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HEALTH & FAMILY WELFARE DEPARTMENT,

HIMACHAL PRADESH

CHIEF MEDICAL OFFICER SHIMLA, DISTT. SHIMLA, H.P.

Phone: 0177-2657225 Fax: 0177-2657225

Website: https://hptenders.gov.in

Email: (cmoshimla@gmail.com)

NOTICE INVITING EXPRESSION OF INTEREST (EOI)

EOI Reference Number. HFW-SML(MOH)DH&FWS/MMU (EOI) /2019/ 186 Date-. 02 .02.2019

The Expression of Interest (EOI) is invited from the various RKS/NGOs/Pvt. Hospitals/Societies/

Registered Companies /Trusts for Operation and Maintenance of two Mobile Medical Units

(MMUs) in Shimla District. The detailed tender document can be viewed and downloaded from

website: https://hptenders.gov.in, from 08.02.2019 to 02.03.2019 up to 11.00 AM. The Last date and

time for submission & uploading of filled in tender documents is 02.03.2019 at 11:00 AM. The

Tender will be opened on 02.03.2019 at 11:30 AM. All subsequent corrigendum, modifications and

clarifications in respect of this tender will be published only on aforesaid website. The bidders are

advised to visit the aforesaid website without assigning any reason.

Chief Medical Officer,

Shimla, H. P. -171001.

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HEALTH & FAMILY WELFARE DEPARTMENT,HIMACHAL PRADESH

CHIEF MEDICAL OFFICER SHIMLA, DISTT. SHIMLA, H.P.

Phone: 0177-2657225 Fax: 0177-2657225

Website: https://www.hptenders.gov.in

Email: (cmoshimla@gmail.com)

EOI Reference Number. HFW-SML(MOH)DH&FWS/MMU (EOI) /2019/ 186 Date-. 02 .02.2019

E-TENDERING SCHEDULE:-

Date & Time of on-line publication : 08.02.2019 at 3:00 PM

Period for Downloading of e-tender document : 08.02. 2019 to 02.03.2019 up to 03:00 PM

Last date and time for submission / uploading of e-

tender alongwith cost of tender document, Earnest

Money Deposit

02.03. 2019 upto 11:00 AM

Chief Medical Officer,

Shimla, H. P. -171001.

Date & Time for opening of e-tender Bid :

02.03.2019 at 11:30 AM

Venue: Chief Medical Officer,

Shimla, H. P. -171001.

Cost of the tender document : Rs. 1000/-(Demand Draft {Non Refundable})

Earnest Money Deposit (EMD) : The Earnest Money Deposit of Rs. 25000/- is

required to be deposited in the shape of Fixed

Deposit Receipt duly pledged in favor of Chief

Medical Officer, Shimla, H. P. -171001.

i) Tenderer shall ensure that Cost of tender document, Fixed Deposit Receipt towards Earnest Money

Deposit, are dropped in the tender box placed in the office of Chief Medical Officer, Shimla, H.P.-

171001 on or before the last date and time indicated above.

ii) If the date fixed for the opening of tender is declared a holiday, the tender shall be opened on the next

working day at the same time as fixed for the original date for this purpose.

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Expression of Interest (EOI) for Operation and Maintenance of Two Mobile Medical Units (MMU) in Shimla District, H.P. Framework The Chief Medical Officer Shimla invites Expression of Interest (EOI) from the various

RKS/NGOs/Pvt. Hospitals/Societies/ Registered Companies /Trusts for strengthening of public health facilities in rural and remote areas of Shimla District by Integrated Medical Checkups, Diagnostics and Referrals to the Hospitals by providing fixed day village camp services for a period of 1 (One year) from the date of the award of the contract and further extendable on the basis of the performance and mutual consent of both the parties. Objective To make Primary Health Care services Promotive, Preventive, Diagnostic and Curative to be made available in underserved and un-served habitations in remote areas of the District

Shimla as per the scope of work at ANNEXURE- I at the door steps of the people free of cost to overcome the problems of accessibility and availability of health care facilities and service providers. Scope of basic services is to provide health camps in the field for all working days in a month in the form of village level health camps as per jointly agreed route & site plan. The camps will be held on the fixed days except on Gazetted/National Holidays. The following services are to be provided:- 1. Diagnostics:

Blood Sugar HB RFT LFT ME for Malaria Urine R & ME Hep-B HIV Blood group Any other tests if required in future

2. Curative services: Referral of Complicated cases; Early detection of TB, Malaria, Leprosy and other locally endemic diseases both

communicable and non-communicable like hypertension, diabetes, and cataract cases etc.;

Minor surgical procedures and suturing. 3. Reproductive & Child Health Services:

Antenatal checkup and related services e.g. injection- tetanus toxoid, iron and folic acid tablets;

Referral for complicated pregnancies; Promotion of institutional delivery; Post Natal checkup; Immunization clinic- to be coordinated with local sub centers and PHC’s; Treatment of common childhood illness such as diarrhea, ARI/Pneumonia,

complications of Measles etc;

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Treatment of RTI/STI; Adolescents care such as lifestyle education, counseling, treatment of minor

ailments and anemia; 4. Family Planning Services:

Counseling for spacing and permanent method; Distribution of Nirodh, oral contraceptives, emergency contraceptive; IUD insertion.

5. Emergency services and care in time of disaster/epidemic/public emergency/

accidents etc.

6. IEC Material on health including personal hygiene, proper nutrition, use of tobacco, diseases, PNDT Act, RT/STI, HIV/AIDS, all Swasthya cards (PMJAY under Ayushman Bharat, Mukhya Mantri Health Care Scheme and Universal Health Care Protection Scheme.), Recent amendments about issuing of disability certificates and digitalization, and other National Health Programmes on LED Screen.

7. Staff Composition:

Name of the Staff Qualifications Number of positions per MMU

Medical Officer Male MBBS 1

Pharmacist D-Pharmacy 1 Lab-technician DMLT / BSc. MLT 1 Driver 10th and Heavy Vehicle Lenience 1 Class -IV Employee 10th Class 1

Supporting staff should be well aware of local parlance. Adequate reserve staff shall be maintained for continuity of services in case of leaves to the staff.

8. Duties And Responsibilities Of The Staff Of The MMU Medical Officer

a. MO will be the in-charge and overall responsible for the effective functioning of the MMU. The other staff of the MMU will work under his/her supervision on a day-to-day basis.

b. In case of referral to the nearest facility, the MO shall maintain suitable records (detail address and the cause of emergency in the register and log book of the vehicle) and issue a clear descriptive referral slips MO and MO I/c of the PHC shall take immediate appropriate actions during outbreaks of diseases and epidemic and inform concerned BMO as well as to render assistance as required and feasible.

c. MO I/C will be responsible for submitting monthly report on prescribed format to

CMO Shimla as per “ANNEXURE J” d. MO I/C will be responsible for verifying all stock, inventory and drug issue register

etc. Pharmacist cum Administrative Assistant

a. To dispense the medicines to the patients prescribed by the MO in the MMU. b. To take appropriate action for Bio Medical Waste Management with the MO.

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c. To maintain all adequate stock, inventory and issue registers. d. To carry out all other tasks as ordered by the MO of the MMU.

Laboratory Technician

a. To carry out the diagnostic tests/laboratory tests as per the requirement and feasibility.

b. To keep the required documents/records related to laboratory services. c. To prepare the monthly report and submit to the MMU MO. d. To carry out all other tasks as ordered by the MO of the MMU.

Drugs/ Medicines will be available as per Mukhya Mantri Free Drugs Policy in PHC’s.

as per ANNEXURE –D. 9. Service Description And Responsibilities

1. Maintenance of Mobile Medical Unit along with the equipments therein in good condition. The MMU should be equipped with all the equipments proposed in

“ANNEXURE -C” and staff as per the requirement given as above in point No. 7 of the objectives.

2. Conducts the Clinics at the designated villages as per pre-scheduled dates with the staff and equipment and as per the Service Plan/Route plan/Calendar for MMU as approved by the District Health Society Shimla.

3. The MMU vehicles shall be provided with necessary fuel for carrying on operations on regular basis and maintained periodically.

4. Conducting diagnostic tests and dispensing medicines to the patients. 5. Diagnostic Reports shall be provided to the patient/beneficiary on neatly designed

report card. The medicines to the non-communicable diseases and also for the minor ailments shall be given.

6. MMU vehicles shall be equipped with GPS device and the service provider will

ensure the functioning of the GPS device. 7. Every Service provided at the clinic i.e. number of beneficiaries attended, number

of patients treated, number of laboratory diagnostics conducted and medicines provided etc., shall be maintained the record on real time basis.

8. The service provider shall follow the standard operating procedures (SOPs) as

approved by the competent authority in District Health Society Shimla as per

ANNEXURE -H. 9. Service provider shall display the board in all villages about the date and time of

clinic conducted by MMU and phone number for submission of grievance. 10. The staffs recruited/ appointed shall be exclusively on Pay roll of the service

provider. The Service Provider will ensure deployment of the adequate personnel

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as enumerated above to keep the MMU operational and capable of providing the services as agreed upon. All the matter pertaining to their service matters like pay, leave, EPF, ESI etc. will be sole responsibility of service provider as per guidelines issued by State Government time to time.

11. The service provider would procure all necessary road and goods permits on behalf

of District Health Society Shimla for the MMU as per Motor Vehicle Act and maintain the same throughout the period.

12. Service provider shall communicate the names and addresses of the Team

managing a particular MMU during the currency of the agreement and any change in the composition of the team must be intimated to the authority nominated by the District Health Society Shimla. The names of men at work at the MMU at any point of time must also be displayed prominently on the MMU.

13. The Service provider will also comply with confidentiality and privacy laws

including patient details. 14. All records maintained by the Service provider regarding operations of MMUs will

be made available to District Health Society Shimla authority including audit on demand.

15. It should be clearly understood that under no circumstances, the MMU will be used

to advertise the operations of the service provider. It should be clearly mentioned on the outer body of the MMU that Government of Himachal Pradesh provides the service.

16. Requirements of any Act promulgated by the Central State Law will have to meet by

the service provider. 17. Service provider shall establish Administrative Office and register it in Himachal

Pradesh and all the communication shall be made from it. All the financial transactions shall in the Name of the office established in Himachal Pradesh.

10. Responsibilities of District Health Society Shimla:

1. Provides the 2 (TWO) vehicles to the service provider with good condition, GPS, all

medical equipments as stated in ANNEXURE - C and logo. 2. Supply free of cost good quality generic drugs and consumables as per the Mukhya

Mantri Nishulk Dawai Yojna ANNEXURE -D based on the requirement from the service provider through concerned BMO for village health camps in their respective blocks. District Health Society Shimla Government of Himachal Pradesh would make all efforts to keep the MMU well stocked with drugs and consumables at all the times. Supplies shall be made within 10 days of requisitions. Service Provider has to ensure proper accountal of drugs and consumables being issued for MMU and shall submit their expense report after each camp by email to CMO and concerned BMO.

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3. Ensure the attendance of ASHA of concerned village to attend the clinic and support

the service provider for discharging their duties. Besides this MHW/FHW will attend the clinic as per the plan.

11. REFERRAL PROCESS & ELIGIBILITY

It will be the responsibility of District Health Society Shimla to provide the Service provider an “information matrix” for nearest facilities including their capacity in terms of existing Laboratory services, diagnostic services, and human resources available.

It will be the responsibility of the Service Provider to keep the Medical Officer in

charge of the MMU informed of the information matrix. For services not available at the MMU, patients can be referred to nearest facility in accordance with the “information matrix“.

Both the parties hereby agree that no patient will be referred to any private medical

establishment either formally or informally without specific prior approval of the District Health Society Shimla.

With this objective District Health Society Shimla is looking for legal entities (NGOs /

Registered Companies /Trusts/Society) who have the experience of carrying out outreach activities and community level interventions related to Curative Services and other services as specified above. 12. THE E-EXPRESSION OF INTREST DOCUMENT SHALL BE UPLOADED IN TWO PARTS: Technical Bid: The Bidders shall have to submit and upload required documents,

information required in the EXPRESSION OF INTREST document in the website:

https://hptenders.gov.in . It shall contain scanned copies of all requisite documents,

certificates etc. as specified in the EXPRESSION OF INTREST document duly filled in and

digitally signed. All the documents must be scanned and uploaded in pdf format with 100

dpi with black and white option. The scanned documents should be clear and legible.

(ANNEXURE A, B, & F) these annexure duly filled in should also be attached with the

technical bid.

Financial Bid/Price Bid/BOQ: It shall contain financial bid / BOQ uploaded in .xls format

that will be available for Bidder on website website: https://hptenders.gov.in online. The

financial bid/BOQ will be opened only of those Bidders who qualify in the technical bid

evaluation. Financial Bid/BOQ will not be accepted in physical form as the format of BOQ

is given at Annexure-E as sample of specimen. Date & Time for opening of Financial

Bid/Price Bid/BOQ shall be published on the aforesaid website after technical evaluation

and declared technically qualified by the Committee constituted for the purpose.

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13. General Terms & Conditions Two Mobile Medical Units (MMUs) has been distributed to Distt. Shimla.

Should employ minimum One doctor (MBBS), One Pharmacist, One Lab Tech, one

driver, one Class IV for each MMU.

Should be registered body under relevant act (Indian Societies registration Act/ Indian Religious and Charitable Act/ Indian Trust Act/ Indian Companies Act) for more than 3 years.

The organization should have minimum 2 years experience in managing outreach activities in the areas of RCH and National Disease Control Programs.

The organization should have the capacity in terms of technical and human resource competency to provide these services.

The organization should have the capacity and technical competency to start the village level outreach activity.

The format for submission of proposal can be downloaded from the website:

https://hptenders.gov.in on or before the last date i.e. 02/03/2019 upto 11.00 AM. The date of opening the bids has been fixed on 02/03/2019 at 11.30 AM in the office of the Chief Medical Officer. The bidders need to submit Earnest money deposit of Rs. 25000/- in the form of FDR from any Nationalized Bank/Scheduled Bank duly pledged in favor of “Chief Medical Officer Shimla, Himachal Pradesh”. Interested organizations who meet the above criteria can upload the proposal in the prescribed format to the office of the undersigned before the last date on website:

https://hptenders.gov.in. Bids received without Earnest Money deposit (EMD) shall stand rejected and thus

shall not be considered for evaluation etc at any stage. The bid security (EMD) shall be returned to the unsuccessful bidders after

finalization of tender process. The EMD of the successful bidder shall be refunded on submission of adequate performance security.

The finally selected bidder has to enter into Agreement with the “District Health

Society Shimla Himachal Pradesh” within 15 days of awarding the work on stamp paper/non-judicial paper of Rs.100.00. Besides this as a guarantee towards due performance and compliance of the contract work, the successful bidder

(agency) will deposit (within 15 days of award of contract) an amount equal to 10% of Annual Contract value towards Performance Security by way of Bank Guarantee/FDR duly pledged in favour of The “Chief Medical Officer Shimla Himachal Pradesh” drawn on any Nationalized Bank/Scheduled Bank and

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payable at Shimla- failing which (EMD) shall be forfeited unless time extension has been granted by “District Health Society Shimla Himachal Pradesh”.

The EMD shall be forfeited if successful bidder to whom the contract shall be awarded, fails to undertake the work or fails to comply with any of the terms and conditions of the contract. In such situation, next lower bidder shall be called for negotiation.

The bid shall be valid and open for acceptance of the Competent Authority i.e. “District Health Society Shimla Himachal Pradesh” for a period of 1 year from the date of opening of the tenders (financial bid) and no request for any variation in quoted rates and/withdrawal of tender on any ground by successful bidder shall be entertained.

The agency / service provider shall be solely responsible for compliance to the

provisions of various Labour and Industrial Laws, such as, wages, allowances, compensations, EPF, Bonus. Gratuity, ESI etc. relating to contractual staff deployed by it for MMU or for any accident caused to them and the District Health Society, Shimla Himachal Pradesh shall not be liable to bear any expense in this regard. The Agency shall make payment of wages to staffs engaged by it by the stipulated date irrespective of any delay in settlement of its bill by the Chief Medical Officer for whatever reason. The Agency shall also be responsible for the insurance of its personnel. The agency/service provider shall specifically ensure compliance of various Laws, rules in force, statutory regulations/Acts applicable to workers including but not limited to with the following and their re-enactments/amendments/modifications:- The Payment of Wages Act 1936 The Employees Provident Fund & Misc. Provision Act, 1952 The Factory Act, 1948 The Contract Labour (Regulation& Abolition) Act, 1970 The Payment of Bonus Act, 1965 The Payment of Gratuity Act, 1972 The Employees State Insurance Act, 1948 The Employment of Children Act, 1938 Industrial Disputes Act, 1947 The Equal Remuneration Act, 1976. The Motor Vehicle Act, 1988

The undersigned reserves the right to accept or reject any EOI, or to modify terms

and conditions and to annul the selection process at any time, without incurring any liability and without assigning any reason thereof. The date of opening the bids has been fixed on 02.03.2019 at 11.30 AM in the office of Chief Medical Officer Shimla.

Dispute, if any, arising out of the MMU contract, shall be settled on priority basis by mutual discussion in the office of the District Health Society Shimla HP, outcome of the same will be binding on both the parties to contract, and in appeal the dispute shall be decided by Director of Health Services within time bond manner. He shall further issue any dispute direction in this subject matter. The Hon’ble Court at Shimla, Himachal Pradesh shall only have the jurisdiction over the same.

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Compliance of Minimum Wages Act and other statutory requirements The Service provider shall comply with all the provisions of Minimum Wages

Act/ Rates of Government (Finance Department) in case of outsourcing employees and other applicable labor laws. The Service provider shall also comply with all other statutory provision including but not limited to provisions regarding medical education and eligibility criteria of human resources used by the Service provider for providing the services, biomedical waste management, bio safety, occupational and environmental safety.

The overall legal responsibility of provision of medical care lies with the Authority/public health facility. The Service provider shall maintain confidentiality of medical records and shall make adequate arrangement for cyber security.

Income Tax Deduction at Source

Income tax deduction at source shall be made at the prescribed rates from the Service provider’s bills. The deducted amount will be reflected in the requisite Form, which will be issued at the end of the financial year.

Periodicity of Payment

The payment will be made on monthly basis. The Service provider will raise its invoice on completion of services during the period duly accompanied by evidences of services provided. The payment will be subject to TDS as per Income Tax Rules and other statutory deductions as per applicable laws.

Damages for Mishap/Injury

The DISTRICT HEALTH SOCIETY SHIMLA, HP shall not be responsible for damages of any kind or for any mishap/injury/accident caused to any personnel/property of the Service provider while performing duty in the DISTRICT HEALTH SOCIETY SHIMLA, HP / consignee’s premises. All liabilities, legal or monetary, arising in that eventuality shall be borne by firm/contractor.

The service provider is the sole custodian of the Government properties handed over to him (Vehicles, Equipment etc). Service provider shall attend the damages to the government property handed over to him with his own funds and hand over the same to the DISTRICT HEALTH SOCIETY SHIMLA, HP on expiry /termination of the contract in good condition.

Termination of Agreement: The DISTRICT HEALTH SOCIETY SHIMLA, HP may terminate the agreement, if the successful Bidder withdraws its Bid after its acceptance or fails to submit the required Performance Securities for the initial agreement and or fails to fulfill any other contractual obligations. In that event, the DISTRICT HEALTH SOCIETY SHIMLA, HP will have the right to purchase the same goods/ equipment from next eligible Service provider and the extra expenditure on this account shall be recoverable from the defaulter. The earnest money and the performance security deposited by the defaulter shall also be recovered to pay the balance amount of extra expenditure incurred by the DISTT.HEALTH SOCIETY SHIMLA, HP. After completion of the tenure of Bid, the Service

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provider will be allowed to vacate the space within a period of 15 days, in all the facilities where service provider was providing the services.

14. ELIGIBILITY CRITERIA

1. The bidder shall be a sole provider or a group of providers/NGO to implement the Project, represented by a lead member/partner. The bidder cannot be an individual or group of individuals. A bidder cannot bid as a sole service provider as well as a partner in a consortium. No bidder can place more than one bid in any form in the state. The bidder should be registered as a legal entity.

2. The bidder and in case of a consortium all the participants shall have at least Three

years experience in providing medical care at community level . In support of this, a statement regarding assignments of similar nature successfully completed during the last three years should be submitted with technical bid. The assignment of Govt. Depts. / Semi Govt. Depts. should be specifically brought out. (The decision of the state government as to whether the assignment is similar or not and whether the bidder possesses adequate experience or not, shall be final and binding on the bidders). The bidders may in addition provide any other documentation in support of their claims of experience in providing community healthcare.

3. The bidder(s) must have average turnover not less than Rs 25.00 Lakhs for the

last three years. A certificate of turnover has to be uploaded with the technical bid duly signed by the Chartered Accountant. The Final Account Statements for last three years must be attached with the Bid for the financial year 2015-16, 2016-17 & 2017-18.

4. The bidder should not have been blacklisted by any government

agencies/local bodies. An affidavit Attested by SDM / Public Notary to the effect should be attached with the EOI.

5. The bidder shall have the following mandatory Registrations failing which bid shall

not be considered and details of the same be provided in the Technical Bid along

with documentary proof as per ANNEXURE -B

PF and EDLI Registration: ESI Registration: Service Tax Registration/GST Registration: Should have PAN from Income Tax Department on the name of the

organization. Registration certificate as proprietary firm, Partnership firm, Limited Company,

Society, any other corporate body etc., as the case may be.

6. In case of Consortium, the lead member shall be legally responsible and shall represent all consortium members, if any, in all legal matters. Eligibility of lead member shall be considered for evaluating the eligibility of the consortium. In other words, lead member should have qualified in all the eligibility parameters on his own strengths.

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15. EVALUATION OF BIDS

1. Two stage evaluation will be taken up for identification of successful bidder a. Technical Evaluation b. Financial Evaluation

2. Technical evaluation of bids will be done as per the eligibility criteria and bidder who declared technically qualified by the Committee will be eligible for financial evaluation.

3. Financial evaluation will be done as per the L-1 basis and successful bidder will be identified.

4. Financial Bid shall be quoted for operational expenditure per month per Mobile Medical Unit. This Operational Cost shall be inclusive of salaries, Fleet maintenance, Capital expenditure, Data Management, Establishment costs, Taxes, Insurances and other incidental expenditure.

5. The capping cost per MMU per year would be Rs. 19.08 lacs and the bidder quoting lesser amount than that of Rs. 19.08 lacs per annum per MMU shall be declared as L-1.

1. Infirmity / Non-Conformity The District Health Society Shimla, HP may waive minor infirmity and/or non-

conformity in a Bid, provided it does not constitute any material deviation. The decision of the DISTRICT HEALTH SOCIETY SHIMLA, HP as to whether the deviation is material or not, shall be final and binding on the Service providers. 2. Bid Clarification

Wherever necessary, the District Health Society Shimla, HP may, at its discretion, seek clarification from the Bidders seeking response by a specified date. If no response is received by this date, the DISTRICT HEALTH SOCIETY SHIMLA, HP shall evaluate the offer as per available information.

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ANNEXURE A PROPOSAL FORMAT FOR ORGANIZATION Section A: Organization Profile 1. Name of the Organization: 2. Registered Address:

DISTRICT PIN:

Tele: Fax:

Email:

Website (if any):

3. Postal Address:

DISTRICT PIN:

Tele: Fax:

Email:

4. Legal Status:

Sl. No No. Particulars Registration no. Date

I Public Charitable Trust Act

II Society under Societies’ Registration Act/ Company under Companies Act

III Registration under Foreign Contribution (Regulation) Act, 1976

IV Income tax registration:

- Under Section 12 A

- Under Section 80G

-Under Section 35 CCA

- Any other Section

5. Bank Details:

Bank Name Account No. Date of opening Account

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Details of the Contact Person : Name: Designation: Contact No: E-mail: Members Associated with the Organization : Sr.No. Name Nationality Occupation/

qualification Position Held in the organization

Relationship with any other office bearer (if any)

Address

Section B: Operational Background 1. Project/Program related to village level health outreach activity: Sr.No.

Name of the Program

Period No of Outreach session per month

Detail of the program

Total Budget

Source of Funds

From To 2. No. of Project/Program undertaken related to Health:

Sl. Name of the Program

Duration Period Total Source No. From To Budget of fund

3. Staff Details: (kindly provide the details of 5 key positions in the organization)

Name of Staff Position Qualification Working since

4. Any previous association/working experience with Govt. Sector? If yes, please provide the details and attach a certificate issued by such entity in support of the proof.

5. Volume of Year wise Grant Received during the last 3 years (in different projects):

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6. Name of the Major Donors / Funders during the last 3 Years: 7. Whether blacklisted by any government or Private organization in the past? If yes,

provide details: Basic Document required to be submitted along with the proposal for Technical Evaluation:- Copy of Trust Deed if registered under Trust Act. Copy of Bye Laws registered under Society Registration Act. Copy of Memorandum of Association and Articles of Association if registered under

Companies Registration Act. Annual Reports of last 3 years. Audited Accounts for the last 3 years. Organizational Chart. Legal Status of the Society/ Company/firm -Copy of Registration Certificate; Copy of PAN/TAN Number. Copies of GST/GSTIN Numbers. Copies of ESI, EPF registration certificates. Turnover certificate for the last three year duly signed by the C.A. Copy of Income Tax Returns for the last 3 years. Affidavit duly attested by Magistrate/Notary Public stating that the firm is not black

listed. Any other document relevant to the proposal.

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ANNEXURE B PARTICULARS OF THE BIDDER (To be submitted by all BIDDERS)

Sl. Item Particulars Remarks No.

1 Name of the Firm/Organization/Company

2 Type of organization

3 Address 4 Date of Registration

5 EPF Registration No.

6 ESI Registration No.

7 Goods Service Tax

8 GSTIN 9 PAN

10 Annual Turn Over

2015-16

2016-17 2017-18

11 Cost of Community Health Services

2015-16 2016-17

2017-18 12 Staff as on 31.03.2018

Medical Officers

Nursing Paramedical

Others Total 13 Number of MMUs operating

2015-16

2016-17

2017-18

Detailed operational proposal shall be enclosed. Proposal shall include operational methodology, HR deployment, Software and Hardware applications and other components. Proposal shall also indicate the implementation time lines.

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ANNEXURE -C SUGGESTED LIST OF EQUIPMENTS AND ACCESSORIES 1. Examination table with steps. 2. Torch 3. Stethoscope 4. BP apparatus 5. Clinical Thermometer 6. Weighing machine (Adult & Child) 7. Knee hammer 8. Measuring Tape 9. Cold Storage(Vaccine Career-2) 10. ENT and Eye examination kits 11. Oxygen cylinder 12. Nebulizer 13. Ambu Bag (Adult & Pediatric) 14. Laryngoscope (Adult & Pediatric) 15. Suction Apparatus (Foot Operated) 16. First aid kit 17. Resuscitation Kits 18. Heamoglobinometer 19. Uristix 20. Microscope 21. Auto Analyzer, Centrifuge and Incubator 22. Generator Set 23. Syringe and needles 24. Suture instrument and material 25. Needle cutter 26. Vaginal specula 27. Water Storage Device 28. Furniture: Foldable cot/chair/tables/stool for pharmacist 29. Linen and rubber sheets 30. Gloves 31. Glass Slides 32. Dust bins-separate for infective and non-infective waste 33. Room Heater

34. Patient cards with NRHM logo (Specimen is attached as ANNEXURE - F) 35. Storage bins for drugs 36. Display board on service offered by MMU Note: The concerned service provider will provide Stationery, public address System, Patient cards with NRHM logo.

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ANNEXURE -D Drugs/ Medicines as per Mukhya Mantri Free Drugs Policy

No. of Drugs

No. of Products

Medicines Dosage Forms

Strength Packing

1 1 Lignocaine Hydrochloriode

Injection 21.3 mg/ml 1 vial 30 ml

2 2 Atropine Sulphate

Injection 0.6 mg/ml 1 Amp 1ml

3 3 Diazepam IP Injection 5 mg/ml 1 Amp 2 ml Amber colour

4

4

Diclofenac

Tablet (sodium)

50 mg 10x10 Tab Strip

5 Injection 25 mg/ml 1 Amp 3 ml

6 Gel 1% w/w 1 Tube 30gms

5

7

Ibuprofen

Tablet 200 mg 10x10 Tab Strip

8 Tablet 400 mg 10x10 tab Strip

9 Susp. 100 mg/5ml 1 Bottle 60 ml

6

10

Paracetamol

Drops 100 mg/ml 1 Pack 15 ml with dropper

11 Tablet 500 mg 10x10 Tab Strip

12 Syrp 125mg/ 5ml 1 Bottle 60ml

7 13 Allopurinol Tablet 100 mg 10x10 Tab Strip

8 14 Cetrizine Tablet 10 mg 10x10 Tab Strip

9 15

Pheniramine maleate

Susp. 15 mg/ml 1 Bottle 100ml

16 Injection (disodium)

22.75 mg/ml 1 Amp 2ml

10 17 Dexamethasone Injection (disodium)

4 mg/ml 1 Amp 2 ml

11 18 Hydrocortisone

Powder for injection (sodium succinate)

100 mg vial 1 Vial

12 19 Levocetrizine Tab 5 mg 10x10 Tab strip

13

20

Promethazine

Tab 25 mg 10x10 Tab strip

21 Injection 25 mg/ml 1 Amp 2ml

22 Susp. 5mg / ml 1 Bottle 60ml

14 23 Adrenaline Injection 1 mg/ml (1:1000)

1 Amp 1ml

15 24 Antisnake venom Injection 10 ml vial 1 vial

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(polyvalent solution) (Dry Powder)

16 25

Phenobarbitone Tablet 30 mg

10x10 Tab Strip

26 Tablet 60 mg 10x10 Tab Strip

17 27 Albendazole Chewable tablet

400 mg 10x10 Tab strip

18

28

Amoxycillin

Capsule (Anhydrous)

500 mg 10x10 Tab Strip

29 Powder for Suspesion

125 mg /5ml 1 Bottle 60ml

30 Dispersible Tablet

250 mg 10x10 Tab strip

19 31 Benzathine Penicillin

Injection powder

12 lacs 1 vial

20

32

Cefixime

Tablet 200mg 10x10 Tab Strip

33 Tablet 100mg 10x10 Tab Strip

34 Dry Syrup 15mg/5ml 1 Bottle 30ml

21

35

Azithromycin

Tablet 250 mg 10x10 tab

10x10 Tab Strip

36 Tablet 500 mg 10x10 tab

10x10 Tab Strip

37 Suspension 200 mg/5 ml 1 Pack 15ml

22 38 Norflox Tablet 400 mg, 10x10 Tab

10x10 Tab Strip

23 39 Ciprofloxacin Tablet (hydrochloride)

500 mg/10x10 tab pack

10x10 Tab Strip

24 40 Doxycycline hydrochloride

Capsule 100 mg 10x 10 cap pack

10x10 Cap Strip

25 41 Gentamycin Injection (sulphate)

40 mg/ ml, 1 vial 2 ml

26

42

Sulfamethoxazole + trimethoprim (Cotrimoxazole)

Tablet 100 mg +20 mg

10x10 Tab Strip

43 suspension 200mg+40mg/5ml ,

1 Bottle 50 ml

44 Tablet 400 mg + -80 mg

10x10 Tab Strip

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27 45 Fluconazole Dispersible Tablet

150 mg ,4x10 tab

4x10 Tab Strip

28

46

Metronidazole

Tablet 200 mg 10x10 tab

10x10 Tab Strip

47 Tablet 400 mg 10x10 tab

10x10 Tab Strip

48 Injection 500 mg/ 100ml ,

1 Bottle 100ml

49 Suspension 200 mg/5 ml bottle

29 50 Ofloxacin+Ornidazole

Tablet 200mg+500 mg

10x10 Tab Strip

30

51

Iron Folic Acid

Tablet Large

100 mg Elevental Iron & 500 mcg of Folic Acid acid(Blue Coloured)

10x10 Tab Strip

52 Tablet Small

45 mg Elemental Iron+ 400 mcg of folic acid ((WIFS Junior), Pink Coloured, Sugar Coated

10x10 Tab Strip

53 Tablet Large

100 mg Elevental Iron & 500 mcg of Folic Acid (Red Coloured)

10x10 Tab Strip

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54 Syrup

50 ml bottle with 1ml autodispenser, each mono-carton of the IFA Syrup must have information leaflet informing parents / care givers regarding need for IFA supplementation, its benefit, dosage, adequate storage, when and whom to administered and what to do in case of mild side effects. (Copy may be obtained from the office of DHS, HP.

1 Bottle 50 ml with 1ml dispenser (Note: Each ml containg 20 mg of elevental iron and 100 mg of folic Acid).

31 55

Folic acid Tablet 5mg

10x10 Tab Strip

56 Tablet 400mcg 10x10 Tab Strip

32 57 Ethamsylate Tablet 250 mg 10x10 Tab Strip

33 58 Metoprolol Tablet 50 mg 10x10 Tab Strip

34 59 Isosorbide dinitrate

Tablet (sublingual)

5 mg 10x10 Tab Strip

35 60 Amlodipine Tablet 5 mg, 10x10 Tab Strip

36 61 Enalapril IP Tablet 5 mg 10x10 Tab Strip

37 62 Telmisartan Tablet 40mg 10x10 Tab Strip

38 63 Clopidogrel Tablet 75mg 10x10 Tab Strip

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39 64 Acetylsalicylic acid

Tablet 75 mg 14x10 Tab Strip

40 65

Polymyxin B Sulphate +Neomicin Sulphate + Zn Bacitracin

Ointment 5000 IU+3400 IU+400 IU / gm

Tube 5 gm

41 66 Silver sulfadiazine

Cream 1% w/w, 1 Jar 500g

42 67 Betamethasone Cream (Dipropionate)

0.025% w/w, 1Ttube 20gms

43 68 Permethrine Lotion 5% w/v, 1bottle100 ml

44 69 Gamma Benzene Hexachloride

Lotion 1% w/v, 1bottle100 ml

45 70 Hydrogen Peroxide Solution IP

Solution 6% w/v, 1 Bottle ! Ltr.

46 71

Povidone iodine Ointment 5% w/v, 1 Tube 15g

Lotion 5% w/v 1 Pack 100ml

47 72 Cetrimide +chlorhexidine sol.

Solution 15%+7.5% , 1 Bottle 1Ltr.

48 73 Gentian Violet Paint IP

Solution 0.5%v/v , 1 Bottle 100 ml

49 74 Frusemide Injection 10 mg/ ml 1 Amp 2ml

50 75 Hydro chlorothiazide

Tablet 12.5mg 10x10 Tab Strip

51

76

Pantoprazole

Tablet 40 mg 10x10 Tab Strip

77 injection 40mg/vial with dilutant

1 vial with dilutant

52 78 Antacid Suspension

Aluminium hydroxide250mg+Magnesium hydroxide 250mg+simethicon 50mg/ 5ml

1 Bottle 170ml

53 79 Ranitidine Tablet (HCL) 150 mg 10x10 Tab Strip

54 80 Metoclopramide Tablet (Hydrochloride)

10 mg 10x10 Tab Strip

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81 Injection (hydrochloride)

5 mg/ ml 1 Amp 2ml

82 Syrup 5mg/5ml , 1 Bottle 30 ml

55 83 Domperidone Tablet 10mg 10x10 Tab Strip

56 84 Doxylamine succinate

Tablet 10 mg 10x10 Tab Strip

57 85

Dicyclomine

Tablet (hydrochloride)

10 mg 10x10 Tab Strip

86 injection 10 mg/ml 1 Amp 2ml

58 87 Hyoscine butyl bromide

Tablet 10 mg 10x10 Tab Strip

59 88 Lactolose Syrup 3.35g / 5ml 1 Bottle 100ml

60 89 Oral rehydration salts

Powder for solution

As per IP WHO formula 20.5Gm / sachet

1 Sachet

61 90 Zinc sulphate DispersibleTablet

20 mg 10x10 Tab Strip

62 91 Glimipride Tablet 1 mg 10x10 Tab Strip

63

92

Metformin

Tablet (hydrochloride)

500 mg 10x10 Tab Strip

93 Tablet (hydrochloride)

1 gm SR 10x10 Tab Strip

64 94 Tetanus vaccine Injection 0.5 ml Ampoule

1 Amp

65

95 Anti Rabies vaccine ( Human Diploid cell)

Injection 1 ml (ID Use) 2.5 unit / 1ml vial

1 vial

96 Injection 0.5 ml (IM use) 2.5 unit / vial 0.5 ml

1 vial

66 97 Chloramphenicol Ointment 1% w/v botlle of 50 applicaps

1 Botlle 50 applicaps

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98 Ear Drops

5 % w/v + 0.025% w/v + 1 % w/v + 2 % w/v ,

1 vial 10ml

67 99 Ciprofloxacin Drops 0.3% 5ml vial 1 vial 5ml

68 100 Gentamycin Eye drops 0.3%w/v, 5 ml 1 vial 5ml

69 101 Saline nasal solution

Nasal Drops 0.65% 1 vial 10ml

70 102 Glycerin Solution 500 gm bottle 1 Bottle 500Gms

71 103

Paradichlorbenzene + Benzocain + Chlorbutol + Turpentine Oil

Ear Drops 2 % + 2.7 % + 5 % + 15 %

1 vial 10ml

72 104

Cough expectorant (Each 5 ml contains Diphenhybramine Hydrochloride 14.08 mg + Ammonium Chloride 138 mg, +Sodium Citrate 57.03 mg, +Menthol 1.14 mg) IP

Syrup 1 Bottle 50ml

73 105 Dextromethorphane Hydrobromide Syrup IP

Syrup 10 mg/5ml 1 Bottle 50ml

74 106 Salbutamol Tablet 4 mg 10x10 Tab Strip

107 Suspension 2 mg/5 ml 1 Bottle 100ml

108

Nebulizing solution

5 mg/ml 1 Pack 15ml

75 109 Theophylline + Etophylline

Injection 169.4 mg + 56.6 mg/2 ml

76 110 Glucose/dextrose

Injectable solution

5%, isotonic 1 Bottle 500ml FFS

77 111 Ringer lactate Injectable IV solution

1 Bottle 500ml FFS

25 | P a g e

78 112 Normal saline Injectable solution

0.9% isotonic W/V

1 Bottle 500ml FFS

79 113 Water for injection

Injection 1 Amp 5ml

80 114 Calcium Carbonate

Tablet

500 mg Elemental calcium + 250mg Vitamin D3

10x10 Tab Strip

81 115 Vitamin A Suspension 100000 IU/ml 1 Bottle 100ml

82 116 B-Complex Tablet

Vit B-1 5mg, B2-5mg, B6-2mg, B12-1mcg, Niacinamide 50mg, Cal. Pentothianate 5mg

10x10 Tab Strip

83 117 Methylcobalamine+Gabapentitine

Tab 500 + 300 mg 10x10 Tab Strip

84 118 Ivermectin Tablet 6 mg 10x10 Tab Strip

85 119 Tab Drotavarine Tablet 500 mg 10x10 Tab Strip

86 120 Inj. Ampicillin injection 500mg 1 vial

87 121 inj. Cefotaxime Injection 500 mg/vial 1vial

88 122 Magnisium Sulphate

Injection IP 50%w/v 5gm in 10ml vial

10ml vial

89 123 Inj. Oxytocin IP injection 5.0 IU/ml 1ml ampoule

90 124 Glucose powder 75 gm 1 sachet

91 125 Absorbent Gauze Than

92 126 Absorbent Cotton Wool I.P.

500Gms 1 Pack 500Gms

93

127 Surgical Dressings (As per schedule F-II Drugs & Cosmetics Act 1940

Size 10Cmsx4Mtr

1 Dozen 10Cmsx4 Mtr.

128 Size 15Cmsx4Mtr

1 Dozen 15Cmsx4 Mtr.

94 129 Povidone Iodine Solution

Solution 10% w/v 1 Bottle 500ml

95 130 Syringe with

Needle

1 syringe 2ml 1 syringe 2ml

131 1 syringe 5ml 1 syringe 5ml

26 | P a g e

132 1 syringe 10ml 1 syringe 10ml

96

133 Intravenous Set(Adult) with Airway and Needle

Adult 1 Set

134 Children 1 Set

97 135 Disposable Gloves sterlised Latex ISI marked

6", 6.5",7 & 7.5" No.

1 Pair each 6", 6.5" & 7" No

98

136

Silk Suture with Needle

1-0 on cutting curved Needle

1 No.

137 2-0 on cutting curved Needle

1 No.

99

138

Vein Flow

Size 20 1 No.

139 size 22 1 No.

140 Size 24 1 No.

100 141 Adhesive Plaster 5 Cms x 9 Meter

1 spool pack

101 142 Ryle's Tube 10,12,14,16,18 1 No.

102 143 Folley's catheter 14, 16 & 18 1 No.

103 144 Urine Bag 2000 ml capacity

1 bag 1.ltr

104 145 Suction Tube 16,18, 20 Catheter

105 146 Cord Clamp

106 147 Mucus Sucker

27 | P a g e

ANNEXURE- E FINANCIAL BID (This is a format only and the Financial Bid shall have to be uploaded online) Name of the Bidder: ______________________________________________________ Operational Expenditure (inclusive of salaries, Fleet maintenance, Capital expenditure, Data Management, Establishment costs, Taxes, Insurances and other incidental expenditure):

28 | P a g e

ANNEXURE- F DECLARATION BY SERVICE PROVIDER I / We ……………………………… agree that we shall keep our price valid for a period of Three years from the date of approval. I / We will abide by all the terms & conditions set forth in the Bid documents No. …….. / I / We do hereby declare I / We have not been de-recognized / black listed by any State Govt. / Union Territory / Govt. of India / Govt. Organization / Govt. Health Institutions.

Signature of the Service provider: Date: Name & Address of the Firm: Affidavit before Executive Magistrate / Notary Public in INR 50.00 stamp paper.

29 | P a g e

ANNEXURE -G Patient cards with NRHM logo

Mobile Medical Unit (Shimla, Himachal Pradesh)

Sr. No.

Investigation

1 A/G Ratio

2 Acid. Phosphatase

3 Albumin

4 Alk. Phosphatase

5 B/Glucose(F)

6 B/Glucose(PP)

7 B/Glucose(R)

8 B/Urea

9 C.B.C.

10 CBNAAT

11 GDM

12 Globulin

13 Hb

14 HIV

15 ME for Malaria

16 Protein

17 S.G.O.T

18 S.G.P.T

19 Sputum for A.F.B

20 Sr.Billirubin(D)

21 Sr.Billirubin(T)

22 Sr.Creatinine

23 STS

24 UricAcid

25 Urine R & ME

ID. No. Age

Patient Name: Gender:

Date/Time: Category

30 | P a g e

ANNEXURE -H Standard Operating Procedures (SOPs)

Laboratory services Responsibility

1

The respective treating physician shall prescribe the various

investigations on the Investigation request slip and patient

reaches to sample collection area with requisition slip.

The lab technician enters the request received in the lab.

Collection Register and allot registration number for the

sample to be collected.

After the sample collection, the patients are intimated about

the time for collection of report.

The lab technician segregates the specimens according to the

various testing areas and start testing samples.

The lab Technician at the respective testing area shall record

the details of the samples received in the respective registers.

Lab technician

2.

Reporting

The Lab. technicians shall type the reports and get it approved

and issue the reports to patient /treating physician and also

records the results in register before dispatching reports.

Lab technician

3.

Stock Maintaining & Monitoring:

A stock register shall be maintained for the items and

wherever required re-order level shall be maintained in the

stock register itself.

List of the required items shall be well informed to the

administrative department through indent.

Lab technician

Records:

S no Record

1 Collection Register

2 Biochemistry Register

3 Hematology Register

4 Special Tests Register

Reproductive and Child Health services:-

S. No. Activity Responsibility

Antenatal Care

31 | P a g e

1

Registration at First ANC Visit- Any pregnant women

requiring services during antenatal period visit is

registered & card is prepared and patient is advised to

attend sub centre for registration.

Pregnancy is confirmed by conducting urine examination

using pregnancy test kit (Nischay)

Last Menstrual Period (LMP) is recorded and Expected

date of delivery (EED) is calculated for pregnant woman.

Pregnant Women’s present and past history taken

including any illness or complication during present &

previous pregnancy.

Medical Officer/

Staff Nurse/ ANM

2.

Mother & Child Protection Card-

All the details including family identification, pregnancy

records, institutional identification, next due date of ANC

visit, findings of ANC examination and investigations, post

natal care, care of baby, details of immunization, growth

child etc. is recorded on this card at different stages of ante

and post natal care.

Pregnant woman is instructed to bring this card at every

subsequent visit to the hospital/MMU.

MO/ paramedical

staff like staff nurse

and ANM

3.

Antenatal Check-up

On each visit Patients history & complaints are taken and

physical examination for weight, blood pressure,

respiratory rate, pallor, oedema and citrus is done.

Laboratory test for Haemoglobin, urine albumin & urine

sugar is done on each visit.

Tests for blood group and Rh factor, HIV, blood sugar,

malaria & Hepatitis B are also done for each pregnant

woman.

Regular dose of folic acid is given 1st trimester onwards

and Iron folic acid on subsequent trimester for at least 100

days.

First dose of tetanus toxoid injection (Inj. TT) is given as

soon as possible after ANC registration. A second dose

given after one month from the 1st one.

At each ANC visit pregnant women is counselled for

nutritional requirements, recognizing danger sign of

labour, birth preparedness, breast feeding institutional

delivery, arrangement of referral transport, family

planning etc.

MO/ staff nurse and

ANM

4.

Management of High Risk Pregnancy

If any of signs of high risk pregnancy is identified during

ANC visits the case is referred to in house

obstetrician/Gynaecologist and treatment is started as per

MO

32 | P a g e

Standard Treatment Guidelines as early as possible.

All the high risk pregnancy cases coming from lower

refereeing facilities are directly sent to in-house

obstetrician & gynaecologist for management.

If the management cannot be done at the facility patient is

referred to Medical College / Tertiary Care Hospital.

Pharmacy Management

S. No. Activity/ Description Responsibility

1.

Medicines will be provided by the department of Health

& Family Welfare (CMO Shimla) as per Mukhya Mantri

Nushulk Dawai Yojana (MMNDY) applicable for

Primary Health Centre.

CMO /BMOs

2.

Receipt of Drugs

Drugs are received in the Mobile Medical Unit (MMU)

through BMOs based on the requirement generated &

sent by the MMU. The drugs received are identified and

their quantity checked. The drugs are received through

acknowledgement on the counter slip by the staff of

MMU.

The items & quantity received are entered in the stock

register and page entry must be shared with the Block

Medical Officer who has supplied the medicines.

Staff of Mobile

Medical Unit

3

Storage of Drugs

Stock is arranged neatly in alphabetic order with name

facing the front.

Products of similar name and different strength are

stored separately.

Near expiry drugs are segregated and stored

separately.

Items requiring refrigeration like vaccine etc. are stored

in vaccine carrier.

Look alike and sound alike drugs are stored separately.

Medications that are considered light-sensitive, as

labelled by their respective manufacturers, will be

stored in closed drawers.

Staff of Mobile

Medical Unit

4.

Disposal of Drugs

Record of drugs expired during the month is

maintained in the Expired medicine register.

Expired drugs & damaged drugs are disposed off as per

the state guidelines of the hospital and the record of

disposal are maintained in Expired Medicine Register.

(i.e. date, quantity of expired drug etc)

Staff of Mobile

Medical Unit

33 | P a g e

S. No. Activity/ Description Responsibility

5.

The record of issued drug is maintained in the daily

expense/drug issue register.

A list of available drugs is prepared & intimated to the

doctors. The list is periodically updated.

List of available and non available drugs are displayed

outside the MMU.

Record of drug is maintained in stock register along

with the name, quantity, date of manufacture and

expires etc.

The strips of drug is cut into the small ones and kept in

marked boxes ready for dispensing.

The drugs which are to be kept in controlled

temperature, either kept in dispensary store in

controlled condition or in store in controlled condition.

Staff of Mobile

Medical Unit

Staff of Mobile

Medical Unit

6.

Dispensing of Drugs

FEFO/FIFO principles should be followed while

dispersing medicines.

The patients receive the prescribed medicine along

with the Registration slip.

The Pharmacist will provide only 5 Days of drug which

is prescribed by the Doctor. Only the Drugs of Chronic

Disease (such as Diabetes and Hypertension etc.)Will

be provided till the next visit of Mobile medical unit

(MMU) but not more than one month.

The pharmacist at the dispensary records registration

number, name of drugs issued to the patient, quantity

of drug issued etc. in the dispensary register.

Patient is explained about all instructions given by the

doctor on the prescription slip.

Staff of Mobile

Medical Unit

Records: S. No. Name of Records

01 Stock Register

02 Daily Expense /Drug Issue Register

03 Expired Drug Register

04 Dispensary Register

05 Available Drug List

34 | P a g e

0. ANNEXURE -I Un-Served & Under Served Areas S.N. Area where facility is to be provided Nearby Health Institutions

Block Mashobra

1 Ghanahatti area PHC Ghanahatti

Block Matiana

1 Basadhar Area Kuthar area and Balag

area

PHC Balag and Basadhar

2 Kiara Manan area PHC Kiara

3 Dhar kandru , Karana , Bharana area PHC Dharmpur and HSC Dharkandru

4 Dharech area , Dhamandary area and

Tiyali area

PHC Dharech and HSC Dhamandari

5 Deha Balsan and Ghoond area PHC Ghoond and Darbar Balsan

Block Nerwa

1 GP Malat CHC Kupvi

2 GP Pouria PHC Tharoch

3 GP Kiran PHC Tikkari

4 GP Kanda Banah CHC Kupvi

5 GP Mashdon PHC Dewat

6 GP Halau HSC Paban

7 GP Dhotali HSC Bhallu

8 GP Dhanat PHC Tikkari

9 GP Telor PHC Tikkari

10 GP Bharan PHC Tharoch

Block Nankhari 1 GP Khamadi & Kungalbalti SC Khamadi & PHC Kungalbalti

2 GP Majholi Tippar & Sholi PHC Belupul

3 GP Krangla & Delath PHC Delath

4 GP Jahu Deem & Gahan SC Jahu & PHC Kholighat

Block Kumarsain

1 GP Jadhoon PHC Narkanda & SC Jadhoon

2 GP Sanogi, Kotighat & Kangal CHC Baragaon

3 GP Shelag PHC Malendi

4 GP Bhutti PHC Bhutti

5 GP Shamathla PHC Shamathla

Block Kotkhai 1 GP Tharola PHC Tharola

2 GP Solang Saskir SC Solang Saskir

3 GP Rawlakiar SC Rukhla

4 GP Panog SC Panog

5 GP Khatasu SC Khatasu

6 GP Jharag Nakrari PHC Jharag

7 GP Baghi PHC Baghi

8 GP Mahasu PHC Bakhol

9 GP Jhalta SC Jhalta

10 GP Bhollar PHC Bhollar

35 | P a g e

Block Chirgaon

1. Gaonsari & Andhra PHC Gushali

2. Todsa PHC Jangla

3. Tangnu, Janglik PHC Diudi

Block Tikkar

1 Melthi PHC Katlah

2 Kui SC Dhara

3 Khangtari PHC Khangtari

4 Dalgaon SC Dalgaon

5 Pujarli No. 4 PHC Pujarli No. 4

6 Sheelghat PHC Sheelghat

7 Deoli PHC Dharara

8 Arhal CH Rohru

9 Bhaloon SC Bhaloon

Block Rampur

1 GP Bahli PHC Bahli

2 GP Khul PHC Deothi

3 GP Dofda PHC Gopalpur

4 GP Dhansa PHC Lalsa

5 GP Chandi Branda SC Jaghori/CHC Ghanvi

6 GP Kinoo SC Kinoo

7 GP Sarpara PHC Samej

8 GP Kasha Path SC Kasha Path/SC Munish/PHC Deothi

36 | P a g e

ANNEXURE -J

REPORTING PROFORMA FOR FUNCTIONAL MMU

Sr. No.

Location of MMU

Number of OPD

Number of ANC/ PNC

Number of Lab Test

Conducted

Number of Patients Referred

Nearest Facility to the

MMU (Name & type)