MIS
FORMAT FOR SUBMITTING DATA BY
GOVERNMENT
MEDICAL COLLEGES & HOSPITALS
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Name of College/Hospital |
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Month Ending |
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1.
General Information
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Telephone no (STD code) |
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Fax no |
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E mail address |
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Name and designation of
the Head |
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Name of Superintendent |
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No of beds |
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No of wards |
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No of Major OTs |
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No of Minor OTs |
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Blood bank |
Yes/No |
2.
Out Patients
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No. of OPD days |
No. of OPD registrations |
Old |
New |
BPL |
Govt. |
Senior Citizen |
Casualty + MLC |
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3.
a) In Patients
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Total no of admissions |
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BPL Admission |
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Average length of stay of patients * |
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Average bed occupancy (%) ¨ |
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Note:
* = Total no. of days of stay of discharged pts. / No.
of discharged patients during this month.
¨ = {Average no. of occupied beds per day
(in a month) / Total no. of available beds} ´ 100
b) Department wise information of Inpatients :-
Details of
wards with bed occupancy greater than 100% (Where floor beds are also used)
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Ward (Department) |
Bed Strength |
No. of days when
occupancy was > 100% |
Average daily
number of excess beds |
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c) Operations carried out during the month
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Department |
Unit no. with name
of Unit head |
Unit Head
Designation Honorary /Full
Timer |
No. of major
surgeries* |
No. of minor
surgeries* |
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* As per User Charges G. R. No.
GRF-10.00/P.No.90/2000/Health-3, dated 10/7/2001
d) Number of deaths during this month
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Total no |
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Percentage of death
against no. of admissions |
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Total no. of autopsies |
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Total no. of forensic
PM's. |
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Total no. of Police
Surgeon's PM's |
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4.
Blood Bank
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No of blood units used
this month |
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No of blood units used
without replacement |
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No of blood units
collected with voluntary replacement |
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No of blood units bought
from other blood banks |
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No of blood units found
HIV positive |
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No of blood units found
positive for Hepatitis B and C |
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No of blood donation
camps |
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Component separation |
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No of blood units
collected in camps |
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5.
Drugs
a) Grant
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Sanctioned grant (Rupees
in Thousand): Period… |
Total |
Plan |
Nonplan |
b) Drug / Surgical items /x-ray films etc.
Availability
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Drug |
Stock at the
beginning of the month ( in numbers) |
Quantity received
during month ( in numbers) |
Quantity supplied
to OPD ( in numbers) |
Quantity supplied
to inpatients (Wards, OTs) ( in numbers) |
Stock at the end
of the month ( in numbers) |
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Tablet |
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Injection |
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Liquid / Ointment |
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Disinfectant |
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Surgical Items |
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I.V. Fluid |
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X-ray films |
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Other |
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c) Drug / Surgical items /x-ray films etc. purchased
from outside
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Drug |
Quantity |
Cost |
Local Purchase |
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Poor box fund/PLA |
From Imprest ? |
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Tablet |
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Injection |
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Liquid / Ointment |
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Disinfectant |
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Surgical |
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I.V. Fluid |
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X-ray films |
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Other |
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d) Drug not used for more than 6 months:
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Name of Drug |
Quantity |
Cost |
No. of months not
in used |
Action suggested |
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6. Linen (no. of pieces)
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Linen |
Opening balance |
Received during
the month |
Issued to wards |
Closing balance |
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i)
Operation Linen |
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ii)
Bed linen |
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iii)
Patient's linen |
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iv)
Surgeon's linen |
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7. Major Equipment in the hospital (Over Rs. 5 lakhs):
Like MRI, CT, USG, Heart Lung machine, Biochemistry auto analyser, X-ray
machine etc. (List is only illustrative)
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Department |
Equipment |
No. of
investigations |
No. of breakdowns
with days |
Reason for
breakdown |
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8. Other Equipments not in working condition
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Department |
Equipment |
Days not in use |
Any follow up
initiated for repair |
Reason for non use |
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9. Other machinery in non-working condition like O2
supply system, lifts, AC plants, incinerator, vehicles, ambulances etc. (List
is only illustrative)
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Department |
Machinery |
Days not in use |
Any follow up
initiated for repair with current status |
Reason for non use |
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10. Staff
Details
a) Attendance
Teaching:
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Category |
Nos. |
Total man days
available * |
Total man days
present |
No of Lectures |
No of Clinic /
Practical taken |
Remarks by Dean |
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Required as per
Time Table |
Taken |
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Professors |
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Associate professors |
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Lecturers |
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Non-Teaching:
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Category |
Nos. |
Total man days
available * |
Total man days
present |
Remarks by Dean |
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Resident
Doctors |
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Honoraries |
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Nursing
Staff |
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Paramedical
Staff |
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Administrative
Staff |
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Class
IV employees |
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Note:
* = To
calculate man-days available, find the no. of working days during the month for
each category of staff and multiply by no. of filled staff in that category.
¨ = To calculate man days present, add the number of
days absent for the employees of each category and subtract from total man days
available for that category.
b) Vacancy position of the College (Teaching posts)
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Designation |
Sanctioned posts |
MCI requirement |
Posts filled |
Posts vacant |
Vacant for > 6
months |
Unauthorized
absent |
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UG |
PG |
Regular |
Adhoc |
Contract |
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Professors |
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Associate professors |
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Lecturers |
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Resident Doctor |
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Honoraries |
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Note: Information about
Posts, vacant and filled, should be as per sanctioned posts.
11. Budget: Figures
in Rupees (Thousand) progressive (Cumulative) upto the end of the reporting
month.
College
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Budget Head |
Allocation for
current financial year |
Cumulative Booking
end of reporting month |
Cumulative
Expenditure upto end of reporting month |
Remarks, if any |
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% |
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% |
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Salary |
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Travel Expenses |
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Office Expenses |
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Petrol, Oil, Lubricant |
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Rent, Rates & Taxes |
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Publications |
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Advertising &
Publicity |
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Professional &
special services |
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Other Charges |
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Maintenance work |
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Motor Vehicles |
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Machinery & Equipment |
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Material & Supplies |
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Scholarship / Stipends |
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Grants-in-aid |
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Diet charges |
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Computer expenses |
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Total |
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11. Budget: Figures
in Rupees (Thousand) progressive (Cumulative) upto the end of the reporting
month.
Hospital
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Budget Head |
Allocation for
current financial year |
Cumulative Booking
end of reporting month |
Cumulative
Expenditure upto end of reporting month |
Remarks, if any |
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% |
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% |
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Salary |
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Travel Expenses |
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Office Expenses |
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Petrol, Oil, Lubricant |
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Rent, Rates & Taxes |
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Publications |
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Advertising & Publicity |
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Professional &
special services |
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Other Charges |
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Maintenance work |
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Motor Vehicles |
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Machinery & Equipment |
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Material & Supplies |
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Scholarship / Stipends |
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Grants-in-aid |
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Diet charges |
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Computer expenses |
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Total |
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12. Services
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Rating of quality Service area |
Name of agency |
Satisfactory |
Needs Improvement |
Poor |
Remarks |
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Repairs & Maintenance |
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Civil |
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Mechanical |
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AC & refrigeration |
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Other Services |
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Laundry |
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Ambulance |
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Security |
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Stores |
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Canteen |
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13. Complaints
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Nature of
Complaint/ suggestions |
From whom? Student/Patient/Public/
Staff/ Elected members (MP/MLA) or Anonymous |
No. Received |
No. Disposed |
Remarks by Dean |
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14.
Results (for Regular batch only, as and when applicable)
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Course |
No. Appeared |
No. Passed |
Distinction / Award |
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I MBBS |
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II MBBS |
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III MBBS |
Part - I |
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Part - II |
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PG |
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Superspeciality |
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Any other |
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15.
Research and any other Academic / Non Academic Activities
(Attach
detailed information)
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Sr. No. |
Name of the Activity |
Number of activities during the current month |
Remarks |
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1 |
SEMINARS |
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2 |
CME (Continued Medical
Education) |
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3 |
Research projects |
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a) National |
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b) International |
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4 |
Papers Published |
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5 |
Workshops organized |
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6 |
Camps |
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7 |
Participation in Sports |
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8 |
Cultural Events |
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16. Remarks of the Dean /
Superintendent (Only where Superintendent is Head of Hospital)
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Signature of Dean / Superintendent
(Only where Superintendent is Head of Hospital)
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Date |
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