SWAMI VIVEKANANDA MEDICAL MISSION ATTAPPADY

PROJECT PROPOSAL FOR

CONSTRUCTION OF FIRST FLOOR OF HOSPITAL BUILDING BY SWAMI VIVEKANANDA MEDICAL MISSION ATTAPPADY REG.NO.55/IV/2004 Agali PO, Palakkad District 678581 Ph: 04924 254107 Email : [email protected]

ORGANIZATIONAL PROFILE

Name of Organization Address Phone Email Registered as Registration number Year of establishment Name of Head of Organization No. of trust board members Exemption under Sec 80G Person to contact Phone Email
Geographical area of operation

: : : : : : : : : : : : :
:

Swami Vivekananda Medical Mission Agali P.O.,Palakkad district,Kerala,678581 04924 254107

[email protected]

Trust 55/IV/2004 2004 V.P.S.Menon President 18 Yes Dr.NarayananV Medical officer 9495501504
[email protected] om Attappady block in Mannarkad tehsil of Palakkad district,Kerala

Population served Focus of Activities Staff strength

Activities

: : :
:

66,171 (2001 Census) Health, Tribal welfare, Education 30

1. 2. 3. 4. 5. 6. 7. Tribal Hospital Mobile medical unit Eye camps Village Health Workers Self Help Groups Community Mental Health Program Malleeswara Vidyanikethan School

PROJECT PROFILE
Name of Project Objective : Swami Vivekananda Medical Mission Hospital : To Function two wards, Labour room & Operation Theatre in the first floor of hospital Activities : 1.Construction of first floor 2. Purchase of Furniture &Equipments 3. Appointment of staff

Budget estimate
Construction costs Purchase of Furniture and Equipments Break up of each portion Operation theatre Labour room &New Born Women & Childrens Ward Maternity Ward Construction Rs.800000 Rs.500000 Rs.980000 Rs.950000 : Rs.4300000 : Rs.2144100 Furniture & Equipments Rs.921500 Rs.469300 Rs.141500 Rs.145000 Total Rs.1721500 Rs.1228800 Rs.1121500 Rs.1095000

Staff Required
Consultant Obstetrician (Fulltime) Consultant Surgeon (Visiting) Consultant Anaesthetist (Visiting) Duty Doctor(Full time) Theatre Nurse Staff Nurse Nursing assistant Sanitary worker Theatre assistant

Number
1 1 1 1 1 3 4 1 1

SECTION 1

IDENTIFYING THE NEED

ABOUT ATTAPPADY
Attappady is a backward revenue block of Palakkad district of Kerala state. It has an area of 745 sq.km and encompasses three panchayats. It has a population of 66,171(2001 Census).Tribes form almost half of the population (27,121) and are represented in three sects called Irula, Muduga and Kurumba. They live in hamlets in and around the hills of Attappady. There are 188 such tribal hamlets. The non-tribal population comprises of settlers from Kerala and Tamilnadu. Both the tribes and non tribes pursue agriculture as their means of living. They cultivate a wide variety of crops from spices to pulses and vegetables. The earnings from agriculture are inconsistent, due to the vagaries of nature like drought, flash floods, heavy winds and devastation by wild animals. The tribes engage in paid labour because a bulk of their land holdings is not cultivable. Those living in the remote villages get very less work (about 10 man days per month) compared to those near the central areas. Government schemes like NREGA a nd a government project called Attappady Wasteland Comprehensive Environment Conservation Project implemented by Attappady Hills Area Development Society (AHADS) have marginally improved their employment opportunities and earnings. The traditional tribal life is rich with a strong community bonding, family networks and sense of social responsibility. Dance, music and festivals are inherent components of tribal culture here. The interaction with the modern world has led to erosion of many of these virtues which have exposed the tribes to many hazards including mental illness. Though Kerala has a high literacy and high standards of public health, people of Attappady, especially the tribal population, remain very backward on both counts. The literacy rate is less than 50% and school dropout rates are high. Literacy and education among girls is also very low.

HEALTH SCENARIO IN ATTAPPADY

The health indicators of Attappady remain backward compared to state and national averages. The maternal mo rtality rate (7/1000 compared to state 1.3/1000) and infant mortality rates (66/1000 compared to state 14.1/1000) are very high. Institutional deliveries have remained low resulting in poor maternal and neonatal outcomes. High incidence of severe maternal anaemia, obstetric complications, deliveries by untrained persons all contribute heavily to this situation.

The poor living conditions, extremes of weather, poverty, lack of sanitation and poor awareness about illnesses, together present a bleak prospect for the health of the people of Attappady. Anaemia, malnutrition, deficiency disorders, infections like tuberculosis, typhoid fever and diarrhoeal diseases are rampant in this area. Tribal children are especially vulnerable to respiratory infec tions and diarrhoeal diseases because of low birth weight and poor weight gain during infancy. Deficiency disorders like night blindness, rickets, phrynoderma etc. are commonly seen. About 30% of the tribal population is affected by a genetic disorder cal led sickle cell anaemia, which has a devastating effect on their health and quality of life. Infertility is a very common problem in the native population. Rheumatic heart disease has high incidence because of crowded living, poor prophylaxis and lack of follow up with specialty care. Mental illnesses are very common among the tribal population. Suicides occur very frequently among the tribes. A Comprehensive Mental Health Survey is now being conducted by the mission to find the actual number of mentally ill persons in the community.

Existing Health Facilities in the area

There are four Primary Health Centres and a Tribal Specialty Hospital run by the government, besides four private hospitals. Shortage of doctors and medicines affect the functioning of govt. hospitals, while the high costs of treatment at the private hospitals are not affordable to the poor tribes and other backward sections.

SWAMI VIVEKANANDA MEDICAL MISSION ATTAPPADY

Swami Vivekananda Medical Mission has been engaged in serving the people of Attappady, in Palakkad district for the last six years. The effort of the Mission has been to provide succour to the downtrodden tribes and other backward people of this area, protecting them from exploitation by vested interests a t the same time. The work of the mission is aimed at total development of the community on all spheres of life. This is a registered charitable trust working with a non-profit motive for the betterment of the tribes and other backward people in Attappady. The work of the Mission was started in November 2002.The Trust was formally registered in September 2004 involving prominent citizens from the area who supported the noble cause. AIMS AND OBJECTIVES 1. 2. 3. 4. To provide basic medical care to the general public wit hout a motive of profit. To conduct dispensaries, medical camps and organize health schemes for the poor. To plan and implement schemes for improving public health. To conduct studies and research on the health problems of the tribes of Attappady, especially on diseases like sickle cell anaemia, psychosis etc. and find solutions. 5. To help and promote indigenous tribal medicine. 6. To promote awareness about medicinal plants and encourage their cultivation

ACTIVITIES 1. Hospital: This hospital is in Agali, which is the block headquarters of Attappady. The hospital offers the following services. ? OP Department ? Inpatient Ward with 10 beds ? 24 hours Casualty services ? Antenatal Care ? Immunization ? Laboratory ? ECG ? Ultrasound scanning ? Paediatric OP Daily ? Specialty clinics: Monthly visits by specialists in Obstetrics and Gynaecology, Internal Medicine and Dermatology. The hospital has become a referral centre for other hospitals in the area , especially for childhood illnesses. Medicines are given free to tribes and at a subsidized rate to other backward people. Patients reach the hospital from all over Attappady. An average of 150 patients visits the OP every day and more than half of the patients are tribes. There has been a progressive increase in the number of patients attending the hospital OPD over the years.

Table 1.

Patients attending OPD at our hospital

Table 2.

Patients admitted to the hospital

Every month medicines amounting to Rs.75,000 are provided free to poor patients. All in-patients are also given free food daily. Total number of staff in the hospital is 20. 2 Mobile medical unit: This comprises of a doctor, nurse and paramedical staff. The unit visits tribal hamlets periodically in a vehicle and conducts medical camps. Medicines are given free of cost to tribes. So far the unit has conducted over 300 camps including specialty camps. 3 Sub-center at Paloor: A monthly sub-center clinic is being held at Paloor hamlet in Pudur panchayath, which is one of the most remote and backward areas of Attappady. It benefits tribes and other people from about 15 hamlets around Paloor. M edicines are given free of cost to all patients. 4 Village Health Workers: Voluntary workers from tribal villages are trained to give first aid, organize medical camps, conduct health education etc. and appointed as village health workers. They are given first aid kits. VHW have been appointed in 40 hamlets now. 5 Community Mental Health Project: This project was started in September 2008 in collaboration with the Department of Psychiatry, Medical College Thrissur. The Project was formally inaugurated on 23 rd November 2009 by renowned poet and social activist P.Sugathakumari. Mentally ill patients are identified and given free treatment from the mission hospital under the project. They are followed up by a network of social workers and motivated to continue tre atment so that they remain symptom free. A Comprehensive Mental Health Survey of Attappady was inaugurated on 15 th January by District Medical Officer of Palakkad Dr.P.R.Karunakaran. About 50 patients are on regular treatment and follow up in this programm e.

6 Community Maternal and Child Health Programme: This programme was started in September 2009. High risk pregnant mothers and under five children needing special care are identified by village health workers and social workers of the mission and brought for treatment at the hospital. They are evaluated by specialists and gi ven expert care. Maternal and Child health Camps are held every month at the Hospital which are attended by an Internal Medicine specialist, a Pediatrician and a Gynaecologist. 7 Self Help Groups: Rural women are motivated and guided to form self help group s (SHG) and helped to generate income and employment in an effort to empower them. 8 Eye Camps: In association with Ahalia Eye Foundation, Palakkad and Sankara Eye Centre, Coimbatore, periodic eye camps are being organized and free eye check - up and treatment are being given. So far more than 300 persons have been restored eye sight following cataract surgery. 9 Ambulance Service: There are two ambulances in the hospital which are used to take needy patients requiring expert care to District hospital and Medic al College Hospital free of cost. 10 Ayurveda Clinic : An Ayurveda Clinic is conducted every Saturday at the hospital in
collaboration with Arya Vaidya Pharmacy Coimbatore. Medicines are given free to tribes and poor patients.

11 Malleeswara Vidyanikethan: This school situated at Nellippathy, 2kms from Agali is now 19 years old. It was being managed by Navothana Parishad , Palakkad till March 2011.Now the management is supervised by Swami Vivekananda Medical Mission trust in Agali. It is affiliated to Bharatheeya Vidyanikethan, Palakkad and NIOS, New Delhi. There are 110 students at present from Arun (LKG) to 4 th standard. The instruction is in English medium. The school building has 6 classrooms and office room, kitchen and playground located in a 2.75 acr e plot. About 40% students belong to the Scheduled tribes and are given free education. The school has been aiming to provide quality education to the tribal and rural students based on Bharatheeya culture and values.

MEDICAL TEAM
Dr.Narayanan MBBS DCH Dr.Sampath Kumar MBBS Chief Medical Officer &Pediatrician Resident Medical Officer

Visiting Consultants
Dr.N.Lalitha MBBS MD(O&G) Dr.Suganthi Natarajan MD(O&G) Dr.P.Raj esh MBBS DCH Dr.P.Raman MBBS MD, DV Dr.Srikant S BDS Dr.Chithra Venkiteswaran MBBS MD Dr.Karthikeyan MBBS MD Obstetrician & Gynaecologist Obstetrician & Gynaecologist Pediatrician Dermatologist Dental Surgeon Psychiatrist Radiologist

JUSTIFICATION FOR CONSTRUCTION OF MATERNITY WARD, WOMEN & CHILDRENS WARD, OPERATION THEATRE AND LABOUR ROOM A large number of patients coming to the hospital are referred from other hospitals in the area including Government hospitals. Hence the hospital has been functioning as a Secondary level care centre dealing with high risk cases of all varieties like sickle cell anemia, viral hepatitis, renal failure, dengue fever etc., because of the remoteness of the area and long distance to the district headquarters. This is more so in the case of poor tribal patients who are reluctant to go to distant places because of poverty and ignorance . The hospital has been experiencing a steady increase in the number of Outpatients and Inpatients, especially tribes, ever since its inception. The present inpatient ward with 10 beds is not able to meet the demand of the large number of patients who are in need of treatment. There is no separate women and childrens ward to cater to their needs .

Maternal and Child health services form the backbone of the health delivery system in any region. In the case of Attappady, the situation is very bad due to the high maternal and infant mortality rates. There is a large percentage of high risk cases needin g expert care both among the pregnant mothers and the under five children. The maternal mortality rate (7/1000 compared to state 1.3/1000) and infant mortality rates (66/1000 compared to state 14.1/1000) are very high. Institutional deliveries have remained low resulting in poor maternal and neonatal outcomes. High incidence of severe maternal anaemia, obstetric complications, deliveries by untrained persons all contribute heavily to this situation. A lot needs to be done to ensure the good health of women and children of this region. Swami Vivekananda Medical Mission has been working in the field of Maternal and Child health for the last several years. We have been conducting a Community Maternal and Child Health Programme since September 2009. The aim of the project is to reduce maternal mortality and infant mortality due to maternal diseases like Anemia, Hypertension, Diabetes, ensure foetal well being, promotion of health of under five children by better feeding practices, immunization and early treatment of infections. Early cancer detection by screening and evaluation of positive cases is a very important component of the programme. The key to the programme is the identification of high risk cases by Village Health Workers and other social workers at the community level and referral to the base hospital. At the hospital, evaluation of High risk cases and treatment by a team of experts ensures safe delivery and efficient care of newborn and infant. There is an urgent need for a labour room and an operatio n theatre at the hospital as part of the Maternal and Child care programme, in order to provide facilities for safe delivery and Caesarean section. The mission plans to construct a Womens and Childrens ward, a maternity ward, a labour room and operation theatre along with the associated amenities on the first floor of the existing hospital building. A detailed building plan has been prepared and estimated cost of construction for each part of the construction has been worked out. Approval for building construction has been obtained from the local authority.

SECTION 2

ESTIMATE OF CONSTRUCTION COSTS AND PURCHASE OF FURNITURES & EQUIPMENTS

DETAILED ESTIMATE FOR FIRST FLOOR BUILDING OF SWAMI VIVEKANANDA MEDICAL MISSION HOSPITAL AT AGALI
Height/ Specification Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for column No Length Breadth Depth Quantity Rate Unit Amount

28 12 Total Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for beam 4 1 1 1 8 4 15 2 2 2 Total

0.40 0.23

0.23 0.23

3.15 3.15

8.11 2.00 10.11

m3 m3 m3 115.00 10 dm3 116311.23

23.93 6.23 6.54 11.16 3.60 1.89 3.64 1.52 3.62 5.39

0.23 0.23 0.23 0.23 0.23 0.70 0.23 0.23 0.23 0.23

0.35 0.35 0.35 0.35 0.35 0.35 0.35 0.35 0.35 0.35

7.71 0.50 0.53 0.90 2.32 1.85 4.40 0.24 0.58 0.87 19.89

m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 114.00 10 dm3 226780.83

Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for staircase 2 1 24 1 Sub Total 4.03 3.61 1.71 3.41 1.71 1.68 0.61 0.10 0.10 0.10 1.38 0.61 0.92 0.21 3.11 m3 m3 m3 m3 m3 100.00 10 dm3 31144.40

1/2x0.30x0.15

Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for roofslab 1 1 1 Total 24.13 6.43 6.74 12.06 3.88 3.880 0.12 0.12 0.12 34.92 2.99 3.14 41.05 m3 m3 m3 m3 100.00 10 dm3 410528.88

Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for sunshade 2 2 2 Total 24.53 16.34 3.88 1.00 1.00 1.00 0.10 0.10 0.10 4.91 3.27 0.78 8.95 m3 m3 m3 m3 100.00 10 dm3 89500.00

Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for lintel 4 4 3 2 1 1 1 1 2 1 9 4 Total 23.93 15.28 2.84 5.40 5.70 6.00 3.18 3.89 1.80 3.60 2.30 2.20 0.23 0.23 0.23 0.23 0.23 0.23 0.12 0.12 0.12 0.12 0.12 0.12 0.15 0.15 0.15 0.15 0.15 0.15 0.15 0.15 0.15 0.15 0.15 0.15 3.30 2.11 0.29 0.37 0.20 0.21 0.05 0.07 0.06 0.06 0.37 0.16 7.27 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 101.00 10 dm3 73393.11

Reinforced cement concrete 1:2:4 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for slab 2 4 1 1 Total 3.60 2.00 2.86 1.23 0.83 0.83 0.83 0.63 0.05 0.05 0.05 0.05 0.30 0.33 0.12 0.04 0.79 m3 m3 m3 m3 m3 150.00 10 dm3 11823.53

Reinforcement for RCC work bent, tied and placed in position (plain grill requiring bending cold) using Tore Steel including cost and conveyance of all materials labour charges etc. complete. 1 ##### kg 5400.00 1 Qtl 189000.00 Brick work in CM 1:6 with country burnt briks (nominal size 22.9cmX11.2cmX7.0cm) for foundation and basement Partition Wall 4 4 3 2 1 1 1 1 2 1 9 4 Parapet 2 2 2 Total Deduction Door D1 Door D2 10 16 1.00 0.75 0.23 0.23 2.10 2.10 4.83 5.80 m3 m3 23.93 15.28 2.84 5.40 5.70 6.00 3.18 3.89 1.80 3.60 2.30 2.20 24.00 15.84 3.88 0.23 0.23 0.23 0.23 0.23 0.23 0.12 0.12 0.12 0.12 0.12 0.12 0.12 0.12 0.12 3.25 3.25 3.25 3.25 3.25 3.25 2.20 2.20 2.20 2.20 2.20 2.20 0.80 0.80 0.80 71.55 45.69 6.37 8.07 4.26 4.49 0.80 1.03 0.95 0.95 5.46 2.32 4.42 2.91 0.71 159.99 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3

Window W4 Window W2 Ventilator V Opening O1 Opening O2 Opening Staircase grill coloums coloums Total Net quantity 10 Anjili wood planed framed& shutter work for door, windows and ventillators including cost and conveyance of all materials, labour charges etc. complete. Door D1 Door D2 Window W4 Window W2 11 Ventilator V Roof plastering with CM 1:3, 12 mm thick including cost and conveyance of all materials labour charges etc. for roof slab (inside & out side) Plastering with CM 1:4, 12 mm thick one coat including cost and conveyance of all materials labour charges etc. (inside & out side)

7 9 13 2 2 1 1 24 8

2.00 1.00 0.60 1.50 1.20 3.37 1.89 0.23 0.23

0.23 0.23 0.23 0.23 0.23 0.23 0.23 0.40 0.23

1.50 1.50 0.45 2.10 2.10 2.10 2.10 3.15 3.15

4.83 3.11 0.81 1.45 1.16 1.63 0.91 6.96 1.33 32.81 127.18

m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 m3 3500.00 1 m3 445146.70

10 16 7 9 13

10 16 7 9 13

Nos Nos Nos Nos Nos

6000 5000 3000 2000 1000

1 1 1 1 1

No No No No No

60000.00 80000.00 21000.00 18000.00 13000.00

690.00 12

m2

1600.00

10

m2

110400.00

#####

m2

1550.00

10

m2

170500.00

13

Flooring with Ceramic floor tiles ISO Ist Quality 30cmsx30cms size over cment mortar 1:3 12mm thick and pointing with coloured cement, cleaning the surface, curing, etc., complete. Ward Ward Changing room& operation theatre Stair room Landing Passage &Toilets Passage &Toilets Nurses duty room Doctors room Rooms Nurses station Passage Total Deduction Inner walls Toilet walls

1 1 2 24 1 1 1 1 1 4 1 1

5.70 6.00 3.60 1.68 3.37 5.70 6.00 2.80 2.78 3.64 1.96 1.89

6.79 6.79 5.33 0.45 1.5 2.22 2.22 3.64 3.64 3.64 3.64 23.47

38.70 40.74 38.38 18.14 5.06 12.65 13.32 10.19 10.12 53.00 7.13 44.36 291.79

m2 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2

9 4 1 2 1

2.30 2.20 3.89 1.80 3.60

0.12 0.12 0.12 0.12 0.12

2.48 1.06 0.47 0.43 0.43 4.87 286.92

m2 m2 m2 m2 m2 m2 m2 750.00 1 m2 215192.63

Total Net quantity

14

Dadoing walls with best glazed white or coloured tiles (200mmx200mm ISO first quality) 7.5mm thick or nearest in 12mm cement mortar 1:3 and pointing with coloured cement Toilet walls Nurses duty room Doctors room Rooms Nurses station Passage Ward Ward Operation theatre changing rooms changing rooms (out side) sterilisation room Total Deduction Window W4 Window W2 Total Net quantity 7 9 2.00 1.00 0.90 0.90 12.60 8.10 20.70 496.28 m2 m2 m2 m2 995.00 1 m2 493796.61 9 4 1 1 4 1 1 1 1 1 2 1 1 3.75 3.65 10.05 10.03 11.81 9.80 35.42 22.28 22.88 13.70 6.45 4.33 9.20 2.10 2.10 2.10 2.10 2.10 2.10 2.10 2.10 2.10 2.10 2.10 2.10 2.10 70.88 30.66 21.11 21.06 99.20 20.58 74.38 46.79 48.05 28.77 27.09 9.09 19.32 516.98 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2 m2

15

Providing M. S grills for windows or compound gates including all labour and hire charges for fabricating and cost of materials and applying a coat of iron Primer Materials. Window W4 Window W2 Gate

7 9 1

2.00 1.00 1.89

0.90 0.90 2.10

12.60 8.10 3.97

m2 m2 m2

Hand rail for ramp

20.80

1.00

41.60 66.27

m2 m2 kg 8500.00 1 Qtl 168988.50

66.27@30kg/m2 16 Whitewashing twocoats over plastered surfaces with white cement including cost and conveyance of all materials and labour charges, curing charges etc. complete

1988.1

##### 17 water proof paint on under side of slab including cleaning and scaffolding etc. complete ##### 18 Painting with synthetic enamel paint on door and windows (frame and shutters) including priming coat. Door D1 DoorD2 Window W4 Window W2 Ventilator Total RAMP 19 Earthwork excavation in hard soil and depositng on bank with initial lead up to 50m and lift up to 1.5m including neat banking For column

m2

150.00

10

m2

26850.00

m2

500.00

10

m2

89500.00

10x2.25 16x2.25 7x1 9x1 13x1

1.00 0.75 2.00 1.00 0.60

2.10 2.10 1.50 1.50 0.45

47.25 56.70 21.00 13.50 3.51 141.96

m2 m2 m2 m2 m2 m2 700.00 10 m2 9937.20

1.00

1.00

1.00

8.00

m3

1800.00

10

m3

1440.00

20

Cement concrete 1:4:8, using 40mm (nominal size)hand broken stone including cost and conveyance of all materials, labour charges, curing charges, etc complete For column Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for column

1.00

1.00

1.00

8.00

m3

3800.00

m3

30400.00

21

8 8 Total 22 Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for column 4 4 Total 23 Reinforced cement concrete 1:2:4 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for beam
Reinforced cement concrete 1:11/2:3 , using 20mm nominal size aggregate including all form works, watering, curing etc. complete but excluding cost of reinforcement , for slab Reinforcement for RCC work bent, tied and placed in position (plain grill requiring bending cold) using Tore Steel including cost and conveyance of all materials labour charges etc. complete. Total Fabrication work and other expenses WaterSupply & Electrifications Sanitation Landscaping & Road work etc Unforseen items of work

1.00

1.00

0.20 0.30

1.60 1.36 2.96

m3 m3 m3 115.00 10 dm3 34021.60

(1.002+(0.43*0.33))/2

0.3 0.3

0.23 0.23

4.00 6.00

1.10 1.66 2.76

m3 m3 m3 115.00 10 dm3 31740.00

20.75

0.23

0.3

1.43

m3

114.00

10

dm3

16321.95

24

20.75

2.02

0.12

5.03

m3

100.00

10

dm3

50298.00

25

#####

kg

5400.00

Qtl

81000.00 3316015.16

26 27 28 29

LS LS LS LS

150000.00 232121.06 165800.76 300000.00 136063.02

GrandTotal

4300000.00

Rupees Forty Three lakhs only

EQUIPMENTS AND FURNITURE NEEDED FOR OPERATION THEATRE

ITEM Operation theatre table theatre LIGHTS Oxygen Cylinder Cautery/Diathermy Saline stand Step stool Instrument trolley Autoclave Anaesthetic Equipment Stool Newborn radiant Warmer Medicine trolley Mounted BP Apparatus New born resusctation kit Baby Weighing machine Oxygen Cylinder for baby Suction Apparatus Stretcher recovery cots Pulse oximeter with Cardiac monitor NIBP LINEN Slipper rack Rubber sheets Pillow Sand bag Wardrobes Chairs office table reception chairs (4 seater) INSTRUMENTS NUMBER RATE 1 60000 2 1 7000 1 17500 2 1000 2 750 4 6500 1 150000 100000 2 2000 1 33000 1 14000 1 2500 1 1500 1 5000 1 7000 2 7500 2 6000 2 3000 1 125000 1 4 4 1 2 4 1 1 500 250 300 500 4000 500 2500 4800 TOTAL COST 60000 240000 7000 17500 2000 1500 26000 150000 100000 4000 33000 14000 2500 1500 5000 7000 15000 12000 3000 125000 15000 500 1000 1200 500 8000 2000 2500 4800 60000 921500

EQUIPMENTS AND FURNITURE NEEDED FOR LABOUR ROOM

ITEM Labour Cot Focus Lamp stool Saline stand CTG Machine Hand held Doppler Observation cot Newborn radiant warmer Newborn rescitation kit Oxygen cylinder Patient dress Nursing trolley Bins Suction Apparatus Pulse Oximeter with Cardiac monitor NIBP Mounted BP apparatus Office table chairs reception chairs(4 seater) Vaccum apparatus Forceps Instruments NUMBER RATE 1 30000 1 30000 2 2500 2 1000 1 150000 1 9000 2 3000 1 33000 1 1500 1 7000 10 2 5000 3 1000 2 7500 1 125000 1 2500 1 2500 2 500 1 4800 1 TOTAL COST 60000 30000 5000 2000 150000 9000 3000 33000 1500 7000 10000 3000 15000 125000 2500 2500 1000 4800

5000 469300

EQUIPMENTS AND FURNITURE NEEDED FOR WOMEN AND CHILDREN'S WARD

ITEM COTS Mattresses pillows Bed sheets by stander stools bedside locker cupboard Medicine Shelf Nursing trolley Saline stand Bed pan Nebuliser Hotwater bag Oxygen Cylinder Trays Dressing bins Bedside screen Office table Chair Instruments NUMBER 12 12 12 50 12 12 1 1 1 5 1 1 1 1 5 4 1 1 2 RATE 4000 1000 300 200 200 2000 6000 3000 5000 1000 1000 3000 300 7000 500 500 3000 2500 500 2450 TOTAL COST 48000 12000 3600 10000 2400 24000 6000 3000 5000 5000 1000 3000 300 7000 2500 2000 3000 2500 1000 2500 143800

EQUIPMENTS AND FURNITURE NEEDED FOR MATERNITY WARD

ITEM COTS Mattresses pillows Bed sheets by stander stools bedside locker cupboard Medicine Shelf Nursing trolley Saline stand Bed pan Urinal Oxygen Cylinder Bedside screen office table chair Instruments NUMBER 12 12 12 50 12 12 1 1 1 5 1 1 1 1 1 2 RATE 4000 1000 300 200 200 2000 6000 3000 5000 1000 500 500 7000 3000 2500 500 TOTAL COST 48000 12000 3600 10000 2400 24000 6000 3000 5000 5000 500 500 7000 3000 2500 1000 15000 149500

EQUIPMENTS AND FURNITURE NEEDED FOR POST OPERATIVE ROOM

ITEM Patient Cot Pulse oximeter +Cardiac Monitor+NIBP Saline Stand stool medicine trolley nursing trolley bedside table reception chair (4 seater) NUMBER 2 1 4 2 1 1 1 1 RATE 24000 125000 1000 2000 14000 5000 2500 4800 TOTAL COST 48000 125000 4000 4000 14000 5000 2500 4800 207300

EQUIPMENTS AND FURNITURE NEEDED FOR NEW BORN ROOM

ITEMS Radiant Warmer Phototherapy unit nursing trolley cupboard medicine trolley office table multi para monitor chair NUMBER 2 2 1 1 1 1 1 2 RATE 33000 20000 5000 6000 14000 2500 125000 500 TOTAL COST 66000 40000 5000 6000 14000 2500 125000 1000 259500