Bronchoscopy

Rigid Bronchoscopy

Conrplete Lung Function assessnent inclLrding body Plethysmography

Special Pulmonary function Tests (PFT) (Lung volrrres Airway resistarce colnpliance etc)

Asciric flud PJeirl fluid and Absce Tappru Tracheostomy Thoracocentesis (chest tube ier-io FNAC Biopsy

Colposcopy

Estrogen Receptor

rygI Rt-LUr]l0aI pLutcture

Bone Marrow aspiration

Bone Inarrow biop6J

25

25

50

25

25

25

50

25

25

25

20

a

20

0

50

50

50

20

00

00

00

00

00

00

00

30

r00

250

t50

250

250

250

r00

r00

50

t00

0

r00

r00

r80

100

s00

150

200

t00

150

t25

210so 270

100

r00

4tJ0

1

l]5 rslCllOlosirl TFd Iar-- l]6 i00

As proposed by NACO137

r38 ESWL Laet Theaov-fr On Publicprjvale l=i-----r39 ic ruat)sts partnership (ppp) ro be

r 40 cF charled as approvcd fates_-These tests will be done fiee J cost Government Health IDstitutioDsCuidelinis ur_

wherever availabG aJFJilvrv 1+ The cost oltltese tests are as per An

lj-rtrn$3furill[ilifi+dhilt1iiJri]rlxyilr

This notification will come into force wei date ofthe notificatior n the Official Cazette

AMIT JHA PlircjpaJ Secretary to Covi of flaryana

Health Depadmenl Endst no i78t 992^lHBllI

Dared chandigafh the a70r20r7 A copy is forwarded to the c Printing alld Stationary Harvana-Chardigarrr with rhe feqreslthat the above notific otiltroller

copies orrhe norificarion nuy prur u1ui]l]iirJ-rdinarv Harvana covnn cori uiioii

^ Depury Secrerary Healrh ror ]rnctpal Secretar) lo Covl oJ l_Jcrlrr

Health Depaftne|t EnAst Do3igA992_3HBlI

Dated Chardigarh rh e 07012017A copy is forwarded to the following fo jnformation and necessary action please

L The principal Accountant Ce2 Vice chanceor L

pr ilJf ]llijjjil tl|Jiilji1iAIJ Administrative Secretarier oournment ofHaryara4 Arj Head ofthe counnn rto)PunttscorporationsBoards Haryana State5 Ail Deputy c0fim jor

6_M jssion Director NHI4 Direclor Ceneral Health Services_Z8 Director AyUSH

9 Direcror MER l0 Prir rc jpa^Cor

ern lnen t A) ureda College Krnrl5htraI i ( tvtj 5urgeons in Harata J2

_AlJ pMO Medical Superinrenoenr irr Haryarra

I 3 Executive Director HS HRC Haryana Sectof 2 panchku la14 AccouDrs Officer He All Djsrrjct Oo Ciuit Surgou15 All Treasury Officers in the Stare

7 QvVt-UepUry Secretary Healrll

ror rr tJtctpal Secrelary to Covr of Harylrrrr Health Departntenr

procedures nol All Haryana Cove nlent residents

employees pelsloners arlo tnetr Surgical Civil Hospital covered in MMIY

10

package and SDH FRU as per Annexure I dependenls as Per liaYana

Civil Sefricc fLrles (valid l1n denlal procedure CHC

lndoof Patients onlY)ch4fges nol covered in

asslrred list of MMIY and non-Haryana tesloen$ 1

Service entry Class- lamp Il Rs500f ll medical

examinaion fee Class III Rs200l r Stare of

I

I

Rs 100-Flaryana Class- IV NOlle

Centml Covenllrent elrployee or Rs 500f each i private sectof emploYee

t2 Driving license lee Arms license fee Medical N OieRs 100-

Exarrination fbr students otr

I

adurission ll Birth and death I

As per the provisiotl ofthe Birth and Death Registralion Actcertificaie and I

their copies

OPD registration charges of Ayurvedic College Kurukshetra for the Aniformity is rounded off to Rs 5-

ANNEXURE I

Charges ( )SrNo Name of the Test 5Hemoglobin Estimation (hb)

2 Total Leukocyte Count (TLC) l0 t0

3 Differential Leukocyte Count( DLC) +

Peripheral Blood Film l0

) MP (Slide Method) x 0

l06 ESR

7 Complete Hemogfam 50

Total Eosinophilic Count (TEC) l0 t09 Bleeding Time (BT)

Clotting Time (CT) l0

Prothrombin Time (PTl) 2A

2 PTT-K 60

3 PT-]NR 25

4 BIood Croup (ABO-RH typing) l0

5 Blood Sugar (Fasting PP amp Rardon) 0 each I est

100 6 HbAlc

1 Clucose Tolerance Test (CTT) r00

2A r 8 Blood Urea x

I S Creatinine 20

20 SBilitubin (T) 40

21 SBilirubin (D) + 30

t022 SBilirubin (l)

23 SCOT 30

5024 SCCT l025 soii -

6

___

1

26t 27

28

29

10

ll 32

t3 il 35

16

l7

38

39

40

42

43

45

41

48

49

50

5t

52


STotal Protein

Sefum Lithium


S Uric Acid


Serurr CalciLrrn


serlrJn u tz Assay

Serum lron

Serum Ferritin


Total Lipid profrle


gr1rrir$f RA factor

C-Reactive Protein

T3

ISH I CPK T

CPK MB I

LDH )53 I FSH


51 Ser um Am lase

58 j Selum Calcium





67

68

69 70

11

12

13

74 7 5

16

17

78

19

80

8l

6N

HIV Rapid Test

HBSAC (Rapid) Test

HCV

Widai Test


Fungus CultLrre

AFB Culture

I ) r r


Urine Microscopy

Urine Biochemistrv


i0 20

20

30

50

l0 25

25

l0 r00

25

t00

t50

rc0

30

l0 l0 100

50

25

80

80

90

]]5 160

60

100

r00

80

200

25

25

50

50

r00

r00

254

250

r00

20

50

50

r00

2A

0

t00

70

50

0

50 per test

0

t0

t0 20

0

)







89 ] CSF Clucose

90 I CSF Proteins

9t ] CSF Mjcroscopy






ry I Xray x

09 l luro image

1OO IVP

l0l lBariurr Meal

102 Barium Swailow

103 I Barium Enema

104 Mammography

r05

106

107

108 r09

lt0 lll 1l

|3 I 14

I 15

6

I 17

r 18

l I9

120

121

t22

123

)24

125

126

t27

t28

t29

130

r3t

|]2 r33

174

6^

-




Color doppler

Exercise TMT


EEC


ECT Charges

ABC


Audiometfy test

Fibroptic Endoscopy




Rigid Bronchoscopy




Colposcopy

Estrogen Receptor



Bone Inarrow biop6J

25

25

50

25

25

25

50

25

25

25

20

a

20

0

50

50

50

20

00

00

00

00

00

00

00

30

r00

250

t50

250

250

250

r00

r00

50

t00

0

r00

r00

r80

100

s00

150

200

t00

150

t25

210so 270

100

r00

4tJ0

1
























___

1

26t 27

28

29

10

ll 32

t3 il 35

16

l7

38

39

40

42

43

45

41

48

49

50

5t

52


STotal Protein

Sefum Lithium


S Uric Acid


Serurr CalciLrrn


serlrJn u tz Assay

Serum lron

Serum Ferritin


Total Lipid profrle


gr1rrir$f RA factor

C-Reactive Protein

T3

ISH I CPK T

CPK MB I

LDH )53 I FSH


51 Ser um Am lase

58 j Selum Calcium





67

68

69 70

11

12

13

74 7 5

16

17

78

19

80

8l

6N

HIV Rapid Test

HBSAC (Rapid) Test

HCV

Widai Test


Fungus CultLrre

AFB Culture

I ) r r


Urine Microscopy

Urine Biochemistrv


i0 20

20

30

50

l0 25

25

l0 r00

25

t00

t50

rc0

30

l0 l0 100

50

25

80

80

90

]]5 160

60

100

r00

80

200

25

25

50

50

r00

r00

254

250

r00

20

50

50

r00

2A

0

t00

70

50

0

50 per test

0

t0

t0 20

0

)







89 ] CSF Clucose

90 I CSF Proteins

9t ] CSF Mjcroscopy






ry I Xray x

09 l luro image

1OO IVP

l0l lBariurr Meal

102 Barium Swailow

103 I Barium Enema

104 Mammography

r05

106

107

108 r09

lt0 lll 1l

|3 I 14

I 15

6

I 17

r 18

l I9

120

121

t22

123

)24

125

126

t27

t28

t29

130

r3t

|]2 r33

174

6^

-




Color doppler

Exercise TMT


EEC


ECT Charges

ABC


Audiometfy test

Fibroptic Endoscopy




Rigid Bronchoscopy




Colposcopy

Estrogen Receptor



Bone Inarrow biop6J

25

25

50

25

25

25

50

25

25

25

20

a

20

0

50

50

50

20

00

00

00

00

00

00

00

30

r00

250

t50

250

250

250

r00

r00

50

t00

0

r00

r00

r80

100

s00

150

200

t00

150

t25

210so 270

100

r00

4tJ0

1
























)







89 ] CSF Clucose

90 I CSF Proteins

9t ] CSF Mjcroscopy






ry I Xray x

09 l luro image

1OO IVP

l0l lBariurr Meal

102 Barium Swailow

103 I Barium Enema

104 Mammography

r05

106

107

108 r09

lt0 lll 1l

|3 I 14

I 15

6

I 17

r 18

l I9

120

121

t22

123

)24

125

126

t27

t28

t29

130

r3t

|]2 r33

174

6^

-




Color doppler

Exercise TMT


EEC


ECT Charges

ABC


Audiometfy test

Fibroptic Endoscopy




Rigid Bronchoscopy




Colposcopy

Estrogen Receptor



Bone Inarrow biop6J

25

25

50

25

25

25

50

25

25

25

20

a

20

0

50

50

50

20

00

00

00

00

00

00

00

30

r00

250

t50

250

250

250

r00

r00

50

t00

0

r00

r00

r80

100

s00

150

200

t00

150

t25

210so 270

100

r00

4tJ0

1
























1
























Documents

Standardized revised 25092017