Project Report AIIMS - Guntur - April 2015

C O N T E N T S Page
0 DATASHEET 3
1. INTRODUCTION 10
2. APPROACH & METHODOLOGY 16
3. ANDHRA PRADESH: A BRIEF 19
 General
 Division-wise Distribution of District
 Demographic Profile
 Guntur District
4. HEALTH SCENARIO 27
 Backdrop
 The National Scene
 The State
 Health Infrastructure of Maharashtra
5. PROPOSED FACILITIES AT AIIMS- GUNTUR 51
6. CAPITAL OUTLAY ESTIMATES 58
 Summary
 Details of Construction Cost
 Summary of Civil & Internal Services
7. IMPLEMENTATION SCHEDULE 65
8. EQUIPMENT PLANNING- Department-wise 68
9. MANPOWER REQUIREMENTS 71
10. SYSTEM & SERVICES 73
 Modular Operation Theatre
 Central Sterile Supply Department (CSSD)
 Medical Gases Manifold System
 Kitchen
 Laundry
 Bio-medical Waste Management System
 Mortuary Chamber
ALL INDIA INSTITUTE OF MEDICAL SCIENCES (AIIMS) AT GUNTUR, ANDHRA PRADESH-PROJECT REPORT Page | 1
11. INFORMATION TECHNOLOGY & COMPUTERISATION FACILITIES 90
 General
 Medical College
- LAN & Wi-Fi

- Lecture Theatres
- Library Management System
- Other Facilities
 Hospital (Speciality & Super Speciality)
- Hospital Management System
- Queue Management System (QMS)
- PACS (Hardware & Software)
- Estimated Cost
12. GREEN BUILDING CONCEPT 102
13. PHE & FIRE-FIGHTING CONCEPT 109

14. ELECTRICAL CONCEPT 138
15. HVAC CONCEPT 151
16. STRUCTURAL CONCEPT 170
17. OPERATION & MAINTENANCE OF BUILDINGS 174
18. ANNEXURE 179
 Manpower Requirement Details
 Civil Cost Estimation Details
DATASHEET
DATASHEET
The continued increase in patient load and growing demand for super speciality care, at the
existing centres of AIIMS, made it difficult besides causing hardships to the public at large,
There was felt need for expansion of tertiary care institutions across the country; with the
aim of spreading the super speciality care and correcting regional imbalances; Government
of India took initiative to set up new AIIMS-like institutes and undertake strengthening / up
gradation of existing institutions under the PMSSY (Pradhan Mantri Swasthya Suraksha
Yojana) in a phased manner as under:
Phase-I (2006)
Six new AIIMS like institutes (at Bhopal-MP, Bhubaneshwar-Orissa, Jodhpur- Rajasthan,
Patna-Bihar, Raipur-Chattisgarh, and Rishikesh-Uttarakhand) and up gradation of 13 Govt.
Medical Colleges;
Phase-II (2008)
Two new AIIMS-like Institutes (Rae Bareli – Uttar Pradesh, and Raiganj – West Bengal) and
upgradation of 6 Govt. Medical Colleges;
Phase-III (2013)
Up gradation of 39 existing Govt. Medical Colleges across various locations of India
In July, 2014, Government accorded approval for setting up five new AIIMS-like Institutions
at Hyderabad-Telangana, Nagpur- Maharashtra, Gorakhpur (Uttar Pradesh), Guntur (Andhra
Pradesh) and Kalyani (West Bangal).
Announcement for six more new AIIMS-like institutions, to be set up in Punjab, Tamil Nadu,
Himachal Pradesh, Jammu & Kashmir, Assam and Bihar, was made in Feb.2015, up
gradation of Govt. Medical Colleges; set up 20 years ago would also be taken up
progressively.
To facilitate governance issues, AIIMS-Act 1956 was amended by enactment of AIIMS

(Amendment) Act -2012 which brought new AIIMS-like institutes under the ambit of AIIMS
Act-1956, providing for establishment of more than one AIIMS at various locations. Each
new AIIMS-like institute is thus an institution of National Importance under the Act.
Government of India’s initiative in setting up new AIIMS-like institutes in different states,

thereby promoting regional spread of super-speciality case and its accessibility on one and
up-gradation of existing Medical Colleges set up 20 years ago progressively on the other,
over the plan periods is seen as a step in the direction of furtherance in reduction of gaps
between the demand and supply of doctors as also the hospital beds; this is also in line with
the government of India’s high powered committee recommendations (HLEG)
This Project Report pertains to setting up a new AIIMS-like institution at Guntur District,
Andhra Pradesh.
SITE SELECTION
The state government offered only one site for setting up an AIIMS-like Institute in Andhra
Pradesh. A four member central team was constituted for ascertaining the suitability of the
site for establishment of the Institute.
The central team visited the site offered in Guntur district, studied the site data made
available, and held discussions with the concerned officials. Based thereon, the Central Team
was of the view that on prima-facie considerations the land offered, by the state, fulfilled
broad requirements for establishment of new AIIMS-like Institute.
The Project Report has been prepared based on the limited site information available.
PROPOSED FACILITIES
Hospital: Speciality and Super Speciality Hospitals, Trauma
centre, Ayush centre, suppor services & allied facilities,
Basement Parking.
Institutional (Teaching): Teaching Block, Admin Block, Auditorium, Nursing
College, Night shelter & related facilities
Residential: Housing of Various types, Guest House, Director’s
Bungalow, PG/UG Boys & Girls Hostels, Nursing Hostels
etc
BED DISTRIBUTION (Department-wise)
SPECIALITY DEPARTMENTS
DEPARTMENTS BEDS
Surgical & Allied Specialities 220
 General Surgery 120
 Orthopaedics 60
 Ophthalmology 20
 Oto-rhinolaryngology 20
Medicine & Allied Specialities 220
 General Medicine 120
 Paediatrics 60
 TB & Respiratory Diseases 10
 Dermatology & STD 10
 Psychiatry 10
Obstetrics & Gynaecology 60
 Obstetrics 35
 Post-partum 5
 Gynaecology 20
Sub-total 500
SUPER SPECIALITY DEPARTMENTS
Departments Beds
 Cardiology 20
 Cardio-thoracic Vascular Surgery (CTVS) 20
 Gastroenterology 20
 Surgical Gastroenterology 20
 Nephrology 20
 Urology 20
 Neurology 20
 Neuro-surgery 20
 Medical oncology 20
 Surgical oncology 20
 Endocrinology 20
 Clinical Haematology 20
 Paediatric Surgery 20
 Burns & Plastic Surgery 20
 Pulmonary Medicine 20
Sub-total 300
Total Ward Beds 800
Other Facilities 160
 Intensive Care Unit (ICUs) & Critical Care 50
 Trauma 50
 AYUSH Facilities 30
 PMR Department 30
TOTAL 960
Paid Beds 60
RESIDENTIAL ACCOMMODATIONS
Sl.No. Description of Block 171 Dwelling Units (DUs)

Unit per No. of Blocks Occupancy per
Block Block
1 Director's Bungalow 1 1 −
2 TYPE - II 36 3 108
3 TYPE - III 18 1 18
4 TYPE - IV 21 1 21
5 TYPE - V 24 1 24
6 Guest House 1 1 −
HOSTEL ACCOMODATION
Sl.No. Description of Block 1400 Occupancy

Unit per No. of Occupancy
Block Blocks per Block
7 PG Hostel - D 1 156 2 312
8 PG Hostel - D 2 132 1 132
9 PG Hostel - D 3 155 1 155
10 UG Hostel - Girls 120 1 120
11 UG Hostel - Boys 1 100 1 100
12 UG Hostel - Boys 2 146 1 146
13 Nursing Student Hostel -I 144 1 144
14 Nursing Student Hostel -II 288 1 288
15 Dining Hall - I 1 1 −
16 Dining Hall - II 1 1 −
AREA STATEMENT
Institutional (Hospital & Teaching)
Hospital (A) Teaching (B)

Floors Floor Area in Sq.m Name of Building Area in Sq.m
Ground Floor 17222 Teaching Block (G+4) 17390
st
1 13322 Auditorium(G+2) 7380
nd
2 14553 Admin Block (G+3) 4600
rd
3 13784 Animal House (G+1) 760
4 th 13719
5 th 25570 Nursing College (G+2) 4650
th
6 10159 Night Shelter (G+3) 3700
Sub Total 108329
Guest House (G+2) 2300
Basement for services 5171
Other Services 5500
Total 119000 Total 40780
GRAND TOTAL (A+B) 159780 SQ.M
Residential (C)
Sl.No Facility (Sq.m)

1 TYPE II RESIDENCES 6894
2 TYPE III RESIDENCES 1464
3 TYPE IV RESIDENCES 2206
4 TYPE V RESIDENCES 4199
5 Director Bungalow 301
6 Guest House 650
7 PG Hostel - D1 7414
10 Dining Hall – I 772
11 Dining Hall – II 958
12 UG HOSTEL GIRL 3558
13 UG HOSTEL BOYS 1 2733
15 NURSES STUDENT HOSTEL D 4746
16 NURSES STUDENT HOSTEL E 4673
Total Area (C) 52931
Total Area (A+B+C) = 2,12,711 Sq.m
CAPITAL OUTLAY ESTIMATES
INSTITUTION BUILDINGS Hospital Medical Residential Total

College
Building & Services
Civil & Internal Services Work 415.69 141.17 132.08 688.94
External Development 17.17 8.46 8.10 33.73
PHE and Fire Fighting 38.24 9.80 15.50 63.54
Electricals 74.91 14.37 12.90 102.18
HVAC 35.60 12.28 0.91 48.79
System & Services (Modular OTs, 60.10 - - 60.1
Gas Manifold, Kitchen, Laundry,
CSSD, Mortuary etc)
IT & Computerization Facilities 30.00 - - 30
Furniture 35.00 14.00 14.00 63
Sub- total 706.71 200.62 183.49 1090.82
Contingencies @3% 21.20 6.02 5.50 32.72
Escalation @6.5% per annum (for 45.94 13.04 11.93 70.91
3 rd year on 2/3 rd cost of ix, and
for 4 th year on 1/3rd cost of ix)
Sub-total 773.85 219.68 200.92 1194.45
Add for Project Consultancy 44.11 12.52 11.45 68.08
Charges @ 5% including service
tax @ 14%
Total Construction Cost 817.95 232.20 212.38 1262.53
Add Service Tax @ 5.6% 70.70
MEDICAL EQUIPMENT Including 285.00

Procurement Consultancy
fee@2% & service tax@14%
TOTAL PROJECT COST 1618.23
Total Project Cost (Say) Rs. 1618 Crores
IMPLEMENTATION SCHEDULE
Pre-construction Phase (12 Months)

 Including necessary approvals after submission of final report, : 12
development of concept designs, preparation of tender Months
documents, and award of work.
Construction & Stabilisation Phase (42 Months)

 Construction Period : 36 Months
: 06 Months
 Commissioning of Services including obtaining
clearances/certificates from local statutory bodies including
stabililation period.
MANPOWER REQUIREMENT (Total Staff= 2998)
Description Medical College Super- Speciality Nursing AYUSH

& Speciality Hospital & Trauma College Centre
Hospital Centre including ICUs etc
A. Administration 25 32 8 6
B. Medical Professionals 226 172 42 15
C. Nursing Staff 683 1006 - -
D. Paramedical & Other 419 364 - -
(Technicians, Attendants &
Ancillary Services)
Grand Total 1353 1574 50 21
The manpower requirement for medical college & superspeciality block was computed separately. While the
professional staff was generally assessed per unit (each of 20 beds) basis in accordance with the MCI Guidelines, the
nursing staff was largely based on the Nursing Council of India norms.
However, before the requirement process, the actual requirement of manpower to be finalised by the AIIMS
authorities; a separate proposal in this regard to be prepared and submitted by AIIMS to the concerned department
for approval.
EQUIPMENT REQUIREMENT
Director, AIIMS, Bhubaneswar, Director, AIIMS, Raipur and HR Consultant (PMSSY) MOH&FW met on
9th of January, 2014 at New Delhi and deliberated upon the cost estimates of medical equipment for
different clinical, para-clinical and non-clinical departments of AIIMS, Rae Bareli in respect of hospital,
nursing college and medical college. The total equipment cost as suggested by the above committee
was estimated at Rs.385 crore for the Rae-Bareli Project. However, after further deliberation, the items
viz. Biotechnology & Molecular medicine, Rheumatology & Immunology, Medical genetics, HMIS/IT,
Computers, Hospital & biomedical engineering, Human resources, Hospital administration, Publications
& research and Miscellaneous (of Rs.108 crore) are not considered in the present proposal. Hence,
remaining Rs.278 crore has been considered.
[Amount capitalised in the present proposal (New AIIMS Project) is Rs. 285 Crore including 2%
procurement consultancy fee]
INTRODUCTION
ALL INDIA INSTITUTE OF MEDICAL SCIENCES (AIIMS) AT GUNTUR, ANDHRA PRADESH-PROJECT REPORT Page |
10
1. INTRODUCTION
The All India Institute of Medical Sciences (AIIMS), New Delhi was
established 1956 by an Act of Parliament as an institution of national
importance. Over the period, the inpatient bed capacity increased from
800 at the outset to over 2500. Thousand of patient across the country as
also the neighbouring countries come to AIIMS everyday for treatment.
Moreover, to keep pace with the emerging needs, new centres (Dr. R.P.
Centre for Ophthalmic Sciences, Institute of Rotary Cancer Hospital, the
twin centres for Cardiothoracic Sciences & Neurosciences, Centre for Dental
Education, JP Narain Apex Trauma Centre) have been developed. Blocks
for surgery, Mother & Child Care, New OPD etc. have also come about in
the adjoining Masjid Moth area.
So much so that AIIMS has emerged as a brand with the main campus
becoming congested and crowded and no scope for further expansion the
2nd campus has been developed on a 300-acre land at Jhajjar, Haryana to
meet AIIMS’ urgent needs; Immediate priority in the clinical domain being
the establishment of National Cancer Institute. The key focus on Research
& Innovation is to create a World class Biomedical Research Infrastructure.
In the education domain, however, a full-fledged centre for Excellence in
Nursing Education & Research is proposed for establishment in the current
plan period.
Increased Demand for Super Speciality Care
The continued increase in patient load and growing demand for super
speciality care, at the existing centres of AIIMS, made it difficult besides
causing hardships to the public at large, There was felt need for expansion
of tertiary care institutions across the country; with the aim of spreading
the super speciality care and correcting regional imbalances; Government
of India took initiative to set up new AIIMS-like institutes and undertake
strengthening / up gradation of existing institutions under the PMSSY
(Pradhan Mantri Swasthya Suraksha Yojana) in a phased manner as under:
11
Phase-I (2006)
Six new AIIMS like institutes (at Bhopal-MP, Bhubaneshwar-Orissa,

Jodhpur- Rajasthan, Patna-Bihar, Raipur-Chattisgarh, and Rishikesh-
Uttarakhand) and up gradation of 13 Govt. Medical Colleges;
Phase-II (2008)
Two new AIIMS-like Institutes (Rae Bareli – Uttar Pradesh, and Raiganj –
West Bengal) and upgradation of 6 Govt. Medical Colleges;
Phase-III (2013)
Up gradation of 39 existing Govt. Medical Colleges across various locations

of India
In July, 2014, Government accorded approval for setting up five new

AIIMS-like Institutions at Hyderabad-Telangana, Nagpur- Maharashtra,
Gorakhpur (Uttar Pradesh), Guntur (Andhra Pradesh) and Kalyani (West
Bangal).
Announcement for six more new AIIMS-like institutions, to be set up in

Punjab, Tamil Nadu, Himachal Pradesh, Jammu & Kashmir, Assam and
Bihar, was made in Feb.2015, up gradation of Govt. Medical Colleges; set
up 20 years ago would also be taken up progressively.
To facilitate governance issues, AIIMS-Act 1956 was amended by

enactment of AIIMS (Amendment) Act -2012 which brought new AIIMS-
like institutes under the ambit of AIIMS Act-1956, providing for
establishment of more than one AIIMS at various locations. Each new
AIIMS-like institute is thus an institution of National Importance under the
Act.
These new AIIMS-like institutions are being established by an Act of

Parliament on the lines of the original AIIMS-New Delhi which imparts both
undergraduate and post graduate medical education in all its branches and
related fields, along with nursing and paramedical training to bring together
12
in one place educational facilities of the highest order for training of
personnel in all branches of healthcare activity.
Bridging Healthcare Infrastructure gap
From the academic session 2013-14, the total number of MBBS seats in the
six new AIIMS-like Institutes went up to 600, providing an opportunity to
an additional 300 MBBS aspirants. With these new additions, the overall
availability of MBBS seats in the country rose to 42,169. According to the
Medical Council of India, MBBS seat availability, from 398 medical colleges
is 52,105 for the year 2014-15. Health Ministry is striving to achieve the
WHO target doctor-patient ratio of 1:1000 by 2021 which at present is
1:2000. The government plans to increase the overall availability of MBBS
seats to 80,000; aim being to reduce the shortage of doctors, currently
pegged at around 800,000.
It may be mentioned that the High Level Expert Group (HLEG), instituted
by the Planning Commission, in its report had opined that production of
allopathic doctors in the country, as per the current trends, is both
inadequate and uneven. HLEG proposed a phased addition of around 200
colleges during 12th and 13th plan periods for equitable health care
accessibility across the states. Such a measure could approximate WHO
norm of doctor per 1000 population by 2028, largely as under:
Year Population Served for Doctor
2017 1731
2022 1451
2025 1201
2028 1000
In terms of hospital beds too, with a strength of around 1.37mn beds (0.9
beds/1000population) India ranks among the lowest far below the global
average of 2.9 beds.
13
Government of India’s initiative in setting up new AIIMS-like institutes in
different states, thereby promoting regional spread of super-speciality case
and its accessibility on one and up-gradation of existing Medical Colleges
set up 20 years ago progressively on the other, over the plan periods is
seen as a step in the direction of furtherance in reduction of gaps between
the demand and supply of doctors as also the hospital beds; this is also in
line with the government of India’s high powered committee
recommendations (HLEG)
This Project Report pertains to setting up a new AIIMS-like institution at

Guntur, Andhra Pradesh.
SITE SELECTION
The state government offered only one site for setting up an AIIMS-like
Institute in Andhra Pradesh. A four member central team was constituted
for ascertaining the suitability of the site for establishment of the Institute.
The central team visited the site offered in Guntur district, studied the site
data made available, and held discussions with the concerned officials.
Based thereon, the Central Team was of the view that on prima-facie
considerations the land offered, by the state, fulfilled broad requirements
for establishment of new AIIMS-like Institute.
The Salient features of site are broadly as under:
It is around 20 km from Guntur and 10 km from Vijaywada; National

Highway (NH-16) is 250 meter from the site;
Nearest airport, at Vijaywada is around 30 km away, while nearest Railway

Station (Mangalagiri) is just 2 km from the proposed site;
The area of the site is 193 acre – Government land , in possession of state
government;
Site is within the municipal limits
14
Soil type is hard gravelly with bearing capacity of 30 ton / sqm.
The Project Report has been prepared based on limited site information
available.
15
APPROACH & METHODOLOGY
16
2. APPROACH & METHODOLOGY
The approach to preparation of Project Report for establishing the AIIMS like
institution at Guntur, Andhra Pradesh broadly as under:
 Nomination of a Project Manager and constitution of a multi-disciplinary
team of professionals comprising medical doctors, architects, civil
engineers, economist.
 Desk Research by the in-house team.
 Site Selection:
 Visit of Central Team, constituted for the purpose to select site,
those offered by the state government, and the data made
available thereon.
 Collation of data & study of preliminary site information
 Preparation of Project Report
 Submission of Project Report
 Presentation of Project Report
The process, so adopted, is depicted in the chart attached:
17
FLOW CHART: APPROACH & METHODOLOGY
THE WORK PLAN
Nomination of a Project Coordinator &

MOH&FW
Multi-disciplinary team of
professionals by HSCC
Preparation of Checklist
Central Team Visit Desk Study/Research
(Home team)
 Discussion with
Concerned officials
 Visit Proposed Site
Collation & Study of Data
Concept Plan Presentation/Discussion

(To be prepared during
DPR Stage)
Preparation
of
Client’s Approval
Project
Report
Finalization of
Concept Plan
Concept Plan to be
prepared during DPR
Stage
Submission of REPORT &

CONCEPT PLAN
18
ANDHRA PRADESH STATE: A BRIEF
19
3. ANDHRA PRADESH STATE: A BRIEF
Andhra Pradesh is one of the 29 states of India, situated on the country's

south-eastern coast. The state is the eighth largest state in India covering an
area of 160,205 km2. According to 2011 census, the state is tenth largest by
population with 49,386,799 inhabitants. The new capital of Andhra Pradesh is
in Guntur District north of Guntur City and will be developed under a new
Capital Region Development Authority. As per Andhra Pradesh Reorganisation
Act, 2014, Hyderabad will remain the de jure capital of both Andhra Pradesh
and Telangana states for a period of time not exceeding 10 years.
The state has the second longest coastline of 972 km among all the states of
India, second only to Gujarat. It borders Telangana in the northwest,
Chhattisgarh in the North, Odisha in the northeast, Karnataka in the west,
20
Tamil Nadu in the south and the water body of Bay of Bengal in the east. A
small enclave of 30 km2 of Yanam, a district of Pondicherry, lies in the Godavari
delta to the northeast of the state.
There are two regions in the state namely Coastal Andhra and Rayalaseema
and hence, the two regions are more often referred as Seemandhra by the
news media. There are 13 districts with 9 in Coastal Andhra and 4 in
Rayalaseema. Visakhapatnam is the largest city and a commercial hub of the
state with a GDP of $26 billion followed by Vijayawada with a GDP of $3 billion.
Guntur, Nellore, Kurnool, Tirupati, Rajahmundry, Kakinada, Ongole and Eluru
are other important cities.
The state is endowed with a variety of physio-graphic features ranging from

Eastern Ghats, Nallamala Forest, Coastal plains to deltas of two major rivers
of Krishna and Godavari. The state is the largest producer of rice in India, and
hence, it is nicknamed as The Rice Bowl of India.
As per 2011 Census of India, the state had a population of 49,386,799 with a
population density of 308/km2. The total population constitutes 70.4% of rural
population with 34,776,389 inhabitants and 29.6% of urban population with
14,610,410 inhabitants. Visakhapatnam district has the largest urban
population of 47.5% and Srikakulam district with 83.8%, has the largest rural
population, among others districts in the state. The overall population of the
state comprises 17.1% of Scheduled Caste and 5.3% of Scheduled Tribe
population.
There are 24,738,068 male and 24,648,731 female citizens—a sex ratio of 996
females per 1000 males, higher than the national average of 926 per 1000.
The average literacy rate stands at 67.41% with 29,772,532 literates,
significantly lower the national average of 73.0%. West Godavari district has
the highest literacy rate of 74.6% and Vizianagaram district has the least with
58.9%.
21
Districts of Andhra Pradesh
District Headquarters No. of Area Population Density

Mandals (km²) (2011) (/km²)
Anantapur Anantapur 63 19,130 4,083,315 213
Chittoor Chittoor 66 15,152 4,170,468 275
East Godavari Kakinada 59 10,807 5,151,549 477
Guntur Guntur 57 11,391 4,889,230 429
Kadapa Kadapa 50 15,359 2,884,524 188
Krishna Machilipatnam 50 8,727 4,529,009 519
Kurnool Kurnool 54 17,658 4,046,601 229
Prakasam Ongole 56 17,626 3,392,764 193
Nellore Nellore 46 13,076 2,966,082 227
Srikakulam Srikakulam 37 5,837 2,699,471 462
Visakhapatnam Visakhapatnam 43 11,161 4,288,113 340
Vizianagaram Vizianagaram 34 6,539 2,342,868 384
West Godavari Eluru 46 7,742 3,934,782 490
Source: Census of India-2011
Human Development Index- Indian States
Rank State/Union consumption 13 West Bengal 0.492

Territory based HDI 14 Uttaranchal 0.490
(2007–08) 15 Andhra 0.473
High HDI Pradesh
1 Kerala 0.790 India 0.586 (2014
2 Delhi 0.750 U.N.)
Medium HDI 16 Assam 0.444
3 Himachal 0.652 17 Rajasthan 0.434
Pradesh 18 Uttar Pradesh 0.380
4 Goa 0.617 19 Jharkhand 0.376
5 Punjab 0.605 20 Madhya 0.375
6 NE (excluding 0.573 Pradesh
Assam) 21 Bihar 0.367
7 Maharashtra 0.572 22 Odisha 0.362
8 Tamil Nadu 0.570 23 Chhattisgarh 0.358
9 Haryana 0.552
10 Jammu and 0.529 Source: IAMR, Planning Commission, Govt. of
Kashmir India
11 Gujarat 0.527
12 Karnataka 0.519 The state is ranked 15th in terms of
HDI at 0.473 which is grouped
amongst the medium HDI states and
is lower than the national average of
0.586.
22
GUNTUR DISTRICT
Guntur district of the state lies in the delta of Krishna River on the south-east
coast of the country. The district is bounded on the south–east by Bay of
Bengal, on the south by Prakasam district, on the west by Mahbubnagar
district, and on the north-west by Nalgonda district, Krishna river forms the
north-eastern and eastern boundary of the district, separating Guntur district
from Krishna district. The district coast line approximates 100 km. Guntur city
is the largest city and the administrative capital of Guntur district.
The district is a major centre for education and learning. Andhra Pradesh’s
capital would come up in Guntur district with the government identifying
30,000 acre across 17 villages.
As per the 2011 census, Guntur district, with a population of 4,889,230 ranked
22nd out of a total of 640 districts in the country. The district witnessed a lower
population growth rate of 9.50% against 11.10% of the state. Spread over an
area of 11,391 km 2, the district had a population density of 429 inhabitants
23
per square kilometre against the state average of 308. Guntur district at-a-
glance is attached. With population distribution of 2,441,128 males and
2,448,102 females, Guntur’s sex ratio is 1003 females for every 1000 males
is higher than 992 of the state the literacy rate of the district being 67.99% -
marginally better than that of the state (67.66%). The district is divided into
4 Revenue Divisions, further sub-divided into 57 Mandals, 57 Panchayat
samitis (Blocks), 728 Revenue villages, 1026 Gram Panchayats and 120
notified Gram Panchayats. The 14 towns (urban settlements) include 12
municipalities, 1 census town and 1 municipal corporation of Guntur city. The
distribution of municipalities and mandals across the Revenue Divisions is as
under:
Revenue Division Municipality Mandal

Guntur 3 19
Tenali 4 18
Narasaraopet 3 11
Gurazala 2 9
(formed in 2013)
Total 12 57
In so far as the Human Development Index (HDI) is concerned, there are

significant inter-district disparities in the index values. The values across
districts vary from 0.717 in Hyderabad to 0.397 in Mahabubnagar; the HDI for
Guntur district, improved over the period, was higher at 0.599 against the
state average of 0.537. Mandal wise analysis and rankings according to HDI
is also available-based on sampling method for the three revenue divisions of
the district, at a rate of four mandals from each division, 24 villages at the rate
of two villages from each mandal, fifteen households selected four villages;
aggregate sample size of 360 households in the district. The Table below
presents the 12 sample mandals, ranked according to their HDI values:
24
HDI Ranking of Mandals of Guntur District
Revenue Division Mandal HDI Value Rank

Narasaraopet Narasaraopet 0.705 2
Karampudi 0.647 10
Veldurthi 0.653 9
Nuzendla 0.642 11
Tenali Ponnur 0.686 4

Cherukupalli 0.685 5
Kollur 0.698 3
Nizampatnam 0.679 7
Guntur Guntur 0.724 1

Pedarrandipadu 0.680 6
Tadepalle 0.678 8
Bellarnkonda 0.641 12
District 0.676
Source: HDI in Guntur District of A.P.; Voice of Research vol.2, issue 4; March 2014.
As may be observed, Guntur Mandal of Guntur Revenue Division occupies the

first rank with an HDI value of 0.724 followed by Narasaraopet mandal of
Narasaraoet revenue division at HDI value of 0.705. The Table suggests gross
disparities exist in HDI within each revenue division as also within the district.
25
GUNTUR DISTRICT – AT –A- GLANCE
1 Geographical Area (Sq.Kms.) 11391
2 No. of Revenue Divisions 3(Guntur, Tenali,

Narasaraopet)
3 No. of Revenue Mandals 57
4 No. of Mandal Parishads 57
5 No. of Revenue Villages 728
6 No. of Municipal Corporations 1

(Guntur Municipal Corporation)
7 No. of Mjuniscipalities 9
a) Guntur Division Mangalagiri, Sattenapalli
b) Tenali Division Tenali, Ponnuru Bapatla,
Repalle
c) Narasaraopet Division Narasaraopet,
Chilakaluripet, Macherla
8 No. of Grama Panchayats 1026
9 No. of Notified Grama Panchayats 120
10 No. of Towns 11
11 No. of Habitations (Rural) 1755
12 No. of Municipal wards 314
26
HEALTH SCENARIO
27
4. HEALTH SCENARIO
BACKDROP
The constitution charges the states with ‘the raising of level of nutrition and
the standard of living of its people and the improvement of public health’.
Central Government efforts at influencing public health have focused on five-
year plans, on coordinated planning with the states, and on sponsoring major
health programmes. The Government expenditures are jointly shared by the
Central and State Governments. Thus while the principal responsibility of
public health funding lies with the states, which provide about 80% of public
funding, the Central Government contributes another 15% mostly through the
national health programmes.
Healthcare in the country is delivered on three levels : Primary, Secondary and

Tertiary; the primary level of care is provided at rural Primary Health Centres
(PHC), each of which services about 30,000 people (20,000 in hilly, desert and
difficult terrains) and is staffed by a medical officer and two health assistants,
along with health workers and a support staff. A PHC’s functions include basic
medical care, maternal & child health and family planning, prevention & control
of locally endemic diseases, implementation of national health programmes,
basic laboratory services, health education and referrals.
The Secondary Health Care addresses more complex health-related problems

at district hospitals and Community Health Centres (CHCs). At Tertiary level,
however, the service provided involves the higher or more specialized care
particularly at specialized hospitals, medical college hospitals, regional
institutions etc; at the village level, however, there are sub-centres. A sub-
centre provides service to about 5000 people (or about 3000 in hilly, tribal and
underdeveloped areas). These are typically staffed with 1 male and 1 female
multi-purpose health worker, offering services e.g. Immunization and family
planning.
28
Today, only 25% of the population can be said to have access to the western
(allopathic) medicine, practiced largely in urban areas. Many of the rural
populace rely on alternative forms of treatment e.g. ayurvedic, unani and
accupuncture. With a view to improving rural healthcare and providing
effective healthcare, the Government launched the National Rural Health
Mission (2005-12); for the purpose, effort has been directed on 18 states that
have low public health indicators coupled with inadequate infrastructure.
The Mission also seeks to enhance the capabilities of primary facilities and ease
the burden on tertiary centres by providing training to the staff and additional
equipment to complement the capacities.
THE NATIONAL SCENE
The country has made substantial progress in creation of health infrastructure.

There are 12,760 hospitals having 576,793 beds; of these 6,795 hospitals with
149,690 beds are in rural area. Besides, there are over 24,000 dispensaries,
and 3400 hospitals under AYUSH.
Despite that the picture on physical infrastructure is not encouraging. While

there is shortfall in rural healthcare infrastructure, these are not evenly spread
across the country.
In terms of medical education infrastructure, according to the MCI, today there

are 355 medical colleges in the country having 45,464 MBBS seats. According
to the MOHFW Annual Report to the People on Health, the distribution of
medical and nursing colleges in the country is highly skewed, as states with
greatest needs of medical human resources have lowest capacity of producing
them; the five south-western states (Andhra Pradesh, Maharashtra,
Karnataka, Kerala and Tamil Nadu) with 31 percent of the country’s population
account for 58 percent of medical colleges – both public and private – and 63
percent of the GNM nursing colleges (95% being private). States (Bihar,
Madhya Pradesh, Rajasthan and Uttar Pradesh) with poor health indicators
have nursing densities lower than the national average and account for only 9
percent of the nursing schools in the country.
29
As the Indian economy enjoying a steady growth, the healthcare industry in
India is heading towards growth phase. The health sector in India is
characterized by a government sector that provides publicly financed and
managed curative, preventive and promotive health services from primary to
tertiary level throughout the country free of cost to the people and a free-
levying private sector that plays a dominant role in the provisioning of curative
care.
(1) Public Health Sector: The provision of healthcare by the public sector is a
responsibility shared by the state government, Central Government and
local governments. General health services are the primary responsibility
of the states with the Central Government focusing on medical education,
drugs, population stabilization and disease control. The National Health
Programmes of the Central Government related to reproductive and child
health and to the control of major communicable diseases like malaria and
tuberculosis have contributed significantly to the state health programmes.
Recently, under the 122 NRHM, the Central Government has emerged as
an important financier of state health systems development. The
government health care services are organized at different levels. Primary
health care is provided through a network of over 151,684 health sub-
centres, 24,448 PHCs and 5,187 CHCs. At the district level on an average
there is a 150-bedded civil/district hospital in the main district town and a
few smaller hospitals and dispensaries spread over other towns and larger
villages.
(2) Private Health Sector: At the time of independence only about 8% of all
qualified modern medical care was provided by the private sector. But over
the years the share of the private sector in the provision of health care has
at about 80% of all outpatient care and about 60% of all in-patient care.
The private sector in India has a dominant presence in all the submarkets
– medical education and training, medical technology and diagnostics,
pharmaceutical manufacture and sale, hospital construction and ancillary
30
services and, finally, the provisioning of medical care. Over 75% of the
human resources and advanced medical technology, 68 per cent of an
estimated 15,097 hospitals and 37% of 623,819 total beds in the country
are in the private sector. Of these most are located in urban areas. The
private sector’s predominance in the health sector has led to equities in
access to healthcare. Hospitalization rates among the well-off are six times
higher than those among the poor.
In the present era of population growth and demographic restructuring, the

burden of providing health area has increased. Many countries have
pursued health services distribution to their citizenry through merely
expanding services with non-governmental organization (NGO) assistance.
The solution is not permanent, especially in developing democratic
countries like India, where the prime duty of the government is to provide
better and equally accessible services to every strata of the population.
Nonetheless, concerns about the ability of governments to finance health
services adequately, the poor performance of public health service delivery
systems and the desire to expand the choices available to patients have led
a number of Asian countries to encourage the expansion of private-sector
healthcare (William & Patricia, 1997). India is not an exception; private
health care services are increasingly prevalent throughout the nation.
Today, the private sector provides almost 75% of health services in India
(NRHM, 2005-12).
The country’s healthcare sector, growing at a 15 percent compound annual

growth rate (CAGR) grew from US$ 45 billion in 2008 to US$ 78.6 billion in
2012 and is expected to touch US$158.2 billion by 2017 and to 280 billion
by 2020 according to equities capital. India’s per capita healthcare
expenditure, however, increased at a CAGR of 10.3 percent from US$ 43.1
in 2008 to US$ 57.9 in 2011 and is expected to rise to US$ 88.7 by 2015.
The factors attributed to the growth are rising incomes, better access to
31
high- quality healthcare facilities and greater awareness of personnel health
and hygiene.
The private sector has emerged as a vibrant force in country’s healthcare

industry; its share in healthcare delivery is expected to increase from 66
percent in 2005 to 81 percent by 2015. Its share in hospitals and hospital
beds is estimated to be of the order of 74 percent and 40 percent
respectively.
Changes in lifestyle have resulted in dual disease burden - emanating from

the complexity of communicable and non-communicable diseases in rural
and urban areas of the country. This has impacted the healthcare
infrastructure requirements – posing challenges for service providers, both
for the government as also the private players. Lack of healthcare
infrastructure coupled with trained & qualified health workforce denies
access of healthcare services to significant portions of the populace;
consequently, India fares rather poorly not only amongst developed
economics but also with other BRIC Nations as shown in table below:
Table
Indicator Year India Other BRIC Nations Developed Economics

Brazil Russia China USA UK Japan
Life expectancy on birth 2012 66 74 69 75 79 81 84
(Years)
Infant Mortality Rate 2012 44 13 9 12 6 4 2
Maternal Mortality Rate 2013 190 69 24 32 28 8 6
Sources: WHO, World Health Statistics – 2014
When compared with the global standards, the country’s healthcare

infrastructure too is grossly inadequate; India has an average hospital beds
(per 10,000 population) of 7 against a global average of 27 and an average
of 0.7 doctors per 1000 population against the global average suggesting
gaps both in terms of physical infrastructure – hospitals/ hospital beds and
availability of doctors. Table – below highlight the same:
Table
32
Year India Other BRIC Nation Developed Economics
Brazil Russia China USA UK Japan
Hospital Bed Density (Per 2006- 7 23 97 38 29 29 137
10,000 population) 2012
Doctor Density per 10,000 2006- 7.0 18.9 43.1 14.6 24.5 27.9 23.0
population. 2013
Nurses per 10,000 2006- 17.1 76.0 85.2 15.1 99 - -
population 2013
Births attended by skilled 2006- 67 99 96 - 88.3 114.9
health personal (%) 2013
Source: WHO, World Health Statistics – 2014
Country had 4,32,526 government beds in 4,419 urban hospitals and 1,96,182
beds in 15,398 rural hospitals, placing the average population served per govt.
hospital at 61,744 and average population served per govt. hospital bed at
1,946. As may be seen from Table – below, wide disparities exist across
different status:
In so far as inadequacy of doctors is concerned, High Level Expert Group,

Planning Commission (HLEG) had observed that the production of allopathic
doctors, in the country, is both inadequate and uneven. It had proposed a
phased addition of 187 medical colleges during the XII & XIII plans for
equitable healthcare accessibility across the country, this would enable
additional availability of 1.2 lakh doctors by the year 2017, enhanced further
from newly added medical colleges so that 1.9 lakh additional doctors world
be added during 2017-2022, yielding a doctor population ratio of 1:1058 at
the end of XIII the plan. With this growth rate, the target of 1 doctor per 1000
population could be achieved by the end of year 2027. As already mentioned
in HLEG’s view, linking new medical colleges to district hospitals would besides
reducing financial burden considerably also contribute towards the normative
provision of 2 beds per 1000 population.
Likewise, availability of nursing & midwifery personnel would need to be

enhanced through phased addition of nursing colleges & ANM schools across
the country.
Disparities in Govt. Hospitals & Bed in Rural & Urban Areas

(Select states as on 1.1.2014
33
Hospitals
State Rural Urban Total Average Population
Served Per:
No. Beds No. Beds No. Beds Govt. Govt.
Hospital Hospital
Bed
Andhra 308 10,970 144 26,584 452 36,954 1,90,772 2,333
Pradesh
Bihar 1,325 5,250 111 6,302 1,436 11,552 69,639 8,681
Gujarat 300 9,925 88 17,983 388 27,908 1,56,106 2,170
Maharashtra 440 11,302 613 41,866 1,053 53,168 1,09,674 1,176
Kerala 1,135 17,595 144 20,021 1,279 37,616 27,392 931
Rajasthan 2,649 32,948 489 13,631 3,138 46,579 22,288 1,502
Tamil Nadu 407 9,150 381 55,093 788 64,243 86,630 1,063
Delhi -- -- 109 22,961 109 23,961 1,79,163 851
(1.1.2013)
India 15,398 196,182 4,419 4,32,526 19,817 6,28,708 61,744 1,946
Source: Directorate General of State Health Services
National Health Profile: 2013
At the current levels, as per one estimate, the CII-Technopak places the
requirement of additional beds at 2 million in 2028 as under:
2008 2018 2028

Addl. Beds Repaired (Million) 1.1 3.1 2
Bed/ 1000 population Ratio 0.7 – 1.7 4 5
To tide over the situation, HLEG has suggested upgradation of district

hospitals, across the country, making these compatible with the medical
colleges; this would not only increase the beds strength but also tend to
enhance the availability of doctors in the country.
When compared with other economics, the health expenditure across the
select countries presents a mixed picture as shown in table 5 below:
Health Spending in Select Countries
Country Total Govt. Exp. On

Health Health as a
Exp. As a % of total
% of GDP exp. on
Health
2000 2005 2011 2000 2005 2011
USA 13.6 15.2 17.7 43.0 45.1 47.6
Germany 10.4 10.7 11.3 79.5 76.9 76.5
France 10.1 11.2 11.6 79.4 79.9 76.8
Canada 8.8 9.7 10.9 70.4 70.3 70.4
UK 7.0 8.2 9.4 79.1 87.1 82.8
Brazil 7.2 7.9 8.9 40.3 44.1 46.7
34
Mexico 5.1 6.4 6.0 46.6 45.5 50.3
China 4.6 4.7 5.1 38.3 38.8 55.9
Malaysia 3.0 4.2 3.8 55.8 44.8 55.2
Indonesia 2.0 2.1 2.9 36.1 46.6 37.9
Thailand 3.4 3.5 4.1 56.1 63.9 77.7
Pakistan 3.0 2.1 3.0 21.7 17.5 31.0
Sri Lanka 3.7 4.1 3.3 48.4 45.2 42.1
Bangladesh 2.8 2.8 3.8 39.0 29.1 38.2
Nepal 5.0 5.8 6.1 24.6 28.1 45.3
India 4.3 5.0 3.9 26.0 19.0 30.5
Source: World Health Statistics (2007, 2014) ; WHO
The table shows that while the health expenditure as a percentage of GDP as
also the public spending as a percentage of total expenditure are low when
compared with the developed countries, the situation is somewhat different in
comparison with the South-East Asia countries. The health expenditure as a
percentage of GDP is higher than the Asian countries even though the Govt.
spending as a percentage of total expenditure on health is lower than most of
these countries.
India’s disease profile is expected to follow the same pattern as developed

economies. Based on the demographic trends and disease profile, lifestyle
disease – cardiovascular, asthma and cancer have become the most important
segments, and in-patient spending is expected to represent nearly 50 percent
of total healthcare expenditure. In the in-patient market, the share of
infectious diseases is expected to decline. These highlight the critical need for
more health workers to achieve a modest coverage.
The country’s health workforce, on the other hand can be considered to be

distributed across the under mentioned occupational categories.
Physicians Generalists & Specialists

Nurses Professional & auxiliary nurses and other nurses – dental
/ primary care.
Midwives Includes auxiliary midwives but excludes traditional birth
attendants.
Dentists Includes dental assistants & dental technicians.
Pharmacists Includes pharmaceutical assistants.
Lab. Workers Includes Lab. Scientists, Lab. Assistants, lab technicians
and radiographers.
Community Health Includes traditional medicine practitioners, faith healers,
Workers lady health visitors, traditional birth attendants etc.
35
Health Management & Includes managers, statisticians, teaching professionals,
Support Workers accounts / administration Staff, computer technicians,
ambulance staff, engineering staff and general support
staff.
Based thereon, the distribution of health workforce in India is presented in the

table
Distribution of Health Workforce – India
Number Density per 1000 Year

population
Physicians 645,825 0.60 2005
Nurses 865,135 0.80 2004
Midwives 506,924 0.47 2004
Dentists 61,424 0.06 2004
Pharmacists 592,577 0.56 2003
Public & Environmental health 325,263 0.38 1991
Workers
Community health Works 50,393 0.05 2004
Lab Technicians 15,886 0.02 1991
Other Health Workers 818,301 0.76 2005
Source: Extracted from Annex table: 1 to the World Health Report 2006, WHO
12 FIVE YEAR PLAN & HEALTH SECTOR
1. “The Twelfth Plan will build on the successes of the NRHM in treating
healthcare as a system of preventive and curative medicine. Thus,
universal health would include all aspects of a clearly defined set of
healthcare entitlements including preventive, primary and secondary health
services. In setting targets for achievement in the Twelfth Five year plan
period, essentially the state specific targets will aim at reduction of IMR,
MMR, TFR and disease prevalence. In case of IMR, target for each State
will be to reduce IMR by 40% and MMR by 55% over the 5 year period of
12th Plan. Similarly, for TFR and disease control programs, state-specific
targets will be set in the MoU to be signed with the States.
36
2. At the national level, the Plan would largely aim at :
a. Reducing:
 MMR to <100 per 100000 live births
 IMR to <27 per 1000 live births
 NMR to <18 per 1000 live births
 TFR to 2.1
b. Raising the sex ratio for age group 0 to 6 to 950 by 2016-17.
c. Providing clean drinking water for all by 2017
 Anemia among women and girls by 30% with a 50% reduction in
moderate and severe anemia in pregnant women.
3. In terms of service delivery goals would aim at achieving:

 Over 80% institutional delivery in high – focus states and over 95%
in non – high focus states and 100% safe delivery in all states;
 Over 80% Immunization in all states with over 95% immunization in
non – high focus states;
 Over 90% antenatal and post natal care in all states with 100% in
non high focus states.
 Universal access to safe abortion services.
 Meeting the unmet need for contraception with equal emphasis on
spacing and limiting methods.
 An average public sector OPD attendance in each district of 2 per
year per capita for the district. At least 70% of this load should be
managed in the PHCs and CHCs.
 A bed occupancy rate in each district of over 70% for in-patients.
 An assured referral transport system between facilities and an
emergency response system in every district.
 Access to emergency life saving services and trauma care in every
district.
 Free distribution of medicines as per the Essential Drug List and basic
diagnostics should be provided free of cost in public sector hospitals.
37
The long-term strategy for the Twelfth Plan would therefore be to
establish a system of universal health coverage based on the
recommendations of High Level Expert group (HLEG) by the Planning
Commission, report on numeral health coverage for India, broadly as
under:
 Substantial expansion and strengthening of public sector healthcare

system, freeing the vulnerable population from dependence on high –
cost private sector healthcare system;
 Increasing cooperation between private and public sector healthcare

providers to achieve health goals; this may be through increased. Public
–Private – Partnerships.
 In order to increase availability of skilled human resources for health a

large scale expansion / setting up of new medical colleges, nursing
schools / colleges is called for; govt. needs to play a major role in the
process.
 Need to focus on pillars of the health system so as to prevent, detect

and manage each of the unique challenges faced across the country.
 Priority be accorded to evolving essential health package – conducting

a series of prescription drugs reforms, promotion of essential, generic
medicine and making these available universally free-of-cost to all
patients in public facilities.
 Effective regulation in medical practice, public health, food & drugs is

essential to safeguard people against risks and unethical practices.
 A strong regulatory system needs to be in place to supervise quality of

services delivered – both in public and private sectors. Standard
treatment guidelines should from the basis of clinical case across the
public and private sectors, with adequate monitoring by the regulatory
bodies to improve the quality and control the cost of care.
 Reforming the present Rashtriya Swasthya Bima yajana (RSBY) which

provides cashless in-patient treatment through an insurance – based
38
system to enable across to a continuum of comprehensive primary,
secondary & tertiary case RSBY to cover the entire BPL population to be
covered during the Plan period.
39
THE STATE
The Total Fertility Rate of the State is 1.8. The Infant Mortality Rate is 43 and
Maternal Mortality Ratio is 134 (SRS 2007 - 2009) which are lower than the
National average. The Sex Ratio in the State is 992 (as compared to 940 for
the country). Comparative figures of major health and demographic indicators
of undivided Andhra Pradesh are as follows:
Demographic, Socio-economic and Health profile of Andhra Pradesh as

compared to India figures
Indicators Andhra India
Pradesh
Total Population (In Crore) (Census 2011) 8.4 121.01
Total decadal growth (%) (Census 2011) 11.1 17.64
Infant Mortality Rate (SRS 2013) 39 40
Maternal Mortality Rate (2010-12) 110 178
Total Fertility Rate (2012) 1.8 2.4
Crude Birth Rate (SRS 2013) 17.4 21.4
Crude Death Rate (SRS 2013) 7.3 7
Natural Growth Rate (SRS 2013) 10 14.4
Sex Ratio (Census 2011) 992 940
Child Sex ratio (Census 2011) 943 914
Schedule Cast Population (In Crore) (Census 1.23 16.6
2001)
Schedule Tribe population (In Crore) (Census 0.50 8.4
2001)
Total Literacy Rate (%) (Census 2011) 67.6 74.04
Male literacy Rate (%) (Census 2011) 75.56 82.14
Female Literacy Rate (%) (Census 2011) 59.74 65.46
Source: RHS Bulletin, March 2012, M/O Health & F.W., GOI
40
Health Infrastructure of Andhra Pradesh
Particulars Required In position shortfall
Sub-centre 12283 12522 *
Primary Health Centre 2004 1624 380
Community Health Centre 501 281 220
Health worker (Female)/ANM at Sub 14146 21853 *
Centres & PHCs
Health Worker (Male) at Sub Centres 12522 4608 7914
Health Assistant (Female)/LHV at PHCs 1624 2251 *
Health Assistant (Male) at PHCs 1624 0 1624
Doctor at PHCs 1624 3448 *
Obstetricians & Gynecologists at CHCs 281 99 182
Pediatricians at CHCs 281 110 171
Total specialists at CHCs 1124 346 778
Radiographers at CHCs 281 65 216
Pharmacist at PHCs & CHCs 1905 1851 54
Laboratory Technicians at PHCs & CHCs 1905 1422 483
Nursing Staff at PHCs & CHCs 3591 4177 *
Source: RHS Bulletin, March 2012, M/O Health & F.W., GOI
Medical Education
There are 46 medical colleges in the undivided Andhra Pradesh with seats
aggregating 6700; of which, 12 medical colleges is under newly formed
Telegana state. Annex-A list out the medical colleges in the state. The two in
newly formed Andhra Pradesh i.e., Vijayawada & Anantpur included for
upgradation under PMSSY-III programme.
41
Table: STATUS OF INTAKE CAPACITY OF MBBS SEATS (Statewise)
Sl. State Government Private Total
No. No. Seats No. Seats No. Seats
of Colleges of Colleges of Colleges
1 Andhra Pd. 14 2050 26 3550 40 5600
2 Assam 5 626 0 0 5 626
3 Bihar 7 540 4 360 11 900
4 Chandigarh 1 50 0 0 1 50
5 Chhattisgarh 3 300 0 0 3 300
6 Delhi 4 750 2 200 6 950
7 Goa 1 150 0 0 1 150
8 Gujarat 9 1530 13 1700 22 3230
9 Haryana 2 300 4 400 6 700
10 Himachal Pradesh 2 200 0 0 2 200
11 J&K 3 250 1 100 4 350
12 Jharkhand 3 250 0 0 3 250
13 Karnataka 11 1350 32 4655 43 6005
14 Kerala 6 1000 17 1850 23 2850
15 Madhya Pd. 6 720 6 900 12 1620
16 Maharashtra 19 2200 26 2995 45 6060
17 Manipur 2 200 0 0 2 200
18 Meghalaya 1 50 0 0 1 50
19 Orissa 3 450 4 400 7 850
20 Pondicherry 1 150 7 900 8 1050
21 Punjab 3 350 7 795 10 1145
22 Rajasthan 6 800 4 550 10 1350
23 Sikkim 0 0 1 100 1 100
24 Tamil Nadu 19 2205 23 3350 42 5555
25 Tripura 2 200 0 0 2 200
26 Uttar Pradesh 10 1240 15 1800 25 3040
27 Uttaranchal 2 200 2 200 4 400
28 West Bengal 13 1750 2 250 15 2000
29 AIIMS 7 377 0 0 7 377
30 JIPMER 1 127 0 0 1 127
31 BHU, Varanasi 1 59 0 0 1 59
32 AMU, Aligarh 1 150 0 0 1 150
168 20574 194 25055 362 45629
Source: Medical Council of India as on 2012
42
Annex
List of MBSS Teaching Colleges in Andhra Pradesh (As per MCI list)
S.No. Course State Name and Address University Mgmt.of Year of Annual Status of MCI
Name of Name College Inceptio Intake Recognition
Medical College / n of (Seats)
Medical Institution College
1 M.B.B.S. Andhra ACSR Government NTR University of Govt. 2014 150 Permitted u/s
Pradesh Medical College Health Sciences, 10(A) for 2014-
Nellore VijayWada 15. The
Permission is
conditional.
2 M.B.B.S. Andhra Alluri Sitaram Raju NTR University of Trust 2000 150 Recognized
Pradesh Academy of Medical Health Sciences,
Sciences, Eluru VijayWada
3 M.B.B.S. Andhra Andhra Medical NTR University of Govt. 1923 200 Recognized for
Pradesh College, Health Sciences, 150 seats.
Visakhapatnam VijayWada Permitted for
renewal of
permission for
increase of seats
from 150 to 200
for 2014-15.
4* M.B.B.S. Andhra Apollo Institute of NTR University of Trust 2012 100 Permitted for
Pradesh Medical Sciences and Health Sciences, renewal of
Research, Hyderabad VijayWada permission for
2014-15.
5 M.B.B.S. Andhra Bhaskar Medical NTR University of Trust 2005 150 Recognized
Pradesh College, Yenkapally Health Sciences,
VijayWada
6* M.B.B.S. Andhra Chalmeda Anand Rao NTR University of Trust 2003 150 Recognized
Pradesh Insttitute Of Medical Health Sciences, when granted on
Sciences, VijayWada or after Apr2008
Karimnagar
7 M.B.B.S. Andhra Deccan College of NTR University of Trust 1985 150 Recognized
Pradesh Medical Sciences, Health Sciences,
Hyderabad VijayWada
8 M.B.B.S. Andhra Dr. P.S.I. Medical NTR University of Trust 2002 150 Recognized
Pradesh College , Chinoutpalli Health Sciences, when granted on
VijayWada or after Apr2008
9 M.B.B.S. Andhra Dr. VRK Womens NTR University of Trust 2010 0 Not Permitted
Pradesh Medical College, Health Sciences, for renewal of
Aziznagar VijayWada permission u/s
10(A) for 2014-
15.
10 M.B.B.S. Andhra Fathima Instt. of NTR University of Trust 2010 100 Permitted for
Pradesh Medical Health Sciences, renewal of
Sciences,Kadapa VijayWada permission u/s
10(A) for the
year 2014-15 on
the basis of
undertaking filed
by the college
authority before
Hon ble
Supreme Court
(WP(C) No. 469
of 2014).
11 * M.B.B.S. Andhra Gandhi Medical NTR University of Govt. 1954 200 Recognized for
Pradesh College, Hyderabad Health Sciences, 150
VijayWada seats.Permitted
for renewal of
permission for
increase of seats
from 150 to 200
u/s 10(A) for
2014-15.
12 M.B.B.S. Andhra Government Medical NTR University of Govt. 2000 100 Recognized
Pradesh College, Anantapur Health Sciences,
VijayWada
13 * M.B.B.S. Andhra Government Medical NTR University of Govt. 2013 100 Permitted for
Pradesh College, Nizamabad Health Sciences, renewal of
VijayWada permission u/s
10(A) for 2014-
15.
14 M.B.B.S. Andhra Government NTR University of Govt. 1980 150 Recognized for
Pradesh Siddhartha Medical Health Sciences, 100 seats.
College, Vijaywada VijayWada Permitted for
renewal of
permission for
increase of seats
from 100 to 150
for 2014-15.
15 M.B.B.S. Andhra Great Eastern NTR University of Trust 2010 0 Not permitted
Pradesh Medical School and Health Sciences, for renewal of
Hospital,Srikakulam VijayWada permission for
the year 2014-
15.
16 M.B.B.S. Andhra GSL Medical College, NTR University of Trust 2002 200 Recognized for
Pradesh Rajahmundry Health Sciences, 150 seats.
VijayWada Permission for
increase of seats
from 150 to 200
for 2014-15.
17 M.B.B.S. Andhra Guntur Medical NTR University of Govt. 1946 200 Recognized for
Pradesh College, Guntur Health Sciences, 150
VijayWada seats.Permitted
for renewal of
permission for
increase of seats
from 150 to 200
u/s 10(A) for
2014-15.
18 * M.B.B.S. Andhra Kakatiya Medical NTR University of Govt. 1959 200 Recognized for
Pradesh College, Wrangal Health Sciences, 150 seats.
VijayWada Permitted for
renewal of
permission for
increase of seats
from 150 to 200
u/s 10(A)for
2014-15.
19 M.B.B.S. Andhra Kamineni Academy NTR University of Private 2013 150 Permitted for
Pradesh of Medical Sciences & Health Sciences, renewal of
Research Center, VijayWada permission u/s
Hyderabad 10(A) for 2014-
15
20 M.B.B.S. Andhra Kamineni Institute of NTR University of Trust 1999 150 Recognized
Narketpally VijayWada
21 M.B.B.S. Andhra Katuri Medical NTR University of Trust 2002 100 Recognized for
Pradesh College, Guntur Health Sciences, 100 seats. Not
renewal of
permission for
increase of seats
from 100 to 150
for 2014-15.
22 M.B.B.S. Andhra Konaseema Institute NTR University of Trust 2005 150 Recognized
Pradesh of Medical Sciences & Health Sciences,
Research Foundation, VijayWada
Amalapuram
23 M.B.B.S. Andhra Kurnool Medical NTR University of Govt. 1957 200 Recognized for
Pradesh College, Kurnool Health Sciences, 150 seats.
renewal of
permission for
increase of seats
from 150 to 200
for 2014-15.
24 M.B.B.S. Andhra Maharajah Institute NTR University of Trust 2002 150 Recognized for
Pradesh of Medical Sciences, Health Sciences, 100 seats when
Vizianagaram VijayWada granted on or
after Apr2008.
Permitted for
renewal of
permission for
increase of seats
from 100 to 150
for 2014-15.
25 * M.B.B.S. Andhra Malla Reddy Institute NTR University of Society 2012 150 Permitted for
Pradesh of Medical Sciences, Health Sciences, renewal of
Hyderabad VijayWada permission u/s
10(A) for 2014-
15 on the basis
of undertaking
filed by the
college authority
before Hon ble
Supreme Court
(WP(C) No. 469
of 2014)
26 * M.B.B.S. Andhra Mallareddy Medical NTR University of Society 2013 150 Permitted for
Pradesh College for Womens, Health Sciences, renewal of
Hyderabad VijayWada permission u/s
10(A) for 2014-
15.
27 * M.B.B.S. Andhra Mamata Medical NTR University of Trust 1998 150 Recognized
Pradesh College, Khammam Health Sciences,
VijayWada
28 M.B.B.S. Andhra Medicity Institute Of NTR University of Trust 2001 150 Recognized for
Pradesh Medical Sciences, Health Sciences, 100 seats.
Ghanpur VijayWada Permitted for
renewal of
permission for
increase of seats
from 100 to 150
for 2014-15 on
the basis of
undertaking filed
by the college
authority before
Hon ble
Supreme Court
(WP(C) No. 469
of 2014)
29 * M.B.B.S. Andhra MNR Medical College, NTR University of Trust 2002 100 Recognized
Pradesh Sangareddy Health Sciences,
VijayWada
30 M.B.B.S. Andhra Narayana Medical NTR University of Trust 2000 250 Recognized for
Pradesh College, Nellore Health Sciences, 150 seats.
increase of seats
from 150 to 250
u/s 10(A) for
2014-15.
31 M.B.B.S. Andhra NRI Institute of NTR University of Trust 2012 150 Permitted for
Pradesh Medical Sciences, Health Sciences, renewal of
Visakhapatnam VijayWada permission u/s
10(A) for the
year 2014-15.
32 M.B.B.S. Andhra NRI Medical College, NTR University of Trust 2003 150 Recognized
Pradesh Guntur Health Sciences, when granted on
VijayWada or after
Apr2008.
33 * M.B.B.S. Andhra Osmania Medical NTR University of Govt. 1946 250 Recognized for
Pradesh College, Hyderabad Health Sciences, 200 seats.
renewal of
permission for
increase of seats
from 200 to 250
u/s 10(A) for
2014-15.
34 M.B.B.S. Andhra P E S Institute Of NTR University of Trust 2001 150 Recognized
Pradesh Medical Sciences and Health Sciences,
Research, Kuppam VijayWada
35 * M.B.B.S. Andhra Prathima Institute Of NTR University of Trust 2001 150 Recognized
Karimnagar VijayWada
36 * M.B.B.S. Andhra Rajiv Gandhi NTR University of Govt. 2008 100 Recognized on
Pradesh Institute of Medical Health Sciences, or after
Sciences, adilabad VijayWada February, 2013.
37 M.B.B.S. Andhra Rajiv Gandhi NTR University of Govt. 2006 150 Recognized on
Pradesh Institute of Medical Health Sciences, or after March
Sciences, Kadapa VijayWada 2011
38 M.B.B.S. Andhra Rajiv Gandhi NTR University of Govt. 2008 100 Recognized on
Pradesh Institute of Medical Health Sciences, or after
Sciences, Srikakulam VijayWada February, 2013.
39 M.B.B.S. Andhra Rajiv Gandhi NTR University of Govt. 2011 100 Permitted for
Pradesh Institute of Medical Health Sciences, renewal of
Sciences,Ongole, AP VijayWada permission u/s
10(A) for 2014-
15.
40 M.B.B.S. Andhra Rangaraya Medical NTR University of Govt. 1958 200 Recognized for
Pradesh College, Kakinada Health Sciences, 150 seats.
renewal of
permission for
increase of seats
from 150 to 200
u/s 10(A) for
2014-15.
41 M.B.B.S. Andhra S V Medical College, NTR University of Govt. 1960 200 Recognized for
Pradesh Tirupati Health Sciences, 150 seats.
renewal of
permission for
increase of seats
from 150 to 200
u/s 10(A) for
2014-15.
42 * M.B.B.S. Andhra S V S Medical NTR University of Trust 1999 150 Recognized for
Pradesh College, Health Sciences, 100 seats.
Mehboobnagar VijayWada Permitted for
renewal of
permission for
increase of seats
from 100 to 150
u/s 10(A) for
2014-15.
43 M.B.B.S. Andhra Santhiram Medical NTR University of Trust 2005 100 Recognized
Pradesh College, Nandyal Health Sciences,
VijayWada
44 M.B.B.S. Andhra Shadan Institute of NTR University of Society 2005 150 Recognized
Pradesh Medical Health Sciences,
Sciences,Research VijayWada
Centre and Teaching
Hospital,
Peerancheru
45 M.B.B.S. Andhra Sri Padmavathi Sri Venkateswara Govt. 2014 150 Permitted u/s
Pradesh Medical College for Institute of 10(A) for 2014-
Women, Alipiri Road, Medical Sciences, 15.
Tirupati Tirupati
46 M.B.B.S. Andhra Viswabharathi NTR University of Society 2014 150 Permitted u/s
Pradesh Medical College, Health Sciences, 10(A) for 2014-
Kurnool VijayWada 15.
Note: * come under newly formed Telegala State
Source: Medical Council of India
PROPOSED FACILITIES
AT
AIIMS- GUNTUR
51
5. PROPOSED FACILITIES
Hospital: Speciality and Super Speciality Hospitals,
Trauma centre, Ayush centre, suppor
services & allied facilities, Basement Parking.
Institutional (Teaching) : Teaching Block, Admin Block, Auditorium,
Nursing College, Night shelter & related
facilities
Residential: Housing of Various types, Guest House,
Director’s Bungalow, PG/UG Boys & Girls
Hostels, Nursing Hostels etc
The facilities are as follows:
DEPARTMENTS- TEACHING BLOCK
Every medical college and medical institution for 100 MBBS admissions
annually shall have the following department i.e.
1. Human Anatomy
2. Human Physiology
3. Biochemistry
4. Pathology (including Blood Bank)
5. Microbiology
6. Pharmacology
7. Forensic Medicine including Toxicology
8. Community Medicine
1. General Surgery
2. General Medicine
3. Paediatrics
52
4. Orthopaedics
5. Ophthalmology
6. Psychiatry
7. Dermatology
8. ENT
9. Obst & Gyane
10.Physical Medicine and Rehabilitation (PMR )
1. Cardiology
2. Cardio-thoracic Vascular Surgery (CTVS)
3. Neurology
4. Neuro-Surgery
5. Gastroenterology
6. Gastroenterology Surgery
7. Surgical Oncology
8. Medical Oncology
9. Pulmonary Medicine
10. Pediatric Surgery
11. Urology
12. Nephrology
13. Endocrinology
14. Clinical Haematology
15. Burns & Plastic Surgery
OTHER DEPARTMENTS
 Radiology
 Anesthesia
 Transfusion Medicine (Blood Bank)
TRAUMA FACILITY
53
AYUSH CENTRE
NURSING COLLEGE (Initially start with 50 intake, expandable to 100)
NIGHT SHELTER, GUEST HOUSE, ANIMAL HOUSE ETC.
BED DISTRIBUTION (Department-wise)
DEPARTMENTS BEDS
Surgical & Allied Specialities 220
 General Surgery 120
 Orthopaedics 60
 Ophthalmology 20
 Oto-rhinolaryngology 20
Medicine & Allied Specialities 220
 General Medicine 120
 Paediatrics 60
 TB & Respiratory Diseases 10
 Dermatology & STD 10
 Psychiatry 10
Obstetrics & Gynaecology 60
 Obstetrics 35
 Post-partum 5
 Gynaecology 20
Sub-total 500
54
Departments Beds
 Cardiology 20
 Cardio-thoracic Vascular Surgery (CTVS) 20
 Gastroenterology 20
 Surgical Gastroenterology 20
 Nephrology 20
 Urology 20
 Neurology 20
 Neuro-surgery 20
 Medical oncology 20
 Surgical oncology 20
 Endocrinology 20
 Clinical Haematology 20
 Paediatric Surgery 20
 Burns & Plastic Surgery 20
 Pulmonary Medicine 20
Sub-total 300
Total Ward Beds 800
Other Facilities 160
 Intensive Care Unit (ICUs) & Critical Care 50
 Trauma 50
 AYUSH Facilities 30
 PMR Department 30
TOTAL 960
Paid Beds 60
55
RESIDENTIAL ACCOMMODATIONS
Sl.No. Description of 171 Dwelling Units (DUs)

Block Unit per No. of Occupancy per
Block Blocks Block
1 Director's Bungalow 1 1 −
2 TYPE - II 36 3 108
3 TYPE - III 18 1 18
4 TYPE - IV 21 1 21
5 TYPE - V 24 1 24
6 Guest House 1 1 −
HOSTEL ACCOMODATION
Sl.No. Description of Block 1400 Occupancy
Unit per No. of Occupancy

Block Blocks per Block
7 PG Hostel - D 1 156 2 312
8 PG Hostel - D 2 132 1 132
9 PG Hostel - D 3 155 1 155
10 UG Hostel - Girls 120 1 120
11 UG Hostel - Boys 1 100 1 100
12 UG Hostel - Boys 2 146 1 146
13 Nursing Student Hostel -I 144 1 144
14 Nursing Student Hostel -II 288 1 288
15 Dining Hall - I 1 1 −
16 Dining Hall - II 1 1 −
56
AREA STATEMENT
A. Institutional (Hospital & Teaching)
Hospital (A) Teaching (B)

Floors Floor Area in Sq.m Name of Building Area in Sq.m
Ground Floor 17222 Teaching Block (G+4) 17390
st
1 13322 Auditorium(G+2) 7380
nd
2 14553 Admin Block (G+3) 4600
3rd 13784 Animal House (G+1) 760
th
4 13719
th
5 25570 Nursing College (G+2) 4650
th
6 10159 Night Shelter (G+3) 3700
Sub Total 108329
Guest House (G+2) 2300
Basement for services 5171
Other Services 5500
Total 119000 Total 40780
GRAND TOTAL (A+B) 159780 SQ.M
Residential (C)
Sl.No Facility (Sq.m)

1 TYPE II RESIDENCES 6894
2 TYPE III RESIDENCES 1464
3 TYPE IV RESIDENCES 2206
4 TYPE V RESIDENCES 4199
5 Director Bungalow 301
6 Guest House 650
10 Dining Hall – I 772
11 Dining Hall – II 958
12 UG HOSTEL GIRL 3558
15 NURSES STUDENT HOSTEL D 4746
16 NURSES STUDENT HOSTEL E 4673
Total Area (C) 52931
Total Area (A+B+C) = 2,12,711 Sq.m
57
CAPITAL OUTLAY ESTIMATES
58
6. CAPITAL OUTLAY ESTIMATES
This section translates the physical assets i.e., buildings, equipment etc.
identified, into monetary value to arrive at the estimated capital outlay. The
capital outlay estimation is based on the area proposed for the Institution
campus including the residential facilities.
INSTITUTION BUILDINGS Hospital Medical Residential Total

College
Building & Services
Civil & Internal Services Work 415.69 141.17 132.08 688.94
External Development 17.17 8.46 8.10 33.73
PHE and Fire Fighting 38.24 9.80 15.50 63.54
Electricals 74.91 14.37 12.90 102.18
HVAC 35.60 12.28 0.91 48.79
System & Services (Modular 60.10 - - 60.1
OTs, Gas Manifold, Kitchen,
Laundry, CSSD, Mortuary etc)
IT & Computerization Facilities 30.00 - - 30
Furniture 35.00 14.00 14.00 63
Sub- total 706.71 200.62 183.49 1090.82
Contingencies @3% 21.20 6.02 5.50 32.72
Escalation @6.5% per annum 45.94 13.04 11.93 70.91
(for 3rd year on 2/3rd cost of
ix, and for 4th year on 1/3rd
cost of ix)
Sub-total 773.85 219.68 200.92 1194.45
Add for Project Consultancy 44.11 12.52 11.45 68.08
Charges @ 5% including
service tax @ 14%
Total Construction Cost 817.95 232.20 212.38 1262.53
Add Service Tax @ 5.6% 70.70
MEDICAL EQUIPMENT 285.00

Including Procurement
Consultancy fee@2% &
service tax@14%
TOTAL PROJECT COST 1618.23
Total Project Cost (Say) Rs. 1618 Crores
59
SUMMARY OF BUILDING & SERVICES
BUDGETARY ESTIMATE – HOSPITAL Block
Total Cost (Rs in

S.No Description of Items
Lac)
A Building and services
i Civil and internal services
a Building 39610.67 A
b Basement 1958.45
Total- Civil and internal services 41569.12
ii External Development
a Development Work - levelling, internal roads and paths & sewer 1265.50
b Horticulture Operations 171.59
c Signage 279.92
Total- External Development 1717.01
iii PHE and Fire Fighting
a Water Tank(Underground and overhead) 542.02
b Water Suply Distribution & grid lines 396.81
c Storm water Drains 182.32
d STP-895 KLD 537.00
e Borewells (1 No.) 9.00
f Solar Hot Water 70000 litres 147.00
g Fire Fighting & Fire Alarm system 1503.88
h Effluent Treatment Plant 90 KLD 63.00
i Hydropneumatic system/ WTP/ Softner 1474 KLD 443.00
Total- PHE and Fire Fighting 3824.02
iv Electricals
As per enclosure 7391.10
Shifting of existing services 100.00
Total- Electricals 7491.10
v HVAC systems
a Air-conditioning and ventilation 3559.60
Total- Air-condotioning/Ventilation 3559.60
vi Others
a Special Services (Modular OT, CSSD etc.) 6010.00
b IT, Computerization facility etc 3000.00
c Furniture 3500.00
Total ( i to vi ) 70670.84 B
vii Contingencies
a Add for contingencies @3% on B 2120.13
60
viii Add for escalation @ 6.5% PA
For 3rd year on 2/3rd cost of B 3062.40
For 4th year on 1/3rd cost of B 1531.20
Total (i to viii) 77384.57
Add for Project consultancy charges @ 5% including Service Tax
ix @ 14% 4410.92
Total cost 81795.49
Say Rs 817.95 Cr
Note: Cost of equipment and recurring expanses are not included in the above cost
Note: Details of Civil works Cost estimations are attached as Annexure at end of the Report
61
BUDGETARY ESTIMATE - MEDICAL COLLEGE Block
S.No Item Total Cost (Rs in Lac)

i Civil and internal services
a Building work 13516.70 A
b Compound wall 500.00
b Interior/accoustic of auditorium incl. Audi Chairs 100.00
c Signage 127.90
d Borewells (2 Nos.) 18.00
e Solar Hot Water 12023 litres 26.00
f Fire Fighting & Fire Alarm system 451.83
g WTP 274 KLD 83.00
iv Electricals
a As per enclosure 1054.98
b Lifts 204.58
c Streel Light 176.96
v HVAC systems
Total- Air-condotioning/Ventilation 1282.28
Sub-total 18662.03
vi Furniture 1400.00
Total ( i to vi ) 20062.03 B
vii Contingencies
a Add for contingencies @ 3% on B 601.86
62
Add for Project consultancy charges @ 5% including Service
Tax @ 14% 1252.17
Total cost 23220.09
Say Rs 232.20 Cr
63
BUDGETARY ESTIMATE – Residential Facilities
Total Cost (Rs in

S.No Item
Lac)
i Civil and internal services 13208.09 A
c Signage 91.16
d STP-420 KLD 252.00
e Borewells (3 Nos.) 27.00
f Water treatment plant 259 KLD 78.00
g Solar Hot Water 47927 litres 143.78
h Fire Fighting & Fire Alarm system 524.73
iv Electricals
a As per enclosure 338.25
b Lifts 774.33
c Street Light 176.96
v HVAC systems
Total- Air-conditioning/ Ventilation 91.44
vi Furniture 1400.00
Total ( i to vi ) 18349.16 B
vii Contingencies
a Add for contingencies @3% on B 550.47
Add for Project consultancy charges @ 5% including
Service Tax @ 14% 1145.26
64
Total cost 21237.59
Say Rs 212.38 Cr
IMPLEMENTATION SCHEDULE
65
7. IMPLEMENTATION SCHEDULE
Keeping in view various activities associated with construction of the

Institution campus (Medical College & Hospital and Residential facilities)
an implementation schedule has been drawn up. The schedule/ plan
envisage commissioning of the institute in about 54 months from the date
of decision to go ahead has been taken, broadly as under:
Pre-construction Phase (12 Months)
 Including necessary approvals after submission of : 12

final report, development of concept designs, Months
preparation of tender documents, and award of work.
Construction & Stabilisation Phase (42 Months)
 Construction Period : 36 Months
 Commissioning of Services including obtaining : 06 Months

clearances/certificates from local statutory bodies
including stabililation period.
In order that implementation proceeds as per the plan, it would be necessary

that the project activities are effectively monitored and funds released are
placed at the disposal of the project authorities.
An attempt has also been made to assess the requirements of funds, during
the various stages of project implementation; the same is as under:
Phase Fund Requirement

(% of Project Cost)
Pre-Construction Phase (12 Months) 5%
Construction Period (36 Months)
1st Year 25%
2nd Year 30%
3rd Year 40%
Stabilisation Period (6 months)
As may be seen from the implementation schedule attached, the project will be
completed within 54 months including the commissioning of services (from the
date of government of India approval).
66
TENTATIVE IMPLEMENTATION SCHEDULE
DURATION IN MONTHS
S.No. ACTIVITY / DURATION 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 40 48 50 54
1. Preparation of DPR, Concpt Plan & Approvals

EFC etc.
2. Preparation of Detailed Design/Drawings
3. Preparation of Tenders
4. Approvals from local / statutory authorities
5. Tendering and Evaluation of Tenders
6. Approval & Award of Work
7. Construction Work at site by Contractor (s)
8. Testing, Commissioning and Handing over

Building & Services
9. Procurement of Equipment &
Installation/Commissioning
Defect Liability Period of 12 months from completion / handing over
Pre-Construction Stage (0-12 months)

Construction (12-48 months)
Stabilisation Stage (48-54 months)
EQUIPMENT PLANNING
68
8. EQUIPMENT PLANNING
A Technical Committee comprising of Director, PGIMER, Chandigarh, Director,

AIIMS, Bhubaneswar, Director, AIIMS, Raipur and HR Consultant (PMSSY)
MOH&FW met on 9th of January, 2014 at New Delhi and deliberated upon the
cost estimates of medical equipment for different clinical, para-clinical and
non-clinical departments of AIIMS, Rae Bareli in respect of hospital, nursing
college and medical college. The total equipment cost as suggested by the
above committee was estimated at Rs.385 crore for the Rae-Bareli Project.
The following was the recommendation of the Committee to the Ministry of

Health & Family Welfare.
S.No. Name of Department Cost estimates

in Rs. Lakh
1. General Medicine 50
2. General Surgery 200
3. Burn Unit & Plastic Surgery 100
4. Transplant Surgery 100
5. Orthopedics 150
6. Radiology & Imaging 2000
7. Lab. Medicine and Pathology 250
8. Ophthalmology 350
9. Anesthesia 2000
10. Dermatology 50
11. Dentistry 200
12. Pediatrics 100
13. Pediatrics Surgery 100
14. Pulmonary Medicine 200
15. Hospital Furniture (Linen and Office 3000
Furniture)
16. ENT 150
17. Cardiology 1000
18. CTVS 200
19. Nephrology 200
20. Urology 200
21. Neurology 100
22. Neuro Surgery 300
23. Radiation Oncology 4500
24. Medical Oncology 50
25. Surgical Oncology 100
69
26. ICU/ICCU 3000
27. Obstetrics/Gynecology 200
28. Gastronetero Medicine 200
29. Gastroentero Surgery 100
30. Ambulance & Student Vehicles 400
31. Endocrinology 50
32. Pharmacology 200
33. Forensic Medicine & Toxicology 150
34. Microbiology 500
35. Physiotherapy & PMR 100
36. Blood Bank & Transfusion Medicine 300
37. Psychiatry 50
38. Anatomy 100
39. Physiology 100
40. Biochemistry 300
41. Community & Family Medicine 50
42. Nuclear Medicine 3500
43. Nursing 500
44. Biotechnology & Molecular Medicine* 2000
45. Rheumatology & Immunology* 100
46. Trauma & Emergency Medicine 2000
47. Medical Genetics* 1500
48. HMIS/IT* 2000
49. Hospital & Biomedical Engineering* 1000
50. Computers* 1000
51. Human Resources* 100
52. Hospital Administration* 50
53. Publications & Research* 50
54. Library 200
55. Miscellaneous* 3000
Grand Total 38450
Say Rs. 386 crore*
* However, after further deliveration, the items viz. Biotechnology & Molecular medicine,
Rheumatology & Immunology, Medical genetics, HMIS/IT, Computers, Hospital &
biomedical engineering, Human resources, Hospital administration, Publications &
research and Miscellaneous (of Rs.108 crore) are not considered in the present
proposal. Hence, remaining Rs.278 crore has been considered.
[Amount capitalised in the present proposal (New AIIMS Project) is Rs. 285
Crore including 2% procurement consultancy fee]
70
9. MANPOWER REQUIREMENTS
[The manpower requirement for medical college &
superspeciality block was computed separately.
While the professional staff was generally assessed
per unit (each of 20 beds) basis in accordance with
the MCI Guidelines, the nursing staff was largely
based on the Nursing Council of India norms.
However, before the requirement process, the actual

requirement of manpower to be finalised by the
AIIMS authorities; a separate proposal in this regard
to be prepared and submitted by AIIMS to the
concerned department for approval. ]
71
Table: Manpower Requirement (Total staff Requirement = 2998)
Description Medical Super- Nursing AYUSH

College Speciality College Centre
&Speciality Hospital &
Hospital Trauma Centre
including ICUs
etc
A. Administration 25 32 8 6
B. Medical Professionals
1. Professor 24 15 2 1
2. Associate 25 19 2 1
Professor/Reader
3. Asstt. Professor/ 49 35 38 1
Lecturer
4. Sr. Resident/ Tutor 66 53 - 6
5. Jr. Resident 59 50 - 6
Total (B) 223 172 50 21
C. Nutrition & Blood Bank 3 - -
D. Nursing Staff
1. Administrative 34 6 - -
2. Staff Nurses 649 1000 - -
E. Paramedical & Other
I. Technicians, Attendants etc 261 364 - -
II. Ancillary Services 158 - - -

Grand Total 1353 1574 50 21
Total Staff= 2998
Note: Department-wise break up is annexed.
SYSTEMS & SERVICES
73
10. SYSTEMS and SERVICES
The following Systems & Services play important roles in proper and efficient
functioning of the Hospital.
1. Modular Operation Theatres

2. Central Sterile Supply Department (CSSD)
3. Medical Gases Manifold System
4. Kitchen
5. Laundry
6. Bio- Medicals Waste Management System
7. Mortuary Chamber (4 Body).
The considerations for each of the above services are explained in the following
sections.
Modular Operation Theatre
The objectives of Modular OT are Infection control, Promoting high standard of

asepsis, Facilitating coordinated services, Ensuring maximum standard of
safety, and Optimizing utilization of OT with flexibility and staff time,
Optimizing working condition, Ensuring functional separation of spaces, Patient
and staff comfort in terms of thermal, acoustic and lighting requirements,
minimizing maintenance and regulating flow of traffic.
Modular OT will be constructed for all operation rooms except Minor OT and
emergency OT Labour Room etc of the hospital.
The prefabricated modular construction for walk able Ceiling and Wall panels
will be with PUF (Poly Urethane Foam) sandwiched double skin constructed
with AISI-304 Stainless Steel/Solid Mineral Composite Sheet to set-up
Operating room. The Operation theatre floor finish will be laid with seamless
conductive PVC tiles on a semi-conductive adhesive base.
The Ceiling Air Filtration System using HEPA filters will produce homogenous
low turbulence unidirectional laminar flow of sterile air with differential
velocities decreasing from centre to perimeter of the theatre. Such Ultra Clean
Ventilation System will create draft free comfortable room climate and minimal
undisruptive noise level. The minimum positive pressure will be maintained
inside the operating room. The temperature and humidity will be maintained
at comfortable range inside the OT all the time.
The air management system will be designed to achieve the following
parameters:
74
Bacteriological class - B (5 CFU/ m³)
ECG-GMP Annex I classification - Class A
ISO 14644/1 classification - ISO 5
View window with motorized horizontal Venetian blinds sandwiched in two

parallel toughened glasses.
Peripheral light fixture flushed with the ceiling in the operation theatre will be
suitable to required illumination of OT.
The Surgeon Control Panel will be configured to incorporate all the services
required by the staff in the Operation theatre. The Control Panel will comprise
of following nine (9) services:
• Day Time Clock

• Time Elapse Day Clock
• General Lighting System
• Hands free telephone set with memory card
• Temperature and Humidity Indicator with Controller
• Medical Gas status/alarm
• HEPA Filter Status module
• Room Pressure indicator
• Music control
Modular Operating room will be equipped as following:
• Wall & Ceiling construction

• Integrated Air & Light theatre ceiling
• Antistatic OT flooring with PVC tiles
• Anti bacterial Painting
• Automatic hermetically sealed sliding Door
• Distribution Board
• X-Ray Viewing Screen
• Digital Viewing Unit along with integrated CPU
• Hatch/Pass Box,
• Writing Board (List Board)
• Electronic Touch Screen (Work Station)
• Storage Unit,
• Scrub Station
• Ceiling OT Light with camera and Monitor
• Medical Gas Alarm System
• AGSS Outlets
• Anesthesia Pendent
75
• Surgeon Pendent
• Internal Ducting
• Electrical Wiring
INTEGRATED MODULAR OT
Communication, Conferencing through OT Navigator System for OTs with HD
Camera in addition to the components/equipment mentioned above for
Modular OT.
MINOR OT
Antistatic conductive flooring, Epoxy/PU painted wall, False Ceiling, X-Ray

Viewer, Gas Outlets. Automatic hermetically sealed sliding Door, Storage Unit
and Ceiling OT light.
CENTRAL STERILE SUPPLY DEPARTMENT (CSSD)
Central Sterile Supply Department (CSSD) will comprise the services to

receive, store, process, sterilize, distribute and control the supplies and
equipment, both sterile and non sterile- to all the departments of the Hospital
for care and safety of the patients from infection. CSSD is an absolute necessity
in a hospital where major surgeries are carried out, an intensive therapy ward
is fictional and casualty and emergency services are provided for infection
control.
The following factors have been considered for planning and designing of the
CSSD.
Work Load in CSSD
The Various Fictional Departments of the hospital which will generate

solid items are as under:
 Operation Theaters
 ICU
 Labour Room
 Wards
 OPD
 Other Specialties & Treatment Units
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Location of CSSD
As OT is the major consumers of CSSD, One CSSD will be located at the

Basement near the lift leading to the OT Complex of the Main Block and
another CSSD will be set up to cater for OTs of Maternity Block.
Process Flow in CSSD
- The fictional area in a CSSD has been considered such that the
components/ material flow in a logical sequence from receipt of
contaminated and used goods to the storage sterile and ready to issue to
the end users.
- The basic principle is that there should be no mixing or flow crossing each
other, of sterile and contaminated goods for prevention from cross
contamination.
- Separate entry/exits will be provided for personnel in process area and
sterile area.
Functional areas within the CSSD
CSSD will be divided into following area/zones:

- Contaminated goods receipt
- Sorting area
- Washing, Cleaning and Sterilizing area (Process area)
- Sterile area for storage of sterile goods
- Sterile goods issue area
- Entry exits for personnel into process and sterile area
Special Requirements
Sterile Area will be provided with following special requirement:
- Super finishes with Epoxy/Kota flooring and epoxy/PU paint on walls at

the CSSD room
- No particle shredding materials will be used for construction, storage
racks, doors etc, in the sterile area
- The HVAC System will be provided for temperature and humidity
controls
- The HVAC System will be for continuous operation to maintain the
sterile conditions
- Fine filters will be provided for supply air system
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- Electrical light fixtures will be flushed type to prevent accumulation of
dust particles.
- Separate entry/ exist with provision for change/gowning will be provided
for entry.
For other areas of CSSD
- The CSSD will be provided with good lighting

- The area will be well ventilated
- Easy accessibility to lifts will be provided for transportation of material
to OTS and other units of the hospital
There will be two CSSD in the hospital. One is for Super Specialty Block &
Paid Words other one for Emergency Block.
All the major equipment for CSSD and the related furniture of CSSD will be
made of anti-rust anti-corrosive material like AISI -304 Stainless Steel
CSSD room will be equipped with the following:
- Rectangular Autoclave
- ETO
-Washer Disinfector
- Ultrasonic Cleaner
- Drying Cabinet
-Control and Packing Table
-Wash Station
- Air Spray Gun Rinser for Sink
-Gauge Cutting Machine
- Storage Rack
-Carriage & Trolleys
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MEDICAL GASES MANIFOLD SYSTEM (MGMS) & DISTRIBUTION SYSTEM
Medical Gas Manifold System will be installed at the hospital with the following
advantages:
- Uninterrupted and uncontaminated supply

- Continuous flow of gases whenever and wherever required
- Instant availability of gas on taps
- Aseptic, therefore safe
- Saves space
- Economy on purchases of cylinders
- Easy purchase of gases in bulk quantities at favourable terms
- Rationalization in ordering, storing and transporting a wide variety
and sizes of gas cylinders.
Medical Gases Manifold system will provide medical gases like Oxygen, Nitrous
Oxide and Carbon Oxide in addition to Compressed air of breathing quality and
Vacuum System to various OTs, departments, Wards and Diagnostic Departments
of a hospital from a well ventilated Gas Manifold room with Gas Bank and Plant
Room to be set up at the hospital. Apart from those the MGMS will also provide
Anesthesia Gas Scavenging System. The Centralized system will ensure un-
interrupted supply of Oxygen to the patients through automatic changeover for
supplies from Liquid Oxygen source.
The area for set up of Liquid Oxygen system and provision for connection with the
centralized Medical Gas Manifold System will also be provided in the hospital
premises. As per the cost benefit analysis, the set-up of Liquid Oxygen tank 10K
Litres along with its System on rental basis will be more economical than purchase
and installation of new Liquid Oxygen Container and its system.
The following will be the key consideration in planning and designation of the
Medical Gas Manifold System.
 Medical gases Outlets

The Outlet Disposition will be planned based upon the facilities and
requirement of the hospital, Medical gas Manifold Room and Plant Room
 A Central Medicals Gas Manifold Room will be set-up where Oxygen, Nitrous
Oxide and Carbon di oxide cylinder banks along with manifold system will
be provided.
 A central Plant Room will be set up for providing of Breathing quality air
from Air compressor and Air filtration and Drying system and Vacuum from
Vacuum System and AGSS.
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 Pipeline Distribution System.
The medical graded copper pipeline will be used for supply of medicals gas,
compressed air and providing of Vacuum system and AGSS from the Gas
Manifold Room/ Plant Room to different outlets of the hospitals.
 Pendant, Valve Box, Isolation valves and Master Alarm, Area Alarm and Bed
Headed Panel along with accessories will be provided.
The Medical Gas Manifold System will be provided as per international standard
NFPA-99/HTM02-01/EN737 and the major equipment will be of UL listed/CE
marked.
Medicals Gas Manifold systems will be equipped with the following:
Oxygen System
- Oxygen Manifold System

- Emergency Oxygen manifold System
- Fully Automatic Control Panel
Nitrous Oxide System

- Nitrous Oxide Manifold System
- Emergency Oxygen manifold System
- Fully Automatic Control Panel
Vacuum System
- Vacuum Pumps
- Storage tank
Compressed Air System
- Air Compressor
- Compressed Air Filtration System to breathing quality
- Storage tank
Anesthesia Gas Scavenging System
- Vacuum Pump System

- AGSS Systems
Pipeline Distribution System
- Copper Pipelines
- Isolation Valves
- Valve Box
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- Oxygen, Nitrous Oxide, AGSS, Carbon dioxide, Compressed Air & Vacuum
Outlets (Imported)
Alarm System
- Master Alarm Panel
- Area Alarm Panels
Anesthesia Pendants for OTs
- Will be supplied with Modular OT

- Anesthesia Pendant for OT
Horizontal Bed Head Panel
Accessories:
- Flow Meter with Humidifier (Imported)

- Ward Vacuum Unit
- Theatre Vacuum Unit (Imported)
KITCHEN
Hospital Dietary Services/Kitchen will supply the required diets to the patients
prepared in a hygienic environment. The dietary department will be
responsible for preparation and distribution of food and also for the storage of
raw materials. The dietary services or kitchen will also take care of special diet
requirements of patients.
The following are the key considerations for planning the Hospital Dietary
Services/ Kitchen.
Functional Areas within kitchen
The kitchen will comprise of following functional areas.
- Raw material Storage area

- Cold Room
- Preparation area cum Vegetable Cutting area
- Main Cooking area
- Pantry area
- Set-up & Food Services area
- Dish Washing Area
- Pot Washing Area
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- Trolley Washing Area
- Office of the Dietitians and stewards
A dietician Room will be provided for checking the quality of incoming raw
material as well as for the prepared food and for counseling.
Planning of Functional Areas of kitchen

- Suitable precautions will be taken to prevent entry of rodents/
files/inspects into the kitchen.
- Insectocutor/s will be provided at suitable locations.
- Air curtain/s will be provided at suitable locations.
- Drain line with Grating
- Exhaust hood over the heat/fumes/Smoke sources
- Air washing and Ventilation at the Kitchen area
- Light Fixtures for proper illumination
All the Kitchen furniture and major equipment will be made of anti-
rust anti-corrosive material AISI-304 Stainless Steel.
Kitchen will be equipped with the following :
- SS Work Table with 1u/s

- SS Wall Shelf
- SS Work Table with Sink
- Wall Shelf
- Weighing Scale.(Electronic)
- Dunnage Rack
- Storage Rack (5 racks & 4 racks)
- Onion / Potato Bin
- Cereal/Atta Bin
- Platform Trolley
- Double Door Refrigerator
- Deep Freezer
- Water Cooler
- Hand Wash Unit
- SS Storage Rack with SS Uprights
- Vegetable Cutting Machine
- Potato Peeler
- Chopping Block
- Stock Pot
- Titling Boiler
- Milk Boiler
- Water Boiler
- Egg Boiler
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- Brazing Pan
- Automatic Chapatti Making machine
- Chapatti plate cum Puffer
- Chapatti Rolling Table
- Chapatti Collection Trolley
- Dough Kneader
- Wet Grinder
- Pulverizer
- Spice Carrying Trolley
- Four Burner Gas Range with Oven
- Multipurpose Juicer
- Blender
- Conveyor Toaster
- Micro Oven
- Tea/Coffee Dispenser
- Garbage Cart
- Dirty Dish Landing Table with Garbage Chute
- Hot Water Geyser
- Pre-rinse Jet Spray
- Dish Washer
- Unloading conveyor Table with Dish wash rack holder
- Storage Racks
- Two Sink Pot Wash
- Masonic Sink (Tile finish)
- Hot Water Geyser
- Pre-rinse jet spray
- SS Pot Rack
- Plate Dispenser
- Tray set-up (Conveyor type)
- Hot Bain Marie
- Hot Food Service Trolley
- Cold Room
- Dry Store
- LPG Bank
- Air Curtain
- Insectocutor
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LAUNDRY
Laundry will provide clean, adequate and timely supply of Hospital linen
comprising of bed linen, body linen, operation theatre linen, Surgeon & staff
linen, contaminated linen, Miscellaneous linen such as curtains/screen etc. to
various OTs, Wards and departments.
The following are the key considerations in planning of the laundry:
Linen Load
Solid Linen will be generated from the following fictional areas of the
Hospital:
 Wards
 Operation Theatres/Labour Rooms
 Pre & Post OTs
 ICU
 Treatment Areas
 Other Support Areas
Based on the estimated linen load, the required washing process is

identified as the soiled/stained linen from operation theatres and other
various departments will also be done by sluicing process to remove
stains etc.
Process Flow in Laundry
The linen flow will have unidirectional seamless flow. Back and forth
movement of linen during the process will be avoided as it hinders other
processes and also requires the manpower requirement.
Fictional area within Laundry
The laundry will generally comprise of following functional area.

- Solid Linen Receipt and Sorting Area
- Sluicing area
- Washing and Extracting area
- Drying area
- Ironing/ Finishing area
- Finished Linen store and issue area
- Mending area
Laundry room will be equipped as following :
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- Sluicing cum Washer extractor
- Washer Extractors
- Drying Tumblers
- Flat Ironer
- Flat Bed Press
- Vacuum Finishing Table
- Boiler
- Air Compressor
- Mobile Tables
- Wash Station
- Storage Racks
- Mending machine
- Trolleys
BIO-MEDICAL WASTE MANAGEMENT SYSTEM
Improper handling of general waste may lead to cross-contamination with the

hospital infectious waste and contaminate entire waste. If improperly handled
and disposed of untreated, the bio-medical waste generated in a hospital may
cause serious threat to the personnel handling the waste and also to the
society.
The following are the key consideration in planning and designation of the
biomedical Waste Management System.
 Identification of Bio-Medicals Waste:

Bio-Medical Waste is generated primarily from the operation Theaters,
ICU and Laboratories, Wards and other departments.
 Bio-Medical Waste Management System:

The Bio-Medical Waste Management System process will cover the
following aspects:
Waste identification, Segregation Collection Identification of the Bio-medical

Waste, Segregate the Bio-
Medical Waste from general
waste at the point of its
generation.
Waste Transportation Safely transportation of the Bio-

Medical Waste for treatment in
closed/covered trolleys.
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Waste Treatment/Decontamination Disposal Treatment/Decontamination of
the Bio-Medical Waste and
disposal of the de-contaminated
waste.
Bio-Medical Waste Treatment Facility
A Bio-Medical Waste Treatment Facility shall be provided with the following areas:
 Waste storage area

 Waste sorting area
 Waste Treatment area
 Treated Waste collection and disposal area
 Trolley Park area
The System is elaborated as under:
I) Waste Identification
Areas Identified from where Bio Medical Waste generated are identified
as:
 Operation theatres/Labour Rooms

 Pathological labs and other laboratories
 ICU
 OPD
 Wards
 Causality
 Diagnostic Areas
 Other treatment areas and in the hospital
II) Waste segregation and Collection
Segregation and collection of waster is the first and the most important
pre-requisite in the process of waste management in order to minimize
quantities of hazardous waste and preventing cross contamination wit
non-hazardous waste. Different colored collection bags and containers
will be provided for collection of bio-medical waste as follows:
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COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIO-MEDICAL
WASTE
Colour Type of Waste Category Treatment/Disposal

Coding Container option
Yellow Plastic Bag Human Anatomical wastes, Incineration / Deep

Animal wastes, Burial
Microbiology and
Biotechnology waste
(Infectious wastes from
laboratory)
Red Disinfected Microbiology and Autoclave/Microwave/C

container / plastic Biotechnology wastes, hemical Treatment
bag Soiled wastes and solid
wastes
Blue/White Plastic Waste Sharps and solid Autoclave/Microwave/C

Translucent bag/Puncture wastes hemical
proof Container Treatment/Destruction
and Shredding
Black Plastic bag Discarded medicines, Disposal in secured

Cytotoxic drugs, landfills
Incineration ash and
chemical waste
III) Waste Collection Bags
The yellow colored polybags provided for waste collection shall be made
on non-chlorinated polythene which can be safely incinerated without
having to open the bag. The bags shall be of colors as per
recommendation of Ministry of Environment & Forests. Each bag can be
easily tied up when it is full without touching the contaminated waste.
The bags shall have bio-hazard symbol and inscription of type of waste
to be collected into it.
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The red, blue/white translucent poly bags used for collection of plastic
and other solid waste are safe for autoclaving. The bags are specially
designed to withstand high temperatures during autoclaving.
iv) Waste Collection Containers
The Polybags will be placed inside the collection containers which in turn
shall be placed at locations where waste is actually generated so that its
segregation and collection is possible at the source itself.
The Collection containers are specially designed with following features
 Foot operated lid

 Sturdy construction
 Arrangement for holding non-chlorinated polybags
 Steel construction with epoxy power coating for durability
The collection container(s) shall be with or without caster wheels

depending on the location of its placement.
The waste collection containers shall be of different colors for easy

identification of waste that is to go into it.
v) Waste Transportation
Easily movable trolleys with large castor wheels shall be provided for
collection of waste from different areas of the hospital and transporting
the waste to the waste management yard. The trolleys shall have large
containers with foot operated covers, mounted on the base framework.
The trolleys shall be of sturdy construction and provided with castor
wheels to easily move through various areas of the hospital.
Polybags shall be tied and taken out from the waste collection
containers, which will be put into the transportation trolleys and then
taken to the waste treatment yard for treatment and disposal. Persons
handling polybags shall be provided with protective gloves.
vi) Waste Treatment
Waste collection trolleys shall be taken to the waste treatment building

for its treatment / Shredding & Autoclaving/Incineration and thereafter
the waste shall be disposed off.
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MORTURY CHAMBER
Mortuary chambers shall be used for keeping cadaver under cool condition to
prevent decomposition either for the purpose of conducting postmortem or
before handing it over to the relatives of the dead patient.
The Mortuary Chamber shall be suitable for keeping 4 dead bodies and shall
be complete with refrigeration system, locking arrangement, SS steel tray,
Loading Trolley and Foul Order Treatment by means of Activated Carbon filter
for De-Odorizing System.
ESTIMATED COST
Sl. No. Description of Specilized services Qty. Unit cost Amount

Rs. Rs.
1 Integrated Modular Operation 4 22000000 88000000
Theatre
2 Modular Operation Theatre 19 10000000 190000000
3 Minor OT 3 2500000 7500000
4 CSSD 1 90000000 90000000
5 Medical Gas Manifold System 1 155000000 155000000
6 Kitchen 1 17000000 17000000
7 Laundry 1 35000000 35000000
8 Bio Medical Waste Management 1 20000000 20000000
9 Mortuary Chamber 2 2500000 5000000
10 Two level Puzzle parking system 300 250000 75000000

Total Rs. 682500000
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INFORMATION TECHNOLOGY &
COMPUTERIZATION FACILITIES
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11. INFORMATION TECHNOLOGY & COMPUTERIZATION
FACILITIES
General
The Information Technology (IT) has permeated all the sectors of economy,
including healthcare. Its usage in hospitals too is well known. Depending upon
the resources committed, IT usage has been adapted by different hospitals to
varying degrees. Systems that have been designed for hospitals cover a wide
range of administration and management processes. In fact, an integrated
end-to-end hospital management system provides relevant information in a
seamless flow across the hospital to support effective decision making for
patient care – both in terms of quality & control of diagnosis-related costs,
productivity, procedures, hospital administration and financial accounting etc.
In the proposed Institute, the Information Technology is expected to cover the

entire gamut of education right from selection and maintenance of database
of students & faculty alike through organizing classes, training, delivery of
lectures, library etc.
Ensuing paragraphs discuss the IT facilities considered for the proposed

institution. Attempt has been made to provide state-of-the-art Wi-Fi connected
user-friendly IT facilities in the campus.
1. Hospital Management and Information System (HMIS)
Installation, Customization, Integration, Implementation, Testing, Operation,

Training and Maintenance of HMIS.
This section describes the functional requirements along with the services for
the functional modules and sub modules:
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1. Clinical
a. EMR
b. Nursing Management System
c. Order Management
d. OT management
e. Anesthesia Management System
2. Administrative
a. Registration – Outpatient and Inpatient
b. Admission discharge and Transfer
c. Master Patient Index
d. Appointment Scheduling
3. Diagnostic Investigations
a. Pathology
b. Microbiology
c. Biochemistry, hematology and serology
d. Radiology information system
4. Inventory control
a. Pharmacy management system
b. CSSD
c. Laundry department
d. Equipment Management System
e. Inventory Management
5. Accounts and Billing

a. Patient billing
6. Miscellaneous services
a. HR management
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Other functionality to be covered as per the requirement of the hospital.
2. Picture Archiving and Communication System (PACS)
The Picture Archiving and Communications System (PACS) is intended to
setup a film-less system for performing radiology services within the
hospital. Anticipated benefits of implementation of the system include
significant reduction in the costs associated with film and it’s processing,
handling, and storage, improved operational efficiency and enhanced
patient care within the hospital. The function of the PACS is to acquire,
distribute, display and archive imaging data and related information used
by the hospital. This data will be incorporated into and stored in the PACS
at the full contrast and spatial resolution originally obtained by the
acquisition devices. Access to the data will be limited to the authorized
person. The system shall be interfaced to HMIS to support display of HMIS
diagnostic reports alongside medical images on user-friendly, high
performance, applications-oriented workstations, and automated image
management and distribution. The PACS image storage and management
subsystem must allow the rules for image management to be determined
by the customer.
1. Installation, Testing, Operation and Maintenance of integrated PACS

Solution
2. PACS Server
3. Workstation for PACS as per the requirements
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3. Server Hardware and System Software
Supply, Installation, Configuration and commissioning of

departmental/user level Hardware and Software for HMIS and PACS
SAN Storage with latest technology, associated hardware, software,

network devices, switches, cables, all accessories etc. as per the
requirement & complete in all respect for HMIS and PACS. One complete set
and end to end storage solution. Tape Drive for backup for HMIS and PACS
separately with associated hardware and software, all the accessories etc.
All the Servers for HMIS including associated hardware, software, OS,
Database, necessary licenses, all the accessories etc. All the servers will be
Active-Active cluster mode with latest configuration and technology as per
the functional and technical requirements
4. Computer Desktops, Printers & other Software
Supply, installation, testing and commissioning of the following items :
1. Desktop/Thin-Clients
2. Antivirus for desktops
3. Microsoft Office 2013 Professional Software Licenses for Desktop
(latest )
4. Printers
 Black & White LaserJet Printer
 Black and White Multifunction (Print, Scan, Copy) LaserJet
Network Printer
5. Network Infrastructure (LAN and Wi-Fi system)
To setup a State-of-the-Art, high performance, fault-tolerant, secure and

highly available IT Networking infrastructure and shall utilize the best of
products and latest, open standards based technology, high quality services
and workmanship.
The entire Local Area Network shall be established on Gigabit connectivity.
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Typical Wired and Wireless Network
Supply, installation, testing and commissioning of the following

network items:
 Structured communication network comprising of Fibre Optics (FO) Cable,

F/UTP Cat cables, switches, patch panels, connectors, racks, etc. for
communication.
 Internal Wireless network as per the requirements.
 Necessary cables including power cable and accessories as may be required
for smooth and reliable operation of networking equipment.
 Supply, Installation, Configuration, Testing and Maintenance of Access
switches
 Supply, Installation, Configuration, Testing and Maintenance of Wireless
Access point (indoor)
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6. Queue Management System
The number of seriously ill patients admitted to the hospitals has increased
steadily over the years. Overcrowding of Out Patient Department (OPDs) and
the wards is now a common scenario. This can largely be attributed to the
number of the patients receiving care, healthcare professionals providing that
care, and often people visiting the patients. Overcrowding may affect patient’s
symptoms, clinical outcome and satisfaction levels. It can also affect
physician’s effectiveness and lead to frustration and sometimes violence.
The Problem needs urgent redressal lest public may not rely on the quality of
the care provided by the hospitals. The OPD in any hospital is considered as
the mirror of the hospitals which reflects the functionality- being first point of
contact between the patient and the hospital staff.
As such, providing best OPD services are one of the primacies of the hospital.
This can, to a great extent, be overcome by using IT, leading to enhanced
productivity and reduction in waiting time. Queue Management system can be
deployed to streamline the patient flow in the hospitals.
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Q-Management System
7. Virtual Classroom
Modern day Training rooms is a place to discuss, collate information (info),
exchange of ideas, conduct brainstorming sessions on burning issues and
detailed debriefing sessions on lessons learnt from past operations. Unlike in
the past, Training rooms nowadays are akin to a live studio which is interlinked
to other geographically located offices and Training rooms. Thanks to the
improved communications, a live preview of various activities being performed
at remote location can be seen by all and real time assessment and progress
can be seen. Delegates today are fed a host of information in the form of live
video, recorded video and computer data/ presentation in different forms.
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We hereby propose to establish the concept of “Digital Classrooms“ & E-
Learning Set Up ”as described above which will enable a cohesive and
coherent system to be in place. It will also enable seamless flow of data
and video from diverse sources to be converged and presented to the
target audience. The setup will be state of the art, elegant and more
important, it will provide a platform conducive for discussions and
presentations where participants and presenter can concentrate more towards
the content rather than stage logistics as a result the academy will effectively
display, impart knowledge, capture, stream, archive and manage the
AV content to increase the Student’s receptiveness to the Lecturer’s
message hence will endeavour in achieving excellence in training.
8. Education Management System

Salient Features
a. General Administration, File management, Tender & Procurement.
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b. Admission Management.
c. Academics Management.
d. Examination Management System.
e. Student Portal.
f. Fee Management.
g. Facilities Management.
h. Placement Cell.
i. Research
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9. Library Management System
Salient Features
a. Application Login through smart cards.

b. RFID enabled smart library for Cataloguing and circulation of materials.
c. Electronically issuing of books through Self Check In/Out and receiving
through Book Drop.
d. Centralized Database.
e. User identification through their smart cards.
f. Theft detection.
g. Statistics and reporting.
h. Web based module.
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Institute Website
This website provides a good advertising platform for projecting the

organization worldwide and provides the information about the Institute and
hospital for various services and facilities etc.
The following information may be cover in the website:
• Details about the Institute and Hospital – Facilities and Services

• Departments
• Health tips for the visitors
• Online health related problem solving by the experts
• Online panel of experts and their comments
• Mailing system for the users who are seeking information
• Appointment booking for consulting doctors in OPD
• Appointment cancellation/re-scheduling
• Reminder via e-mail, SMS etc.
• Health related news and tips
• Course and training program details
• Other information as per the requirement of the institute
Estimated Cost for Development of IT infrastructure
IT SERVICES
Amount
S.No. Description
(in lakh)
1 HMIS (Hospital Management and Information System)
including call centre, helpdesk, hospital portal for online
appointment system. 1500
2 Server Hardware and system software including common
storage & NAS for HMIS & PACS, Data Centre
infrastructure 400
3 PACS (Picture Archiving and Communication System)
including workstation 200
4 Network Infrastructure (LAN & Wi-Fi)
800
5 Computer Hardware (Computers, Printers and UPS etc.)
900
6 Library Management System (LMS)
100
7 Education Management System
100
8 Queue Management System 200
Total 4200
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GREEN BUILDING CONCEPT
102
12. GREEN BUILDING CONCEPT
Buildings have major environmental impacts over their entire life cycle. Resources
such as ground cover, forests, water, and energy are depleted to give rise to
buildings. Further, during their life, the buildings cause major effect on urban air
quality and contribute to climate change. Hence, in this prestigious project an
attempt has been made to design green buildings, the essence of which would be
to address all these issues in an integrated and scientific manner. It is a known
fact that it costs more to design and construct a green building. However, it is
also a proven fact that it costs less to operate a green building that has
tremendous environmental benefits and provides a better place for the occupants
to live and work in. It is attempted, in this redevelopment project, to achieve the
benefits of green buildings at an affordable predetermined cost. This is
scientifically carried out by studying the various features of the green design &
the accruing benefits thereby.
Features of Green Building:
 Depletes the natural resources to the minimum during its construction and
operation.
 Minimize the demand on non-renewable resources.
 Maximize the utilization efficiency of non-renewable resources, when in use,
and maximize the reuse, recycling, and utilization of renewable resources.
 Maximizes the use of efficient building materials & construction practices.
 Optimizes the use of on-site sources and sinks by bio-climatic architectural
practices
 Uses minimum energy to power itself; uses efficient equipment to meet its
lighting, air-conditioning, and other needs
 Maximizes the use of renewable sources of energy
 Uses efficient waste and water management practices
 Provides comfortable and hygienic indoor working conditions
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Benefits of a Green Building:
Benefits of a green design to a building owner, user, and the society as a whole
are as follows:
 Reduced energy consumption without sacrificing the comfort levels.

 Reduced destruction of natural areas, habitats, and biodiversity, and reduced
soil loss from erosion etc.
 Reduced air and water pollution (with direct health benefits).
 Reduced water consumption.
 Limited waste generation due to recycling and reuse.
 Reduced pollution loads.
The following aspects of the building design are looked into an integrated way in
a green building:
 Site planning
 Building envelope design
 Building system design HVAC (heating ventilation and air conditioning),
lighting, electrical, and water heating.
 Integration of renewable energy sources to generate energy onsite.
 Water and waste management.
 Selection of ecologically sustainable materials (with high recycled content,
rapidly renewable resources with low emission potential etc.).
 Indoor environmental quality (maintains indoor thermal and visual comfort and
air quality).
A building is assessed based on its predicted performance over its entire life cycle
– inception through operation. The stages of the life cycle that have been identified
for evaluation are the pre-construction, building design and construction, and
building operation and maintenance stages. The issues that get addressed in these
stages are as follows.
 Pre-construction stage (intra- and inter-site issues)
104
 Building planning and construction stages (issues of resource conservation and
reduction in resource demand, resource utilization efficiency, resource
recovery and reuse, and provisions for occupant health and well being).The
prime resources that are considered in this section are land, water, energy,
air, and green cover.
 Building operation and maintenance stage (issues of operation and

maintenance of building systems and processes, monitoring and recording of
consumption, and occupant health and well being, and also issues that affect
the global and local environment).
In India TERI (The Energy Research Institute) is doing major work in this direction.
To popularize the green building, TERI developed a tool for measuring and rating
a building's environmental performance in the context of India's varied climate
and building practices. This tool, by its qualitative and quantitative assessment
criteria, would be able to ‘rate’ a building on the degree of its ‘greenness’. The
rating would be applied to new and existing building stock of varied functions –
commercial, institutional, and residential.
Rating System
The primary objective of the rating system is to help design green buildings and,
in turn, help evaluate the ‘greenness’ of the buildings.
Scoring points for TERI–GRIHA
TERI-GRIHA has a 100 point system consisting of some core points, which are
mandatory to be met while the rest are optional points, which can be earned by
complying with the commitment of the criterion for which the point is allocated.
Different levels of certification (one star to five stars) are awarded based on the
number of points earned. The minimum points required for certification is 50.
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Points scored Rating
50–60 One star
61-70 Two star
71-80 Three star
81-90 Four star
91-100 Five star
For the proposed an attempt has been made to classify the various criteria into
one of the following category
a. Mandatory criteria
b. Criteria which is easy to meet
c. Criteria which can be met with some effort
d. Criteria which is rather difficult to achieve
Now the various criteria were studied & against each a realistic categorization was
envisaged. Accordingly, following are the possibilities for the likely score.
 A score of 66 can be easily achieved by meeting the mandatory criteria as well
as the criteria which is easy to meet (i.e., a and b alone).
 A score of 82 can be achieved by meeting a, b and c.
In both these extreme cases one can attempt to get at least two star (61-70) or
maximum four star (81-90) ratings for the proposed buildings/projects.
Thus by meeting the mandatory criteria & the criteria that is easily achievable, a
2 to 3 star rating is envisaged as shown in the following table.
The thirty one (31) number criteria have been captured in the two sub-tables to
list out the point against each criteria & the effort in achieving the criteria
examined so as to call out the category it is put under i.e., a, b, c, or d.
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Evaluation Procedure of Criterion of TERI-GRIHA
List of criteria Points Remarks Category

Criteria 1: Preserve and protect landscape 5 Mandatory a
during construction /compensatory
depository forestation.
Criteria 2: Soil conservation (post 4 Easily achievable b
construction)
Criteria 3: Design to include existing site 2 (Partly) a
features Mandatory
Criteria 4: Reduce hard paving on site 2 (Partly) a
Mandatory
Criteria 5: Enhance outdoor lighting 4 Easily achievable b
system efficiency
Criteria 6: Plan utilities efficiently and 3 Easily achievable b
optimize on site circulation efficiency
Criteria 7: Provide, at least, minimum 2 Mandatory a
level of sanitation/safety facilities for (Contractor’s
construction workers scope)
Criteria 8: Reduce air pollution during 2 Mandatory a
construction
Criteria 9: Reduce landscape water 3 Easily achievable b
requirement
Criteria 10: Reduce building water use 2 Achievable with c
effort
Criteria 11: Efficient water use during 1 Achievable with c
construction effort
Criteria 12: Optimize building design to 6 Mandatory a
reduce conventional energy demand
Criteria 13: Optimize energy performance 12 Difficult to d
of building within specified comfort achieve
Criteria 14: Utilization of fly-ash in 6 Easily achievable b
building structure
Criteria 15: Reduce volume, weight and 4 Achievable with c
time of construction by adopting efficient effort
technology (e.g. pre-cast systems, ready-
mix concrete, etc.)
Criteria 16: Use low-energy material in 4 Easily achievable b
interiors
Criteria 17: Renewable energy utilization 3 Achievable with c
effort
Criteria 18: Renewable energy based hot- 2 Easily achievable b
water sys
Criteria 19: Waste water treatment 2 Easily achievable b
Criteria 20: Water recycle and reuse 5 Easily achievable b
(including rainwater)
Criteria 16: Use low-energy material in 4 Easily achievable b
interiors
Criteria 17: Renewable energy utilization 3 Achievable with c
effort
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Criteria 18: Renewable energy based hot- 2 Easily achievable b
water system
Criteria 19: Waste water treatment 2 Easily achievable b
Criteria 20: Water recycle and reuse 5 Easily achievable b
(including rainwater)
Criteria 21: Reduction in waste during 2 Achievable with c
construction effort
(Contractor’s
scope)
Criteria 22: Efficient waste segregation 2 Difficult to d
achieve
Criteria 23: Storage and disposal of waste 2 Easily achievable b
Criteria 24: Resource recovery from waste 2 Difficult to d
achieve
Criteria 25: Use of low - VOC paints/ 4 Easily achievable b
adhesives/ sealants.
Criteria 26: Minimize ozone depleting 3 Mandatory a
substances
Criteria 27: Ensure water quality 2 Mandatory a
Criteria 28: Acceptable outdoor and indoor 2 Difficult to d
noise levels achieve
Criteria 29: Tobacco and smoke control 1 Easily achievable b
Criteria 30: Energy audit and validation Mandatory a
Criteria 31: Operations and maintenance 2 Mandatory a
protocol for electrical and mechanical
equipment
Criteria 32: Bonus 4 Achievable with c
effort (innovative
ideas have to be
implemented)
Total Points =100 (against all criteria full marks)
Points obtained by adding criteria categorized as ‘a’ & ‘b’ alone = 66 i.e., 2 star
rating, Points obtained by adding criteria categorized as ‘a’, ‘b’ & ‘c’ alone = 82 i.e.,
3 Star rating
Source:www.teri.res.in/core/griha/ratingsystem.htm
Note: It has been envisaged to attain GRIHA-3 Rating for the proposed
Institute.
108
109
PHE & FIRE-FIGHTING CONCEPT
110
13. PHE & FIRE-FIGHTING CONCEPT
Introduction
The agency shall be responsible, amongst others, for:
 Design of Public Health & Engineering services taking into account

various topographical, meteorological, Hydrological, etc. reports,
identify the source and quality of water, conduct survey of existing water
supply system, Sewerage system, Drainage system, Fire-fighting
system, other site development works, etc. for planning of services.
 All the design and drawings should be well coordinated with
Architecture, structure and other services drawings.
 All designs shall be as per the latest Indian Standards, Local bye-laws
and statutory norms.
 Ensure that the design meets the requirements with regard to future
extensions and needs.
 The development of the building and surrounding area are to be carried
out with environmentally sound, friendly and aesthetic manner. The
different components related to services are listed as below:
• Site leveling & grading

• External water supply system &water treatment system.
• External Sewerage system
• Sewage Treatment Plant
• Waste Water Recycling (reuse of STP treated water for
Horticulture & Flushing)
• Storm water drainage system
• Rain water harvesting system
• Internal plumbing and sanitation
• Solar Hot Water System
• Fire Fighting system
The salient features and following design criteria for the above elements are
detailed out in the following paragraphs:
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ii) Site Levelling and Grading
Site leveling and grading shall be done keeping in view the topography of the
area, level of surrounding area, existing drainage system of surrounding areas
and overall aesthetic of complex. The site survey and cutting and filling and
fixing levels of different buildings shall be carried out by the Agency as per
excepted Norms and good engineering practices.
iii) Roads and Footpaths
The access to the building will be made by laying roads connecting to the
existing road. Road will be designed as per IRC code/manual. Minimum
carriage width of approach road for two lane will be 7.0 m with 1.0 m footpath
on both side. The road shall be concrete. The roads width and length required
for proper connectivity with campus and meeting the requirement of fire tender
movement all round the building or as approved by Client/HSCC.
iv) EXTERNAL WATER SUPPLY SYSTEM
a. Water Requirement
Water is required to meet the demands of drinking, sanitation, horticulture, Air

Conditioning and fire fighting water requirements. The water requirements for
domestic use and Air conditioning purpose are annexed.
b. Source of water
It is assumed that safe and adequate drinking water will be made available for
functioning of Hospital and other institutional buildings. In absence of
availability of municipal water, bore well option will be provided of adequate
number and size to meet water requirement based on hydrogeological survey.
The permission of competent local authority shall be obtained.
c. Treatment of Water
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Treated water is required for drinking, labs, air –conditioning etc. Water
Treatment Plant shall be provided depending on the quality of water with
Multigrade filter and Activated carbon filter and mixed oxidant disinfection
system (Oxylite) of adequate size and capacity. For soft water requirement
filter/softner shall be provided with minimum 6 mm thick M.S. plate on shell
and minimum 8 mm thick M.S. plate on dished ends as per applicable IS
standards and filtration rate 20,000 lph/sqm(min.). Back wash/regeneration
of filter/softner shall be less than one time a day.
The RO water treatment plant shall be provided for all educational and
institutional buildings. The RO plant shall be located in the terrace of the
building and has a tapping from the building OHT. The treated RO water shall
be stored in a separate SS/HDPE tank distributed to the OTs, ICUs,
labs/drinking water Cooler.
d. Water Storage Tank
The water will be stored in underground tank. The raw water and treated
water/Soft water/Fire water will be stored in separate compartments. The
provision for minimum 1 day storage will be kept for underground tank.
Water Distribution System
There will be external water supply main ring around buildings. The water from
UGT will be pumped to main water supply ring of DI K-7 not less than 100 mm
dia from where it will go to terrace tank located at different buildings. The
water from different outlets will be tapped by gravity. Dual water supply
network to provided, one for treated water supply and other one for flushing
purpose. The necessary sluice valve, air valves, pressure regulating valve and
scour valves will be located along the water mains as per water network loop
design.
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v) HOT WATER SUPPLY
Hot water will be supplied by solar water heating system in all the buildings
where hot water is required for daily use. The hot water demand shall be
calculated as per excepted norms i.e. 35 litres per bed per day in hospitals and
100 litres per dwelling unit per day. Thermo Syphon type solar water heating
system with copper-copper type flat plate collector with stainless steel
insulated hot water storage tank made of stainless steel 304- food grade
quality with 100 mm Glass wool insulation and cladding with 24 SWG
Aluminum sheet, heat exchanger made of SS pipes shall be provided inside
the Solar Tank and suitable make up tank for heat exchanger circuit. The solar
collector shall be arranged on the roof of the building in such a way that shadow
can be avoided. The solar hot water will supply the hot water to all the geyser,
in view of this provision the backup electrical heating system at terrace hot
water tank will not be provided for non -solar days.
Interconnecting system piping shall consist of B Class insulated GI pipes

covered with 50mm thick glasswool & clad with 26 SWG Aluminium Sheet. All
Gate/Ball valves shall be of ISI make.
CPVC pipe of 9 mm thick thermal insulation tubing of elastomeric flexible

material having hermetic blistered closed cell structure of expanded synthetic
rubber over pipes/ fitting as per manufacturer's specifications will be used for
hot water supply into geyser at suitable locations.
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vi) EXTERNAL SEWERAGE SYSTEM
It is proposed to lay separate sewer line for disposal of lab/hospital effluent

and domestic waste. The domestic sewer will finally lead to proposed Sewage
treatment Plant. The treated waste water will be recycled for flushing and
horticulture/HVAC purpose. Sewerage system will be designed assuming
gravity flow, RCC NP2 pipe minimum150 mm dia shall be used in proper
sloping. The lab./hospital effluent will be collected separately in HDPE pipe line
with manhole and finally discharge into ETP.
Diameter of vertical stacks for soil pipes and waste pipes are arrived by using
fixture units. Sewer lines are designed as running partially full with a maximum
depth of sewage equal to half depth of the sewer diameter. All necessary
appurtenances like manholes, drp manholes, grease trap etc. are provided for
the efficient functioning of the sewerage system while complying with the
relevant authorities requirements.
vii) STORM WATER DRAINAGE SYSTEM
It is proposed to have separate drainage system for surface storm water.

Surface storm water will be conveyed to existing drainage system through
open/ closed drain.
viii) RAIN WATER HARVESTING SYSTEM
Roof drainage will be through gutter/ down take pipe. Rain water from roof will
be collected in catch basins located at different places and will be conveyed to
external drainage system which is corrected to proposed recharge wells.
ix) INTERNAL PLUMBING
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It is proposed to have two piping system for water supply - one pipe for
supply of treated water for drinking , labs, bath etc.; and other for flushing
system.
CPVC pipe will be used in water supply for flushing and Copper pipe used for
drinking purpose, hand wash etc. and Stainless steel pipe of SS grade-316
pipes confirming to EN 10312 complete with Press Type fittings suitable for
doubley secure pressing (two pressings simultaneously-one in front of the
crimp and one behind it) shall be used for RO water and soft water supply in
lab, drinking water cooler if required supply in Kitchen and laundry etc. The
hydropneumatic system shall be provided for pumping of water supply for 24
hr. a day with minimum 30% water demand capacity of terrace storage tank.
The sensor type auto operated tap and fitting shall be provided of reputed
make/model. Mixer pillar tap will be used
Similarly it is proposed to have conventional two pipe system for discharge of

soil and waste i .e. one pipe for soil water generated from WCs, Urinal etc.
and other pipe for waste water generated from baths, wash basins, sinks etc.
Kitchen would have a combination of pipe drain with floor traps and open drain
with SS steel gratings.
The soil and waste pipes from upper floors would run in the vertical shafts up
to Ground level and then discharge into horizontal sewer pipes, which would
carry the soil & waste water outside the building, where these would connect
to sewerage system laid underground.
The pipe will run below slab horizontally, wherever there is no sunk. 100 mm
min. dia CI 3989 pipe will be used in soil and waste and laboratory waste water
will be collected in HDPE pipe PE-100 of 110 mm dia will be used internally and
160 mm dia will be used outside.
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x) SEWAGE TREATMENT PLANT
Package type Effluent treatment plant followed by filtration is to be set up on

turnkey basis. The system shall be fully automatic linked with BMS with level
control, compact, odor free, and shall consume low power. All the water
retaining structure shall be designed as water retaining structure as per
provision of IS code and water proofing with fixed or any other approved
chemical shall be carried out by approved agency with 10 year (minimum)
garanty. The entire unit shall be painted by epoxy or fixed with the white
glazed tiles of approved make. The EIA clearance shall be obtained from State
Pollution control board. As per site condition/available space most of the unit
shall be placed below ground under road/green area/ as per site condition and
equipment and Panel room will be above the ground level as per drawings .The
raw sewage will be generated from different sources such as kitchen, hospital
effluent, lab Sinks, toilet of Hospital etc. The treated waste water will be used
for gardening, toilet flushing etc. Sewage treatment plant based on MBBR
(Moving bed Bio Reactor)/FAB technology shall comprise of following units:
Sl no. Unit DESIGN BASIS

1 Bar screen as per CPHEEO manual
2 Equalization tank hydraulic retention time Min.6 Hrs HRT
3 Aeration tank Shall be designed for minimum 5hr. retention time,
minimum water depth of 3.8 m. Air grid of CPVC/GI
pipe material of construction or corrosion resistant
material, Air diffusers (fine bubble), HDPE approved
make Bio media shall be required
4 Tube Settler/Lamina maximum Hydraulic loading 1.75 cu.m/sq.m/hr /1.5
Clarifier cu.m/sq.m./hr. respectively and with approved quality
media with minimum water depth of 2.4 m.+ Free
board & hopper bottom. The lamina clarifier media
shall be of acarlic plate min. 10 mm thick
5 Disinfection system Oxilyte (Mixed Oxidant) Generation System, based on

ECA Technology, producing non toxic mixed Oxidant
Slution at 1000 ppm of Oxidant Concentration.
Multi-grade filter mild steel pressure vessel ( as per IS:2825) 6 mm thick
natural rubber lining fabrication standard multi grade
filter with dished ends, supporting legs, manhole cover,
frontal pipe work fitting with valves with filtration rate
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of 20,000 lph/sqm ( min.). Back washing shall be less
than one time a day.
7 Activated carbon filter mild steel pressure vessel ( as per IS:2825) 6 mm thick
natural rubber lining fabrication standard multi grade
filter complete in all respects, with dished ends,
supporting legs, manhole cover, frontal pipe work
fitting with valves.
8 Centriguge/Filter Shall be designed to increase sludge consistency before
press disposing of solid sludge through filter press
9 Filter press Hydropneumatic filter press with suitable sludge pump
(screw type) along with piping, fittings valve etc.
10 Flow meter and Shall be of digital type

energy meter
11 Lab. Equipments
including digital type
pH meter, COD kit,
TDS kit, bicker,
conical flask
12 Room for pumps and Ventilation fan & ducts with minimum air change 20
control panel CFM and lighting etc and complete civil work.
13 Pumps & Blower Shall be with 100% standby
14 Interconnecting pipes Shall be of HDPE/cPVC/GI/SS
To have flexibility in O&M and to minimize the operation cost during lean flow
or when the occupancy of the hospital is low, the plant shall be designed
preferably in such a way that half portion of plant can be closed for O&M
without disturbing the operation of another half portion of STP. In O & M part
of STP, chemicals and consumables required for testing and any spare parts
require shall be included within the scope of work. The treated effluent
characteristics shall be as per local pollution control board standards for
horticulture and flushing use.
ETP : The effluent collected from lab and hospital liquid waste (other than
domestic sewer) will be treated at ETP, design based on physico chemical
continuous process with provision of barscreen, equilization tank, chemical
dosing tank and system. Reaction tank with agitator, PLC to control the ETP
operation on auto mode, digital pH meter, tube settler, Filter press, sludge
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tank and flow meter, filter, interconnecting pipe, pump valve, oxylite as
disinfection system complete system to meet the functional requirement as
well as Pollution Control norms. ETP will be common for Hospital and other
institutional buildings.
xi) WASTE WATER RECYCLING
The treated effluent of sewage treatment plan shall be used for horticulture &
Flushing Purpose. The treated water will be stored in a Tank & then it will pump
to separate distribution ring for horticulture use.
xii) BASIS OF DESIGN

The proposed hospital complex is service oriented project, hence special care
needs to be taken not only to give the building a functional water supply,
drainage and sewerage system but also a system which can be easily
maintained in future.
Following design criteria would be adopted:
• Provision of adequate and safe water supply 24 hrs.
• Adequate arrangement for satisfactory drainage of all sewage and waste
water.
• Ample provision for access to all pipe work, embedding for joints in walls
would be avoided.
• Sewer system would be designed for a peak factor of 3 and minimum
velocity of 0.75m/sec.
• Storm water drainage system would be designed to run full. A minimum
velocity of 0.6m/sec at designed peak flow will be maintained.
• Rain water harvesting system will be designed as per Central Ground
Water Board (CGWB) guideline/ local by laws.
- While designing services local bylaws, legislation, design criteria will be
followed. Some of the standard code / manual are listed below:
National Building Code
119
 IS 1172-1983: Code of basic requirements for Water Supply, drainage
and Sanitation
• IS 2065-1983 : Code of practice for water supply in buildings
• IS 1742-1983: Code of practice for building drainage
• IS 1200: Code of practice for water supply and drains
• CPHEEO manual on Water Supply & Water Treatment
• CPHEEO manual on Sewerage & Waste Treatment
• TAC manual on Fire Protection System
xiii) FIRE FIGHTING
It is proposed to have external fire hydrant system with main ring around the
buildings. In order to keep water in circulation, the water from municipal/bore
well will coming to fire tank first and then it will overflow to domestic tank. Fire
pump room will be located near domestic tank. The water from UGT will be
pumped to main fire ring of DI K-9 not less than 150mm dia pipe. Internal fire
fighting system shall consist of wet riser, sprinkler, fire pumps etc. depending
upon the building type and fire protection system shall be designed as per
National Building Code.
a. Location & size of Fire pump house
The fire pump house shall be located adjacent to the Underground Fire Water
Storage Tank. Tank slab shall be designed structurally to take the load of the
fire rescue tender weighing 45 tones (If coming in the drive area).
The base of the water tank shall be kept at a level preferably 450 to 600 mm
above the level of base of the Fire pump room so that the pumps operate under
positive suction conditions and the entire water capacity is above the body of
the fire pumps as per best fire engineering practice. The size of Fire pump
house shall be ideally 15 M x 6 M.
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b. Access to fire tenders
For access to fire tenders, a clear motorable approach of at least 6M shall be
kept for the movement of fire tenders all around the building. The width of the
main entrance to the complex shall not be less than 5.5 M and the height of
any arch or canopy shall not be less than 5M from the ground level.
c. Compartmentation
Access to all staircases and lift lobbies shall be through fire doors of two hour
fire rating. All vertical shafts shall be sealed at each floor level.
All Electrical areas like Transformer Rooms, LT/HT panel rooms, DG set room
etc. shall be properly compartmented with 4 hours rated walls and openings
shall be protected by 2 hours rated fire doors.
d. LIGHTING PROTECTION shall be provided as per IS: 2309 (latest edition)
e. FIRE ESCAPE STAIRCASE shall be provided, which shall directly open to

exterior at ground floor along with one main staircase.
FIRE PROTECTION SYSTEM

Scope
The intent of this head is to give a detailed description about the various
type fire protection system envisaged for the proposed buildings at
AIIMS, Raebareli. The basic system requirement is as per National
building code of India 2005 (Part 4 Fire and Life Safety).
Codes and Standards
NBC: National Building Code 2005, Part 4, Fire and Life safety
TAC: TAC Protection Manual/1998 (Guidance only)
Good Engineering Practices
IS-1239/IS-3589: Specification for GI pipes
121
IS-778/14846: Specifications for Gun Metal gate, globe and check
valves for water supply
IS-814: Specifications for covered electrodes for metal arc welding of
structural steel
BS-5155: Specification for C.I. butterfly valve
IS-1641: Specification for C.I. screwed fittings
IS-903: Spefications for Branch pipes (long Pattern)
IS-3844: Code of practice for installation of internal Fire Hydrant in Multi
storeyed building
IS-5290: Specifications for hydrant landing values.
IS-903: Specifications for coupling double male double female
instantaneous pattern for fire fighting.
IS-1879: Malleable iron fittings (Parts I to X)
IS-4853: Recommended practice for radiographic inspection of fusion
welded butt joints in steel pipes.
IS-636: Synthetic, jacketed hose pipes.
IS-1520: Electrically operated multistage / multi outlet pump
IS-5: Specification for painting
The types of fire protection systems for the buildings and premises shall
be as per
National Building Code considering the height of the proposed buildings.
SYSTEM DESCRIPTION
PUMPING SYSTEM
The following pump-sets are proposed for the proposed Motor Driven
Hydrant Main
Pumpset – 2850 lpm of required head (1 No.)
(For Wet riser and Yard hydrant system)
Motor Driven Sprinkler Main Pumpset – 2850 lpm of required head (1
No.) (For Automatic sprinkler system)
Engine Driven Hydrant Standby Pumpset – 2850 lpm of required head
(2 No.) (One for Wet riser, Yard hydrant and one for Sprinkler system)
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Motor Driven Common Jockey Pumpset – 280 lpm of required head (2
No.)(One for Wet riser and Yard hydrant system and one for sprinkler
system)
Positive suction arrangement is considered for fire fighting pumpsets.
UNDER GROUND FIRE WATER SUMP:

The underground fire water sump capacity shall be as per provisions of
National Building Code. This will be exclusively reserved for fire-fighting
purpose.
OVER HEAD TERRACE WATER TANK:

The overhead water tank at terrace level of all buildings shall be
provided as per requirements of national Building Code.
WET RISER SYSTEM ALONG WITH YARD HYDRANTS:

Yard hydrants are provided at every 45m regular interval along the
periphery of each building to give exposure protection.
WET RISER SYSTEM:

The west riser system mainly consists of fire water pumps, reservoir,
pipe network, hydrant value. The pipelines will be laid in rings around
the proposed buildings. The ring main will be laid 1m below the ground
level of proposed Buildings. The under-ground pipe will be of DI material
in order to protect from the soil corrosion. Stand pipes will be tapped
from the ring mains. At the terrace all the risers are interconnected and
also further connected to the delivery of the terrace Pump sets. All the
risers and interconnecting pipes at the terrace are all of GI pipes. The
terrace pump set will be rated 900/450 LPM for each building. The mains
will be charged with water to the system design pressure. The operation
of the system will be automatic through the pressure switches installed
in the system.
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SYSTEM OPERATION – PRESSURISATION SYSTEM
Initially, the system will be charged with water to the normal system
pressure of H kg/cm2. The system pressure is expected to fall down due
to minor leakages. When the pressure drops to the predetermined
pressure of 7(H-1) kg/cm2 the respective pressure switch will sense the
same and send the signal to the MCC & control panel. Immediately,
Jockey pump will be switched on to elevate the system pressure to the
normal level. As soon as the normal system pressure is reached, the
respective pressure switch will send the signal to the MCC & control
panel to switch off the jockey pump. Thus jockey pump will maintain the
system pressure.
SYSTEM OPERATION IN CASE OF FIRE

The normal system pressure will always maintained by the jockey pump
at a degenerated head (H). Since the jockey pump cannot meet the
water requirement in fire condition, the pressure will fall down further.
When the pressure reaches H kg/cm2(H- head of the pumps) the
respective pressure switch will switch on the electrically driven main
pump into operation. If main firewater pump fails to start due to
extraneous reasons, the standby pump will come into operation through
the respective pressure switch at the set pressure of (H-1) kg/cm2. As
soon as any one of the firewater pump comes into operation the jocky
pump will be switched-off by the interlock provided in the MCC. The
firewater pumps (main and standby) will be switched off manually after
ensuring that the fire is extinguished completely.
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DESIGN PARAMETERS
 The yard hydrants will be fixed on the stand post at 45 m intervals
around the proposed buildings.
 In each floor, in each riser, tapping will be taken for connecting a Single
headed hydrant valve and a hose reel drum having 19mm dia rubber
hose of 30m long with nozzle at one end.
 Each single headed hydrant value will be provided with 2 Nos. of 15 m
hose and 1 No. of branch pipe.
 Pipes will be laid in ring form around the area protected. Isolating values
will be provided from maintenance point of view as will be provided from
maintenance poit of view as well as fire service requirements.
 The ring main around the building will be laid 1m below ground level,
2m away, within 15 Mtr. from the face of the building.
 The wet riser cum down comer system piping will be GI Heavy Grade as
per relevant IS standards.
 The hydrant mains will be sized as per design calculation based on
velocity of 5m/sec and minimum of 150 mm dia.
 Minimum pressure of 3.5 kg/cm2 will be ensured at the remotest
hydrant point.
 All the hydrants will be used oblique type with the outlet angle towards
ground.
 All the outdoor hydrants will be provided with two (2) Nos. RRL hoses
(63 mm size x15m long with couplings) and one (1) no. branch pipe
with nozzle (20mm bore).
 At every internal hydrant location, one (1) no. of hose reel arrangement
will be provided except for terrace level.
 The system will be automatic in operation.
 The power supply to MCC & control panel of the firewater pumps will be
directly from the sub-station without any tapping.
AUTOMATIC SPRINKLER SYSTEM

The Automatic sprinkler system shall be provided as per requirements
of NBC 2005.
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SYSTEM OPERATION
One separate main pump is used for the sprinkler system. Sprinkler
system will have installation control valve (Alarm valve), Sprinklers, flow
switch, associated piping, etc. The sprinkler riser mains will be charged
with water to the system design pressure. The operation system will be
automatic through the pressure switches installed in the system. When
the sprinkler bulb breaks due to fire breaks-out, the pressure will drop
down in the pipe line. The drop in pressure is being sensed by the
pressure switch. The pressure switch is connected to the MCC. The MCC
will trigger the prime movers to run when it get signal from the pressure
switch.
DESIGN PARAMETERS
 At least one number sprinkler is to be provided per 12 sq.m of
coverage area.
 One Alarm valve is considered for each sprinkler riser. Tapping is
taken from the sprinkler riser for all the sprinklers at the respective
floors.
 Isolating valve is considered at the tap off points, from maintenance
point of view.
 One number flow switch is also provided near the tap-off point from
the individual vertical riser of each floor to get the fire indication in
the main fire panel.
 The Automatic sprinkler system piping will be GI heavy grade as per
relevant IS standards.
 The Sprinkler mains will be sized based on the number of sprinklers
and design calculation as per code.
 Minimum pressure of 0.35 bar will be ensured at the remotest
sprinkler point.
 The sprinklers used will be of Pendant type with rosette plate.
 One cabin will be housed near the riser to house the spare sprinklers,
spanner, first-aid box, etc.
126
 The system will be automatic in operation.
 The power supply to the MCC & control panel of the firewater pumps
will be independent and taken directly from the substation.
PIPE AND FITTINGS

 Pipe for fire fighting will be GI pipe conforming to IS : 1239 / IS :
3589 (Heavy grade for wet riser / hydrant system and sprinkler
system) including all fittings like bends, elbows, tees anchor
fasteners, couplings etc., and will be of reputed make.
 Pipes 150 mm dia and below will conform to IS : 1239. Pipes 200 mm
dia and above will be rolled and welded conforming to IS : 3589
 For pipes 50mm dia and below, threaded joints, will be used and
fittings will be of forged steel. For pipes above 50 mm dia, flanged
But welded joints/socket welded joints will be used.
 Flanges will have appropriate number of holes as per the relevant IS
Standard fastened with nuts, bolts and 3mm thick compressed rubber
gasket.
PIPE PROTECTION
 All pipes above ground a and in exposed locations will be painted with
one coat of red oxide primer and two coats of synthetic enamel paint
as per IS : 5 (Shade 536).
 All pipes under floors or below ground will be protected against soil
corrosion by wrapping and coating material “Pypkote” as per
IS:10221 or DI pipe will be used below ground (K-9 class). The GI
pipe shall be avoided as far as possible as these pipes have possibility
of corrosion.
PIPE SUPPORT
 All pipes will be adequately supported from ceiling or walls from
existing inserts by structural clamps fabricated from M.S. structural
e.g. rods, channels, angles and flats or by using anchor fasteners
type as per site conditions. All clamps will be painted with one coat
of red oxide and two coats of black enamel paint.
127
PORTABLE FIRST-AID FIRE EXTINGUISHERS
The portable first-aid fire extinguishers shall be provided for all the
buildings as per requirements of NBC 2005.
SYSTEM DESCRIPTION
The extinguishers are used to put-off small fires. The extinguishers will
be used in the incipient stage of fire. Fire extinguishers are easy to
handle. This is useful to put off the fire in the initial stage itself and thus
avoiding major losses.
PHOTOLUMINESCENT SAFETY SIGNGES

Photo luminescent safety signage shall be provided for exits & fire
escape route.
DESIGN PARAMETERS
Photo luminescent signages are provided in the exit staircases, lift
lobby, extinguisher location, fire escape hydrant & hose reel, alarm
valve and main fire alarm panel, etc.
Other Site Development Works

- Design and prepare working drawings (longitudinal & cross section) for
roads/ footpaths/ parking areas, etc.
- Design and prepare working drawings of irrigation system for
horticulture.
- Design and prepare working drawings for water bodies.
- Prepare spécifications and bill of quantities.
128
Annexure (Hospital Block)
AIIMS -HOSPITAL BLOCK(A)

S. No. Description of Area Details Unit Rate Total Remarks
Amount in
Lakhs
1 Underground Tank 2,313,000 liters --- Rate as per PAR
2 Terrace Tank 1075900 liters --- Rate as per PAR
3 Fire Terrace Tank 20000 liters Rate as per PAR
4 Solar Hot Water 70000 liters 147.00 210000 per 1000
litres(Rate as per
PAR-E&M item
no.10.1.3)
5 STP 895 KLD Rs. 537.00
60000
per KLD
6 ETP 90 Rs. 63.00
70000
per KLD
7 Recycling of STP water Rate as per PAR
8 Rain water Harvesting 2 nos. Rs. 2.75 5.50 Rate as per PAR
lakh each
9 Borewell 1 Nos. Rs. 9 9.00
lakh each
10 Water Distribution Filter & unfilter --- Rate as per PAR
both
11 Storm Water Drains --- Rate as per PAR
12 Fire-fighting (based on building) Sprinkler --- Rate as per PAR
System/hydrant
13 Hydropneumatic system/WTP/Softener 1474 KLD Rs. 443.00
30000
per KLD
14 Water curtain system & pumps in LS 15.00
Basement for Fire fighting
Total Water Demand / day
S. Description of Area Details of No. of Population/ Rate of Total
No. area Floors Bed Water Water
(Sq.M) demand(LP Demand
CD) as per (litres /
NBC day)
Ground floor
First floor
Second floor
Third floor
Fourth floor
Fifth floor
Sixth floor
108329 5417 45 243765
Beds 1200 450 540000
Basement area misc. 17171 172 45 7740
Hosp. Service Block 5500 55 45 2475
793980
Labs 79398
Laundry 1200 45 54000
Kitchen 1200 20 24000
2 Basement Parking of 12000 120 45 5400
200 cars
956778
wastage 10% 95677.8
1052455.8
[Green Area] 40000 5 200000
1252455.8
Total water Demand (DOMESTIC USE)- Hospital Block(B) 1253 cu.m./day
STP CAPACITY 894587.43 Litre/day

say 895 cu.m./day
AC Makeup Water To be based on TR of AC / Area to be air conditioned

Demand -Part-
I(Hospital)
900 cu.m./day
130
TOTAL DOMESTIC WATER DEMAND 1253 Cum/day
Hospital Block (A)
WATER DEMAND FOR A.C.- Hospital 900 Cum/day
Block(A)
UNDER GROUND TANK -Hospital Block (A)
Description Capacity Proposed Capacity (CUM)
(CUM)
1 Raw Water 986.50 987
2 Treated Water 626.50 627
3 Fire Tank 200.00 200
4 Soft Water 540.00 500
2,313
TERRACE TANK-Hospital Block(A)
S.N Domestic Tank Cap (cum) Proposed Capacity (CUM)
2 Untreated Water 250.6 250

3 Soft water 450 450
1,076
Fire Fighting Terrace Tank
S.N Domestic Tank Cap (CUM) Proposed Capacity (CUM)
Hospital Block (A)

1 Hospital 20 20
20
HOT WATER REQUIREMENT

Name of the Buildings Hospital Block (A)
No. of Stories B+G+6
Hospital 108329 5417 5 27085
Beds 1200 30 36000
63085
Add for Floating Population / Visitors 10% 6308.5
Grand Total 69393.50
70000.00
Total water Demand =70 Cum/Day
131
Name of the Project AIIMS-Institutional Block-(B)
Amount in
Lakhs
1 Underground Tank 495,000 liters --- Rate as per PAR

2 Terrace Tank 197500 liters --- Rate as per PAR
3 Fire Terrace Tank 75000 liters Rate as per PAR
4 Solar Hot Water 12023 liters 26.00 210000 per 1000

litres(Rate as per
PAR-E&M item
no.10.1.3)
5 Rain water Harvesting 10 Nos. Rs. 2.75 28.00
lakh each
6 Borewell 2 Nos. Rs. 9 18.00

lakh each
7 Water Distribution Filter & unfilter --- Rate as per PAR
both
8 Storm Water Drains --- Rate as per PAR
9 Fire-fighting (based on building) Sprinkler --- Rate as per PAR
System/hydrant
10 WTP 274 KLD Rs. 83.00
30000
per KLD
S. Description Details of No. of Population Rate of Water Total

No. of Area area Floors /Bed demand(LPCD) WaterDemand
(Sq.M) as per NBC (litres / day)
1 Teaching G+4
Block
17930 1196 45 53820
2 Auditorium G+2
7380 850 15 12750
3 Administration G+3
Block
4600 307 45 13815
4 Nursing 4650 G+2 310 45 13950
College
5 Night Shelter 3700 G+3 250 135 33750
6 Animal House 760 10 45 450
7 Guest House 2300 80 135 10800

(40 rooms)
Total 139335
Add 10% for 13933.5

wastage
153268.5
[Green Area] 10000 5 50000
GRAND TOTAL 203268.50
Total water Demand (DOMESTIC USE)-Institutional 204 cu.m./day
Block-(B)
say 205 cu.m./day
STP CAPACITY 130278.225 Litre/day

say 130 cu.m./day
AC Makeup To be based on TR of AC / Area to be air conditioned

Water
Demand
190 cu.m./day
133
TOTAL DOMESTIC WATER DEMAND-Institutional 205 Cum/day
Block-(B) Medical College
WATER DEMAND FOR A.C.-Institutional 190 Cum/day
Block-(B) Medical College
UNDER GROUND TANK Institutional Block-(B)
(CUM)
1 Raw Water 178.50 179
3 Fire Tank 100.00 100
4 Soft Water 114.00 114
495
TERRACE TANK-Institutional Block-(B)
S.N Domestic Tank Cap (cum) Proposed Capacity (CUM)
2 Untreated Water 41 41
3 Soft water 95 95
198
Fire Fighting Terrace Tank -Institutional Block-(B)
S.N Domestic Tank Cap (CUM) Proposed Capacity (CUM)
Institutional Block (B)
1 Teaching block 10 10
2 Auditorium 15 15
3 Admin. 10 10
4 Nursing College 10 10
5 Night Shelter 25 25
6 Animal House
7 Guest House 5 5
75
HOT WATER REQUIREMENT AIIMS-Institutional Block-(B)
Institutional Block
(B)
Teaching Block 17930 1196 5 5980
Auditorium 7380 850 0 0
Admin Block 4600 307 0 0
Night Shelter 3700 250 15 3750
Guest House 2300 80 15 1200
TOTAL 10930
Add for Floating Population / Visitors 10% 1093
Total Water Demand =12 Cum/Day
134
AIIMS-Residential Block(C)
Amount in
Lakhs
1 Underground Tank 750000 liters --- Rate as per
PAR
2 Terrace Tank 350000 liters --- Rate as per
PAR
3 Fire Tank 380000 liters Rate as per
PAR
4 Solar Hot Water 47927 liters Rs. 300 143.78
per liter
5 STP 420 KLD Rs. 252.00
60000
per KLD
6 Recycling of STP water Rate as per
PAR
7 Rain water Harvesting 30 Nos. Rs. 2.75 83.00
lakh
each
8 Borewell 3 Nos. Rs 9 lakh 27.00
each
9 Water Distribution Filter & unfilter --- Rate as per
both PAR
10 Storm Water Drains --- Rate as per
PAR
11 Fire-fighting (based on building) Sprinkler --- Rate as per
System/hydrant PAR
12 WTP 259 KLD Rs. 78.00

30000
per KLD
Total
S. Description of Area Details No. of Population/ Water Total

No. of Floors Bed/DU demand WaterDema
area nd (litres /
(Sq.M) day)
1 Director bunglow 301 1 200 1400

(1 block)
2 Type-II(3 blocks) 6894 S+G+7 108 200 108000
3 Type-III(1 block) 1464 18 200 18000
4 Type-IV(1 block) 2206 21 200 21000
5 Type-V(1 block) 4199 24 200 24000
6 Guest House(15 650 32 135 4320
rooms)
Proposed Hostels
7 PG Hostel-D1(2 blocks) 7414 312 135 42120
10 UG Girls(1 Block) 3558 120 135 16200

11 UG Boys1(1 Block) 2733 100 135 13500
12 UG Boys2(1 Block) 4277 146 135 19710
13 Nurses student hostel 4746 144 135 19440
D-single occupancy
(1 block)
E-double occupancy
(1 block)
15 Dining Hall-I 772 520 70 36400
16 Dining Hall-II 958 435 70 30450
Total 432165
Add 15% for wastage 64824.75
496989.75
[Green Area (plot 40000 5 200000
area- total ground floor
area)*40%]
136
GRAND TOTAL 696989.75
Total water Demand (DOMESTIC USE) 697 cu.m./day
say 700 cu.m./day
STP CAPACITY 422.441288 cu.m./day

say 420 cu.m./day
Total Hot Water Demand / day

S. No. Description Area Population/ Hot water Total Demand
beds/DU demand per (litres / day)
person per
bed or DU/
(ltrs)
1 Director bunglow 301 1 100 100
(1 block)
2 Type-II(3 blocks) 6894 108 100 10800
3 Type-III(1 block) 1464 18 100 1800
4 Type-IV(1 block) 2206 21 100 2100
5 Type-V(1 block) 4199 24 100 2400
6 Guest House 650 32 20 640
Proposed Hostels
7 PG Hostel-D1(2 7414 312 15 4680
blocks)
8 PG Hostel-D2(1 4043 132 15 1980
blocks)
9 PG Hostel-D3(1 4043 155 15 2325
blocks)
10 UG Girls(1 Block) 3558 120 15 1800
11 UG Boys1(1 Block) 2733 100 15 1500
12 UG Boys2(1 Block) 4277 146 15 2190
D-single occupancy
(1 block)
E-double
occupancy(1 block)
15 Dining Hall-I 772 520 5 2600
16 Dining Hall-II 958 435 5 2175
Total 43570
Add for Floating Population / Visitors 10% 4357
Total water Demand =48 Cum/Day
137
AIIMS Residential Blocks(C)
TOTAL DOMESTIC WATER DEMAND 700 Cum/day
WATER DEMAND FOR A.C 0 Cum/day
UNDER GROUND TANK -Residential
(CUM)
1 Raw Water 350.00 350
3 Fire Tank 50.00 50
4 Soft Water 0.00 0
750
TERRACE TANK-Residential
S.N Domestic Tank Cap (Ltrs) Proposed Capacity (CUM)
1 Treated Water 210 210
2 Untreated Water 140 140
3 Soft water 0 0
350
Fire Fighting Terrace Tank
1 Director bunglow(1 block) 0 0
2 Type-II(3 blocks) 75 75
3 Type-III(1 block) 25 25
4 Type-IV(1 block) 25 25
5 Type-V(1 block) 25 25
6 Guest House 5 5
Proposed Hostels
7 PG Hostel-D1(2 blocks) 50 50
10 UG Girls(1 Block) 25 25
11 UG Boys1(1 Block) 25 25
12 UG Boys2(1 Block) 25 25
13 Nurses student hostel D-single 25 25
occupancy(1 block)
14 Nurses student hostel E-double 25 25
occupancy(1 block)
15 Dining Hall-I
16 Dining Hall-II
380
138
ELECTRICAL CONCEPT
139
14. ELECTRICAL CONCEPT
Assumptions:
 All the equipments etc. shall be suitable for 415 V, three phase or 220
V, Single phase, 50 Hz A.C. supply.
 21 MVA power supply is available at 132kV feeder. Our scope starts from
132kV.
1.0 SCOPE
The scope covers complete electrical works including H.T. sub-station,
Diesel Generators, Power distribution, internal electrification, UPS BMS,
Grid interactive solar photovoltaic system, Nurse Call bell, CCTV, Lifts,
Escalator, Access control System, Occupancy Sensor, Telephone system,
street light etc. complete for the proposed AIIMS Like Institute at Nadia
West Bengal with state-of-art facilities. The load of such magnitude is
available at 132 kV.
2.0 DESIGN CRITERIA

2.1 CODES and STANDARDS
The design shall be done taking into account the following latest
revisions applicable to the region in which the project is located.
- Indian Electricity Rules.
- Local by-laws and factory Act.
- Indian Standard Specifications/codes.
- CPWD specifications for electrical works
- National Building/Electric Code.
- Manufacturers Instructions and guidelines.
140
2.2 ELECTRICAL LOAD STATEMENT
The Electrical estimated load including HVAC system is 21 MVA is calculated

on the basis of Architectural plans, covered areas, medical equipments & other
norms.
2.3 LIGHTING
Hospital Building shall be generally well illuminated. Following lighting level
shall be provided in various areas conforming to IS: 3646.
Area Lux Level

Laboratories ,Office area, Library, Computer 300
Center, dispensaries
Kitchen, Stores 200

Waiting area/Reception/OPD/Casualty 150
Toilets, Corridors/Staircase. 100

Operation theatres
General 300
Table Special Light
Wards
General 100
Beds 150
Building shall be generally lit with energy efficient mirror optics fluorescent light
fixtures /compact fluorescent light fixtures except service area where industrial
type fixtures will be used. LED light fixture will also be used in some areas such
as external light, ICU etc.
2.4 ENERGY CONSEVATION:
For the energy conservation following steps have been considered:
i. Occupancy sensors have been proposed.

ii. Grid interactive Solar photovoltaic power generation has been proposed.
iii. Building Management System has been proposed.
141
iv. Automatic Power Factor Correction panel with intelligent relay has been
proposed to maintain the load power factor above 0.95.
v. Energy efficient T-5 fluorescent tubes, CFL with high power factor and
electronic ballast have been proposed.
vi. In hospital block LED fixture and in Institutional, Residential T-5
fluorescent tubes, CFL has been considered.
vii. High Pressure Sodium Vapour lamps and LED light Fixtures will be used
for street light.
viii. Timers have been proposed for street light ON/OFF.
3.0 CONCEPT
3.1 EXTERNAL SERVICES
3.1.1 SUBSTATION EQUIPMENTS
The proposed AIIMS at Nadia Grid substation of 132kV/ 11kV and 11KV/ .433
KV substations for buildings/ blocks has been considered. An emergency
supply through DG set for 100% load in Hospital, Teaching and Service block
has been considered. Emergency supply through DG set for common lighting,
Lifts and pumps for hostels and residential blocks has been considered.
This location is recommended considering the following aspects

I. Close to load centers like air-conditioning plant room.
The following assumptions are considered during report:
I. The 132 KV supply shall be fed from the substation of the state electricity
board through independent feeder.
II. In Hospital, Teaching, Nursing College almost 100% load and in hostels &
Residential common lighting, Lift and Pumps has been considered as
essential load, accordingly DG sets have been proposed.
142
3.1.2 CABLES AND ROAD LIGHTING
LT cables, HT cables (XLPE insulated, aluminum conductor, armoured/ Bus

ducts) from the Sub Station to proposed Main LT Panel and further to the
hospital.
Provision has been considered for outdoor lighting.
3.1.3 POWER FACTOR IMPROVEMENT
It is proposed to improve the power factor above 0.95 at each substation. The
capacitor banks shall be connected to each bus. The capacitor will be heavy
duty low loss type and microprocessor based Intelligent Automatic power
factor correction relay will be used so that the power factor can be improved
to a desired level automatically.
3.2 INTERNAL SERVICES
3.2.1 CONDUITING AND WIRING SYSTEM
Internal electrification installations shall be carried out as per the requirements

of Indian Electricity rules and acts. The wiring shall be carried out in concealed
MS conduits with suitable size of PVC copper conductor wire of required size
for the wiring mains and submain.
3.2.2 LT DISTRIBUTION
Electrical rooms shall be proposed on all floors. Main distribution boards for
normal and emergency feeders shall be proposed and shall be located on the
ground for the electrical room of each floor. For LT distribution to upper floors,
sub distribution for normal & emergency supply is proposed at each floor.
Electrical rooms on various floors shall be located at same location. Cut out
shall be provided in slab for cables connecting Main Distribution Boards.
Submain cables from main and /or submain distribution boards shall be 2 core
/4 core stranded copper conductor wires in concealed / recessed conduit.
Distribution boards shall be provided with miniature circuit breaker for
outgoing circuit. Overload and short circuit protection shall be provided by
143
outgoing MCB for each final circuit/feeder. For human safety against electric
shocks, earth leakage circuit breaker shall be provided as incoming of final
distribution board. Distribution boards catering general lighting, fan, & single-
phase outlet points shall be horizontal type distribution boards. Whereas area
requiring /having 3 phase power supply the distribution board shall be vertical
type.
Main & sub distribution shall be cubicle type with Moulded Case Circuit Breakers
or fuse switch units. For power connection to equipment, power cables, shall
be provided near each of the equipment controlled with switch located beside
the power outlet. 15/5A 6-point socket outlets are proposed in all areas.
Special lab equipment requiring more than 1 KW but not exceeding 2.5 KW
single-phase loads shall be provided with metal clad plug & socket controlled
by MCB. Equipment requiring upto 5 KW, 3 phase supply (without neutral
requirement) shall be provided with 3 pole plus earth metal clad plug & socket
controlled by 3 pole MCB. Hospital equipment having power requirement not
covered by above categories, shall be provided with Fuse Switch Units/
MCCB’s.
3.2.3 TELEPHONE SYSTEM
Provide telephone outlets and telephone network in each area. The main
telephone exchange (Communication Server) shall be provided in building in
suitable room preferably at ground floor. Each floor shall be provided with a
suitable size of TAG block for telephone connections. 2 pair telephone cable in
rigid PVC/MS conduit shall be provided from each 2 pin telephone socket outlet
to telephone tag block of that floor. The main cable shall be provided to each
block from the telephone exchange.
3.2.4 FIRE DETECTION AND ALARM SYSTEM
The design and installation of addressable fire detection and alarm system shall
conform to Standards specifications or latest revision of IS 2189: 2008
amended up to date.
144
Without restricting to the generality of the foregoing the fire detection and
alarm system shall also including the following:
a. Ionization smoke detector / optical detectors / rate of rise cum fixed

temperature heat detector / manual call point / electronic hooters /
response indicators and accessories.
b. Metallic conductor, copper conductor wire / armoured cable / glands / tees
/junction boxes etc.
c. Addressable fire alarm system has been considered.
The entire fire alarm shall give audio / visual alarm signals when temperature/
smoke density exceeds the permissible limit.
The system will be completely safe guarded against all conditions like A.C.
main failure, battery discharge failure, open circuit and earth fault in detector
cabling etc.
3.2.5 PA SYSTEM
Central PA system shall be provided in the hospital complex. PA system

equipment shall be located on control room. Main announcement console shall
be in the control room. At least one additional console shall be provided at
suitable location in each floor.
Speaker shall be provided throughout the building and other areas as per the
requirement. Building shall be divided into P.A. zones, each zone shall have an
amplifier, and standby amplifier shall also be provided in amplifier rack.
3.2.6 SECURITY SYSTEM/ CCTV SYSTEM
Entire hospital building area will have state of art CCTV system consisting of
verifocal colour cameras. At the main entrance and inside the building high
resolution camera with veri-focal lens will be used. All the activities in the
building can be viewed at a high definition resolution flat screen placed at a
CCTV control room.
145
3.2.7 BMS SYSTEM
State of art Building Management System (BMS) will integrate multiple building
functions including equipment supervision and control, alarm management,
energy management, information management and historical data collection
and archiving.
The system shall be modular in nature, and shall permit expansion of both
capacity and functionality through the addition of field devices / programming.
The failure of any single component or network connection shall not interrupt
the execution of control strategies at other operational devices.
The proposed BMS system will consist of the following:
 Central control station for monitoring, control and alarm through

Operator Interface Station (OIS).
 Software for building management system and energy management
system.
 Stand alone intelligent 32 bit Direct Digital Controller (DDC) for the
following:
o Chilled water system
o Hot water system
o Water supply system,
o Water softening plant,
o Electrical system,
o Ventilation system,
o Fire fighting system,
o Fire alarm system,
o Lifts,
o DG system,
o UPS,
o VFD integration,
o Fire alarm integration,
o ACB and KWH integration A
146
o air handling units
 System Integration unit consisting of Gateways, interface units etc.
 Portable operator terminals.
 Sensors and field devices consisting of the following:
o Immersion type temperature sensors
o Duct type temperature sensors
o Out side air and humidity sensor
o Water flow meter
o Differential pressure switch across the AHU
o Level switches for indicating water level in cooling towers , tanks
etc
o Water flow switches
o 4-20 mA pH Sensor
o 4-20 mA TDS sensor
o Differential pressure transmitters
o Current transducers
o Voltage transducers
3.2.8 CABLE TV SYSTEM
MS/ PVC conduits shall be provided from TV outlets to a central place (metal
box) at ground floor of each block. Centralized Cable TV System shall be
provided. Cable TV outlets shall be provided at suitable locations such as pay
wards, waiting areas etc.
3.2.9 EARTHING
Earthing of electrical installation shall be carried out as per IS: 3043 amended
upto date standards. Each main distribution shall be earthed separately with 2
No. Earth electrode. Number of earth electrode shall depend upon earthing
resistance. All sub switchboards on upper floor shall be connected main
distribution board on ground floor for earthing purpose. Galvanized/copper
strips shall be used as earth conductor. From main /sub switchboard to various
final distribution board, 8 SWG copper/ GI wire shall be used as earth
147
conductor. Each final circuit shall be earthed with FRPVC copper conductor.
Copper earthing shall also be provided for computer system and shall be totally
segregated from all other earthing system.
Earthing shall be provided with either GI plate electrode or copper plate

electrode of suitable dimensions as per standards.
Substation earthing shall be done by GI/ copper strip of suitable size including
neutral earthing of electrical equipments. All earth electrodes shall be
interconnected to form a grid.
3.2.10 LIGHTNING PROTECTION
Lightning protection shall be in accordance with CPWD General Specifications

for electrical works (Part-I Internal-2005 and as per Indian standards. The
system shall consist of fixing 20mm x 3mm GI strip as horizontal conductor as
well as vertical conductor. Each vertical conductor shall connect to independent
earth electrode.
3.2.11 LIFTS & ESCALATORS
Passenger lifts, hospital lifts, service lifts, dumb waiter and escalators etc have
been proposed for the entire complex. The installation shall be carried out as
per rules & regulation of local bodies and IS code that governs the requirement
of installation of the lift. The voltage and frequency of the supply shall subject
to variation permissible under Indian electricity act & rules. Escalators have
also been provided for easy movement of the patients & staff.
148
3.2.12 PROVISION FOR COMPUTER NETWORKING.
Main computer room shall be provided in the suitable place. Computer terminal
points shall be proposed in the various blocks to be connected to computer
main frame. Computer terminals points shall be proposed at the
location/Areas.
3.2.13 UPS SYSTEM:
Un-interrupted power supply has been considered for operation theaters, ICU
and computer networking. Separate UPS will be there for OT & net working.
IGBT based rectifier & invertors have been considered for UPS. The UPS of OT
block will be in parallel redundant mode.
3.2.14 ACESS CONTROL SYSTEM:
In order to meet the security concern Access Control system has been
considered in some area. The ACS will consist of E&M locks, readers, smart
cards, cabling, recording, display and hardware and software.
3.2.15 GRID INTERACTIVE SOLAR PHOTOVOLTIC POWER GENERATION

SYSTEM
Grid interactive Solar photovoltaic power generation system has been

considered for the optimum utilization of natural resources. The power so
generated will be supplied to the grid and a data logger used to keep a record
of power generation and feed to the grid.
3.2.16 OCCUPANCY SENSORS:
In order to optimize the energy consumption occupancy sensors has been

proposed at different locations. These will automatically switch off the power
when nobody is there and automatically switch ON when person enters. It will
also have manual over ride.
149
3.2.17 NURSE CALL BELL SYSTEM.
The nurse call bell system shall consisting of (i) power supply (ii) nurses station
console for suitable for proposed number of beds (iii) nurse station indicating
panel (iv) call bell push button.
The system shall operate as under:
When a patient need nursing assistance he/she presses the call push button
on the bed side, a lamp hasting signal with a soft musical audio signal of short
duration shall be on to indicate the number of room/bed at nurses station.
Simultaneously the dome light and the light on the call push button station
shall also start flushing when the nurses acknowledge the call at the nurses
station. By pressing push button on the console all the lights shall become
steady and stops hasting. And the patient is assured that this call have been
acknowledged and shall be attended shortly. The nurses shall restore the
system to its normal working for the particular bed by pushing the cancellation
button call push station after attending patient. And all the light shall be off.
150
Annex-Estimates (Electrical)
Total Area 131000 Total Load in 14000.00

(Sq.M.) KVA
CCTV Area 131000 Access Control 131000
Occupancy 131000 Parking area 17171
sensor area
S.No. PAR S.No. Description Amount (in Lacs) Remark
1 1 ESS @ 7500/KVA for 14000 KVA 1050.00 As per PAR
2 2 DG sets 14000 KVA, with control 1400.00 As per PAR
cable, Earthing @ 10000/KVA
3 5.1 UPS i.e.1400 KVA for 30 min 280.00 As per PAR
backup @ 20000/KVA
4 11 CCTV @300/ Sqm 393.00 As per PAR
5 12 Access Control System @190/ Sqm 248.90 As per PAR
6 15 Occupancy senser @75/ Sqm 98.25 As per PAR
7 9 Grid interactive roof top Solar 140.00 As per PAR
photovoltaic power generation
system including space frame of
140 KWp of load for common light
@ 100000/KW
8 Cables ( LT & Telephone, Bus 273.00
trunking, rising main) 10% of
ESS+DG
9 13.1,13.2 BMS @(48 Lac + extra @160/sqm) 241.60 As per PAR
10 EPABX including telephone sets, 262.00
wiring etc. @200/sqm
11 Nurses Call bell @ 25000 per bed 250.00
for 1000 beds
12 Synchronization Panel for the above 280.00
DG’s (PLC based)@2000/KVA
13 Escalators @ 2576000 (26 Nos) 669.76
14 26 Passanger lift 9 stop,9 opening ( 893.55
1mps) @ 4255000 (21 Nos )
15 Parking Management system @ 171.71
1000 per sqm
16 132/11 kV Grid Sub station 2000.00
including 132kV Transmission Line
Total 8651.77
Say 8652.00
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HVAC CONCEPT
152
15. HVAC CONCEPT
2.0 Scope
The scope covers complete HVAC works including providing and fixing
of central air-conditioning and ventilation systems for the proposed
Hospital Blocks and Institutional blocks for AIIMS like projects.
2.0 Design Criteria

2.1 Codes and Standards
The design shall be done taking into account the following latest revisions
applicable to the region in which the project is located.
- ASHRAE
- ISHRAE
- Indian Standard Specifications / codes.
- National Building Code 2005.
2.2 Design Considerations :
 All the equipments etc. shall be suitable for 415 V, three phases or 220
V, Single phase, 50 Hz A.C. supply.
 Energy efficient chillers, Insulation of roof for reducing heat ingress &
reducing load on AC, double glazing of windows on sun facing sides, Air
tight windows and doors for reducing leakage of air and dust.
 All HVAC equipments shall be as per ECBC, 2007.
 Natural ventilation shall comply with the design guidelines provided for
natural ventilation in the National Building Code of India 2005.
 Cooling equipments shall meet or exceed the minimum efficiency
requirements laid down in ECBC, 2007.
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 Where ever used, the Unitary Air conditioners will meet IS 1391 (part-
I), split air conditioner shall meet IS 1391 (Part –II), Packaged air
conditioner shall meet IS 8148.
The amount of fresh air intake shall be optimized to provide a suitable
environment for specific areas of the buildings depending upon the
function of the area, the number of people involved.
The air circulation system shall be designed using high efficiency filters
to prevent contamination whether it is from outdoor air or from re-
circulated air within the space.
2.3 Assumptions:
Following assumptions have been made for calculation of air-conditioning

cooling load:
i) Construction of walls will be :

External walls: 9 inch thick masonary, plastered inside & outside
Internal walls: 4.5 inch thick brick masonary, plastered inside and
outside.
ii) Glazing : Double Pane transparent glass.
iii) Lighting load: 2 W/sq.ft for other areas
iv) Fresh Air : 15 CFM per person or 2 ACPH whichever is

higher.
iv) Occupancy : App. 60-100 sq. ft. per person or as per actuals.
vi) Equipment load : As per standards or actuals.
vii) Roof insulation : The exposed roof of air conditioned areas shall
be insulated with 50mm thick expanded polystyrene or equivalent
insulation.
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2.4 Outside Ambient Conditions:
As per ISHRAE and ASHRAE
2.5 Inside conditions:
SUMMER 1) 75 +/- 2 deg F DB
& MONSOON 55 +/- 5% RH
(for office area)
68 +/- 2 deg F DB
55 +/- 5% RH
(for OTs)
WINTER 2) 68 +/- 2 deg F DB
55 +/- 5% RH
2.6 Ventilation :
Basement : 30 ACPH during fire.( As per NBC)
15 ACPH during normal condition.
2.7 Electric Power Supply 415V/3ph/50Hz/AC
2.8 Fire Safety:
For fire safety, fire dampers shall be provided in supply and return air
ducts which shall automatically shut off in case of detection of fire. Also
the air conditioning system shall be electrically interlocked with the
central fire alarm system of the building such that in case of detection
of fire the complete air conditioning system shall stop automatically.
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* All the materials used for ducting and insulation shall be fire
retardant type.
* Combination smoke cum fire dampers will maintain the integrity

of firewalls and also prevent the spread of smoke.
* AHU operation under fire conditions: - AHU's will be configured to

operate in the following manner under fire conditions:
* Supply and return fan off
* Smoke extract fan on
* Recirculation dampers closed
* Exhaust dampers fully open
* Fresh air dampers fully open
Each lift well / staircase shall be pressurised during fire condition with
necessary ventilation as per the statutory requirement.
3.0 SPECIAL CONSIDERATION IN DESIGN
The Air-conditioning system design shall take into consideration the

following aspects:
3.1 Application of air-conditioning to health facilities presents many

problems not encountered in conventional comfort air conditioning
systems. The air conditioning systems have been designed taking into
consideration the following factors:
3.1.1 The need to restrict air movement in between various departments and
zones to prevent cross contamination.
3.1.2 The need to maintain different temperature and humidity requirement

for various areas.
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3.1.3 Specific requirements for ventilation and air filtration to dilute and
remove contamination in the form of odour, airborne micro organisms
and viruses, and hazardous chemical and radioactive substances.
3.1.4 The need to provide controls for maintaining accurate control of

environment conditions.
3.1.5 The need to design systems which should be easily maintained by the
hospital staff.
3.1.6 The need to maintain relative pressure differentials with respect to

adjoining areas and the outside.
3.2 The air circulation systems shall been designed using high efficiency
filters to prevent bacterial contamination whether it is from outdoor air
or from re-circulated air within the space.
3.3 The amount of fresh air intake shall be optimised to provide a suitable
environment for specific areas of the hospital depending upon the
function of the area, the number of people involved and the degree of
hazard to which the patient is subjected.
3.4 All operation theatres shall be designed on laminar flow principle with
supply air filtered through three sets of filters viz:
a. Pre filters of 90 % efficiency.
b. Fine filters of 99.9 % efficiency.
c. HEPA filters of 99.97 % efficiency
3.5 The operation theatres shall be designed on air recirculation system at

the rate of 25 air changes per hour out of which at least 5 air changes
per hour are of fresh air.
Recirculation of air has been made feasible due to availability of HEPA

filters and also due to availability of non toxic anaesthesia which do not
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required high level of dilution. This economises and reduces the air-
conditioning load considerably.
3.6 The operation theatres, ICU’s and isolation rooms shall be designed to
maintain high positive pressure with respect to the surroundings to
ensure that no contamination should enter the OTs.
3.7 Air supplied to ICUs shall be filtered through two sets of filters:
a. Pre filters of 90 % efficiency
b. Fine filters of 99.9 % efficiency.
3.8 The diagnostic areas such as X- ray labs, Ultra sound lab, CT scan etc.
shall be designed on conventional air recirculation principle with high air
circulation rate to remove the sensible heat generated by the equipment
room.
3.9 Separate air systems for different departments shall be provided to

provide flexibility of operation and prevent cross contamination.
3.10 Aluminium ducting shall be used for supplying air to operation theatres
to reduce the risk of bacterial formation in the air handling equipment
and the ducts.
3.11 High pressure, all enclosed double skin air handling units shall be used
for critical areas such as operation theatres and isolation rooms etc.
3.12 For fire safety, fire dampers shall be provided in supply and return air
ducts which shall automatically shut off in case of detection of fire. Also
the air conditioning system shall be electrically interlocked with the
central fire alarm system of the building such that in case of detection
of fire the complete air conditioning system shall stop automatically.
3.13 All the materials used for ducting and insulation shall be fire retardant
type.
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3.14 All supply, return and exhaust air grilles and registers shall be decorative
type to match the interiors of the building.
3.15 UVGI shall be provided because it is effective in reducing the

transmission of airborne bacterial and viral infections in hospitals, UVGI
is also recommended in air handling units to prevent or limit the growth
of vegetative bacteria and fungi.
4.0 ESTIMATED REQUIREMENTS
AIRCONDITIONING SYSTEM
Based on the above design data and the preliminary concept drawings
of buildings the preliminary air conditioning load for the complex is
estimated as per attached Annexure.
5.0 Proposed HVAC System

5.1 Based upon the above mentioned air-conditioning load, it is proposed
to provide Central Air-conditioning with chilled water system for the
complex except bio-safety laboratories which shall be provided with
dedicated air cooled chillers.
5.2 For summer / monsoon cooling centrifugal/screw type water cooled

water chilling machines and chilled water pumps shall be provided.
5.3 For winter heating Hot water Generator /heat pumps along with
circulation water pumps shall be provided.
5.4 For humidity control, monsoon reheating & winter humidification shall
be provided for essential areas such as OT, ICU. Independent hot water
coil shall be installed for the monsoon reheating. Other non essential
areas shall be provided without humidity control arrangement.
5.5 Air handling units shall be installed for all the air conditioned areas.
5.6 The chilling units and the pumps will be located in the plant rooms.
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5.7 The chilled /hot water from the Chiller/ HWG will be carried by chilled/
hot water pipes to each AHU's & cooling units.
5.8 To reduce the noise level in the AHU Rooms, room acoustic insulations
shall be provided and in ducts internal duct acoustic lining shall also be
provided as per requirements.
5.9 The cooled & conditioned air from the AHU is supplied to all areas
through GSS/AL ducting. The air shall be distributed in each room
through ceiling / wall mounted diffusers/ grilles. The return air shall be
carried through plenum or GSS/AL ducting up to AHU room.
5.10 Fire dampers shall also be provided in both supply and return air
ducting. If there is any fire, the fire dampers will close automatically
and in turn shut off the AHU motor by interlocking.
5.11 For control of air quantities and maintenance of pressure difference in

Operation theatre, ICU; volume control dampers are provided in the Air
distribution system.
5.12 A central control console and electrical panels shall be provided

with indication lamps and start/ stop control for all the equipments in
the A/C plant room.
5.13 Soft water plant shall be provided for supplying soft & filtered water to
the Air-conditioning plant.
6.0 VENTILATION SYSTEM
6.1 Separate ventilation system shall be provided for kitchen, laundry, and
manifold etc. The system shall comprise centrifugal/axial blowers.
6.2 Basement ventilation shall be provided for normal as well as emergency

condition as per National Building Code.
7.0 SPACE REQUIREMENT
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The proposed air-conditioning system requires A/C Plant rooms, AHU
rooms for each zone and floor etc. The chillers, chilled & hot water
pumps and electrical panels are proposed to be installed in respective
AC plant rooms.
8.0 ENERGY EFFICIENCY CONSIDERATIONS:
Following have been considered in the HVAC system:-
 Energy efficient chillers.

 Insulation of exposed roofs for reducing heat ingress.
 Airtight windows and doors for reducing leakage.
 All heating, ventilation and air conditioning equipments and system
will comply with the mandatory provisions of ECBC-2007.
 Natural ventilation has been considered as per National Building
Code of India 2005.
 Minimum equipment efficiencies will meet or exceed the minimum
efficiency requirements as per ECBC-2007 and ASHRAE 90.1.
 Performance rating as per ARI-550/590 certification for water
chilling machines.
 All mechanical cooling and heating systems will be controlled by
time clock.
 Wherever possible, HRU will be used for heat extraction from
exhaust air.
 Chilled water systems designed for variable flow.
 All Unitary Air conditioner will have 5-Star rating and above. All air
conditioner will meet IS-1391(Part1), IS-1391(Part2) and Is-8148.
9.0 CODES & STANDARDS:-
The system design, material, equipment shall in general comply with

the following requirement of the standards, codes and statutory
regulations issued by the relevant Authorities and Institutions:
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A. General:
i. ASHRAE - American Society for Heating, Refrigeration and Air

Conditioning Engineers.
ii. ISHRAE – Indian Society for Heating, Refrigeration and Air

Conditioning Engineers – 2007 HVAC HANDBOOK
vi. SMACNA – Sheet Metal and Air Conditioning Contractors National

Association- (1982 Edition)
viii. Carrier System Design Manual- (1992 Edition)
ix. IS Standards for HVAC equipments.
a. IS : 2629 Recommended practice for Hot dip galvanizing of Iron &

Steel
b. IS : 4831 Recommendations for units and symbols for Refrigeration
c. IS :3615 Glossary of items used in Refrigeration and Air conditioning

(Reaffirmed 1999)
d. IS : 4736 Specification for Hot dip Zinc coating on mild steel, MS

sockets and other wrought steel pipe fittings.
e. IS: 6392 Steel Pipe Flanges.
B. Material:
i. UL-555/CBRI Fire Damper
ii. IS: Standards for HVAC equipments.
iii. IS : 266 Structural Steel
iv. IS: 277 Galvanised Steel Sheets (plain & Corrugated)
v. IS : 1239 specification for mild steel and tubular(part-I& part-II)
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vi. IS : 3589 Steel Pipes for water & sewerage (168.3 to 2540 mm OD)
specifications
vii.IS : 8183 Bonded mineral wool – Specification
viii.IS : 13095 Butterfly valves for general purposes
C. Fabrication:
i. IS : 655 Metal Air Ducts
ii. IS : 12436 Preformed rigid polyurethane foams for thermal insulation
D. Equipments:
i. IS : 2312 Propeller type A.C. Ventilation fans
ii. IS : 1038 Specification for steel doors, window and Ventilators

(Reaffirmed 2001)
iii. IS : 1231 Dimensions of three phase foot mounted induction motors
iv. IS : 4728 Terminal markings and direction of rotation for rotating

electrical machinery.
v. IS : 4894 Specification for Centrifugal Fans.
E. Testing:
i. IS : 7613 Method of testing Panel type air filters for Air Conditioning
and Ventilation purposes
ii. AMCA (Air Movement and Control Association) Standards for HVAC
equipments.
F. Engineering Safety:
i. IS : 659 Safety codes for Air Conditioning
ii. UL-555S leakage rated dampers for use in Smoke Control systems
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10.0 Brief Equipment Specifications
All the equipments shall be compatible with BMS with BACNET/MODBUS

protocol and RS 485 compatibility.
• Chillers: Factory assembled and tested (ARI citified) centrifugal chillers

using R134a refrigerant. VFD starters & controls for Chillers with active
harmonic filters as per IEEE 519 for hospitals. Use of water cooled centrifugal
water chilling machine along with chiller plant manager to achieve minimum
power consumption. Cooling equipment shall meet or exceed the minimum
efficiency requirements (COP, IPLV and IKW/TR) as per ECBC and ASHRAE
90.1(latest).
Chiller Plant Manager: All the chilling machines shall be connected to a

centralized chiller management system, which shall control the unit in the most
optimum manner to achieve constant condition and energy efficiency. The
system should have the capability to monitor and control chilling units, pumps,
cooling towers etc. The plant manager system shall be fully compatible with
the building management system. The chiller supplier shall provide a chiller
plant management system.
Pumps: Vertical split casing condenser water pumps including standby shall
be used for circulating condenser water from cooling towers through chilling
units. Primary chilled water pumps shall be used including standby to circulate
the chilled water between chilling machines and chilled water secondary
pumps. Secondary chilled water pumps including standby shall be provided for
the distribution of the chilled water to cooling equipments and air handling
units. To regulate the flow of chilled water as per the variation in the air
conditioning load inside the building, the secondary chilled water pump shall
be with variable frequency drive (VFD) and Logic/PLC controllers, differential
pressure sensors and integrated software. Pump efficiencies shall not be less
than 70%.
Cooling Towers: CTI certified cooling towers shall be provided with VFDs as
per ECBC 2007. Cooling tower shall be induced draft type with multi cell
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construction, counter flow type vertical with fiberglass reinforced plastic
construction. The performance of the cooling towers shall be tested at site as
per CTI norms/ procedures. Condenser water shall be circulated through un-
insulated condenser water piping between chilling machines and cooling
towers.
Heating System: Winter heating shall be with electric hot water generator.
Hot water vessel shall be made of Mild steel as per ASME code, suitable for
designed temperature and pressure. The vessel shall be of cylindrical shape
fabricated from suitable thickness MS sheet as per codes and provided with 2”
thick (50 mm) fiber glass insulation of density 32 kg/ cu. m covered with 24
gauge aluminum cladding. The supply air temperature of hot water would be
45 – 50 deg. C. Efficiency of heating system shall be in accordance with ECBC
2007.
AHU’s: Double skinned AHU, draw-through type comprising of various sections

such as mixing box, pre-filter section , chilled / hot water coil section, fan
section, after filters sections, casing with 40kg/m3 polyurethane foam with
aluminium alloy framework having thermal break profile and AMCA certified
high efficiency fans with backward curved/ aerofoil design impellers. AHU coils
shall be AHRI /Eurovent certified. Variable frequency drive (VFD) with fan
motors. All AHUs fan motor shall be suitable for Variable Frequency Drive (VFD)
operation. Motors shall be especially designed for quiet operation.
Thermometer, pressure gauges, butterfly valves, balancing valves and two
way pressure independent valves in the outlet shall be provided. All the
controls related to the AHU and their control wiring.
Filtration: Filter efficiency as per latest ASHRAE standards, MCI guidelines

and other relevant guidelines for hospitals.
Chilled Water Piping: The chilled /hot water from the chillers/HWG shall be
carried by chilled/hot water insulated pipes to each AHU & cooling unit. The
Insulations shall be as per ECBC-2007 /GRIHA requirements. The insulation
165
material shall be class ‘O’ fire rated as per BS 476 and fire retardant type.
Automatic balancing valves shall be considered in chilled water piping system.
Piping Work:
Supply and laying of pipes, fittings and valves as per applicable Indian
Standards: Piping materials and the relevant standard shall be as follows:
Nominal pipe size Material

Standard
Upto 65mm MS tube (Black steel) Class “C” I.S. 1239

ERW
75mm to 150mm MS tube (Black steel)Class “C” I.S. 1239

ERW
200mm to 600mm Welded black steel pipe (8mm. thickness) I.S. 3589
ERW
All fittings for chilled water, hot water, condenser water and condensing water
pipes shall be of Mild Steel (MS) Class `C’ conforming to relevant IS Code. The
dimensions of the fittings shall conform to I.S. 1239/69 Part-II. Pipe and
accessory flanges shall be table –E. All flanges shall be of mild steel as per I.S.
1536/1960(latest) and shall be steel slip-on-type, welded to the pipes.
Thickness of the insulation shall be as specified for the individual applications
as per ECBC 2007 and fire retardant type class ‘O’ as per ECBC-2007.
Electric Motors: All the motors shall be TEFC, IP 55, EFF-1 type suitable for
S1 duty. All motors shall comply with IS: 325, IEC-34.1 or BS – 2313, IEC-
72.1 for foot mounted motors. All motors shall be rated for continuous duty as
per IS: 325. Motor shall be suitable for operation on 415 volts ± 10% volts,
50 ± 5% Hz AC supply (or 230 ± 10% volts, 50 ± 5% Hz for single phase AC
supply). The installation of motor shall be carried out as per IS: 900. Motors
above 100 HP shall be provided with thermal protection and thermistor
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detector in the starter winding. All motors shall be tested at manufacturer’s
works as per I.S. standards and test certificates shall be furnished.
Air distribution systems: The cooled & conditioned air from the AHU's shall
be supplied to all areas through GSS / aluminium ducting. The air shall be
distributed in each room through ceiling / wall mounted diffusers / grilles. The
return air shall also be carried through ducting /plenum up to AHU room. VAV
boxes shall be provided in the air distribution system to conserve energy and
obtain GRIHA points.
Duct work: Factory fabricated ducting as per relevant SMACNA standards.

Ducting will generally be fabricated from galvanized sheet steel except OT, MRI
and special areas. The conditioned air from the AHU shall be distributed
through G.I. ducts, duly insulated. The ducts would be factory fabricated from
G.I. sheet in coil form to reduce the number of longitudinal joints.. The ducts
would be completely insulated with pre laminated aluminum foil faced nitrile /
closed cell polyethylene / pre laminated fiber glass insulation. All the insulation
material shall be ECBC / GRIHA compliant and shall be fire retardant type and
minimum class 1 as per BS 476. The smoke extraction ducts would be made
of 275 gsm GSS sheets and shall be fire rated by suitable material approved
by CBRI and finished.
Air Terminals will be powder coated extruded aluminum and as per relevant
guidelines.
Fire dampers: These will be installed in all ducts that cross fire walls and
slabs, supply and return air duct at AHU. Fire dampers will be of the motorized
type, actuated by a signal from smoke detectors. UL rated / CBRI approved
motorized fire dampers operated through smoke sensors of suitable fire rating
shall be used.
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Mechanical ventilation system: Stores, toilets, pantry etc. shall be
ventilated using high static inline fans. DG set room shall be supply with air
washer and exhaust through axial flow fans.
Noise and vibration control: AHU room will have a floating floor to minimize
transmission of vibration.
Sound Attenuators: Ductwork will have attenuators to maintain sound levels

as per NC levels and applicable guidelines
Control Panel: A central control console and electrical panels shall be

provided with indication lamps and start/ stop/ trip indication with status/
control for all the equipments in the A/C plant room and in the buildings.
Vibration Isolators: All mechanical equipment shall be mounted on vibration

isolators to prevent the transmission of vibration and mechanically transmitted
sound to the building structure. Vibration isolators shall be selected in
accordance with the weight distribution so as to produce reasonably uniform
deflection. Deflections shall be as per Schedule of Vibration Isolators for Air-
conditioning and Ventilation Equipment.
Painting Works: The painting of the Equipments, accessories and pipelines

shall be carried as per CPWD Specification for Electrical Works Part I, II, III,
IV and HVAC Work.
Make up water requirement: Provision for Soft and filtered water for makeup
purposes shall be made available near the make up tank for Cooling Tower &
near the expansion tanks.
Ultra Violet Germicidal Irradiation / Photohydroionization (UVGI /

PHI) Advanced Oxidation metal catalyst based technology shall be used where
IAQ is very critical i.e. OTs, ICUs, Wards, Audi, Conference rooms etc.
Enough redundancy shall be provided for all the major equipments of the
HVAC system. Chillers, primary chilled water pumps, secondary chilled water
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pumps, condenser water pumps, cooling towers etc shall have n+1
redundancy. Research labs shall have redundant AHUs.
Electrical Panel: Motor Control Centre, AHU Sub-Panels etc. shall be

manufactured by approved venders. The power and control cabling & earthing
work shall be carried out as per the CPWD General Specification for Electrical
Works Part-I, II, III, IV as amended up to Date. All panels shall be compatible
with BMS with enough potential free contacts and communication ports.
Electrical panels shall have 20% spare feeders.
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Annex: HCAV Preliminary Estimates
Block Airconditioning / Area AC area AC area Estimated Estimated Cost

Ventilation (Sqm) Percentage (Sqm) TR ( Rs.)
PART-A ( HOSPITAL SITE)
Hospital Block Airconditioning 108329 50% 54165 3885 343175000
Basement Ventilation 17171 27713994
Other services Ventilation 5500 4438500
TOTAL FOR PART-1 131000 54165 3885 375327494
PART-B ( INSTITUTIONAL SITE)
Teaching Block Airconditioning 17390 40% 6956 535 50825000
Auditorium Airconditioning 7380 60% 4428 397 37715000
Administration Airconditioning 4600 50% 2300 165 15675000
Animal House Airconditioning 760 70% 532 114 13110000
Nursing College Airconditioning 4650 20% 930 67 6365000
Night shelter Non AC 3700 0% 0 0 0
Guest house VRV Airconditioning 2300 40% 920 66 4537500
TOTAL FOR PART-2 40780 16066 1344 128227500
PART-C (RESIDENTIAL SITE)
Director Bangalow VRV Airconditioning 301 50% 151 11 756250
Guest House VRV Airconditioning 650 60% 390 28 1925000
Dining Hall-I VRV Airconditioning 772 50% 386 42 2887500
Dining Hall-II VRV Airconditioning 958 50% 479 52 3575000
TOTAL FOR PART-C 2681 1406 133 9143750
Note: 1. Rates for centralised airconditioning are as per CPWD PAR 2012 (Rs. 75000 per TR and Rs. 40000 for standby TR)
2. Rates of VRV airconditioning @ Rs. 55000 per HP.
STRUCTURAL CONCEPT
171
16. STRUCTURAL CONCEPT
1. Structural System:
The structural system chosen for the proposed institute consist of Moment
Resisting RCC Frames. Columns and beams have been laid out in plan in
coordination with architectural and services planning, on a regular grid at most
of the places, Isolated and strip footing shall be designed as per the soil
investigation report.
2. Design Codes:
The RCC design has been based on provisions laid down in IS: 456-2000 - Code
of Practice for Plain and Reinforced Concrete, following Limit state philosophy
and IS: 1893(Part-1)-2002 - Code of Criteria for Earthquake Resistant Design
of Structures. The Structural Steel design where applicable, will be based on
provisions laid down in IS: 800-2007- Code of Practice for General Construction
in Steel. Other codes of practice to be referred to, have been mentioned under
the relevant headings.
3. Loads:
1. Dead Loads:
Following unit weights of building materials have been considered in accordance
with IS: 875 (Part I)-1987, and IS: 1911.
Reinforced cement concrete : 2500 kg/cum
i) Plain cement concrete : 2400 kg/cum

ii) Brick masonry : 1900 kg/cum
iii) Cement mortar / plaster : 2100 kg/cum
iv) Floor finish (marble flooring as/specs; 40mm thk): 150 kg/sqm
2. Live Loads:
Following live loads have been considered in design in accordance with IS:875
(Part II)-1987.
172
i. Bed rooms, wards, dressing rooms,
dormitories and lounges : 200 kg/sqm
ii. Kitchens, laundries and laboratories : 300 kg/sqm
iii. Dining rooms, cafeterias and restaurants: 300 kg/sqm
iv. Toilets and bathrooms : 200 kg/sqm
v. X-ray rooms, operating rooms, general storage areas -to be calculated

but not less than : 300 kg/sqm
vi. Office rooms and OPD rooms : 250 kg/sqm
vii. Corridors, passages, lobbies and staircases including fire escapes as per
the floor serviced but not less than : 400 kg/sqm
viii. Boiler rooms and plant rooms – to be calculated but not less than
: 500 kg/sqm
ix. Balconies to wards : 300 kg/sqm

x. Balconies adjoining public areas : 400 kg/sqm
xi. Lift machine rooms : 1000 kg/sqm
xii. Work areas with machinery/equipment
 Light duty 1 : 500 kg/sqm
 Medium duty To be calculated : 700 kg/sqm

But not less than
 Heavy duty : 1000 kg/sqm
xiii. Store rooms : 500 kg/sqm

xiv. Roof (Accessible) : 150 kg/sqm
xv. Roof (Inaccessible) : 75 kg/sqm
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3. Seismic Loads:
Pseudo-static loads shall be calculated in accordance with IS: 1893(Part-1):
2002, using seismic coefficient method. As per IS:1893-2002 Guntur falls under
seismic Zone III, hence Zone Factor (Z) of 0.16 has been adopted as applicable
for structures built inzone III. The Response Reduction factor (R) as per
Table 7 of IS:1893-2002 is taken as 5. The Importance factor (I) for the
Hospital buildings has been taken as 1.5. The soil-foundation interaction
factor () for the system has been taken as 1.0. Space frame analysis using
STAAD Pro shall be conducted finally to obtain design seismic forces in
combination with other forces.
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MAINTENANCE OF BUILDINGS
175
A. MAINTENANCE OF BUILDINGS
Comprehensive Annual Maintenance Services (CAMS)
Brief Scope of Operation & Maintenance Work:
The Scope of CAMS includes:
i. Daily operation of various equipment, systems & services like – Pumps,

DG sets, Lifts, Electrical Sub-station, AC plant, Solar water heating
system, EPABX system, Nurses call system, General lighting system &
fans, UG Tank & Pump room, Landscape & Horticulture works, Internal
& External electrical works, CCTV system, Internal Roads, Water supply
& Sewerage system, storm water drainage system, etc.
ii. Daily, Periodic & Preventive maintenance, including emergency

maintenance for the above mentioned equipment / system / services
including for Fire detection & Alarm system, Fire-Fighting system, etc.
iii. Annual Maintenance Contracts (AMC) with the original equipment

manufacturer / their authorized dealers for above equipment / systems
/ services, wherever required.
iv. Routine repair of buildings and services within the minimum response
time as per the contract.
v. Emergency repairs of buildings and services, wherever and whenever

required. Contractor shall take alternative emergency measures as per
Contract.
vi. The services include supply of manpower (labour / technician /

supervisory staff), material, spares, fittings & fixtures, tools & tackle
including consumables like diesel, etc.
vii. The scope of work includes obtaining approval from all statutory bodies
required for the different services from time to time.
viii. The scope of work also includes any specific work not mentioned but
essentially required in performance of maintenance and operation of the
Permanent & Temporary assets of the Institute.
176
Manpower Requirement
Following duties shall be performed by trained manpower after deployment

at site:
1. Prospective Contractor will deploy specified manpower as per the

suggested manpower chart to be provided as per the Contract.
2. Verification of Manpower shall be carried out by Project Implementing

Agency (PIA) through Biometric Reader System deployed by Contractor.
Also, the Contractor shall submit manpower deployment schedule on
daily basis indicating location of workers in each shift and their
functions. PIA will also check the presence of worker on random basis.
3. PIA will also ensure that the qualification of manpower e.g. ITI
Certificate and Valid license for Plumber / Electrician as per statutory
requirements.
4. The Contractor shall submit duly filled and signed checklist as per
periodicity specified in the Contract. PIA official deployed at site shall
check the checklist for correctness and for the work done.
5. Contractor shall maintain records of Complaint such as - date & time of

reporting of complaint, time of attending the complaint and same shall
be submitted to the PIA on daily and weekly basis. Also, backlog of
complaints is to be reported with reasons daily to PIA. Requirement of
material for replacement of defective components shall be brought to
the notice of PIA and work shall be done after approval.
6. Manpower deployed by Contractor shall be in approved uniform with

laminated identification badges. Also, manpower shall be provided with
ID Cards containing photograph, duly attested by Client. In case of
misbehavior by any worker, ID Card shall be withdrawn by Client/PIA.
7. Contractor will attend any fault / abnormality immediately and intimate

PIA for further instructions.
8. Contractor shall inform the requirement of shutdown for attending

defects well in advance and plan accordingly.
177
9. Contractor shall prepare the Job cards in quadruplicate to be issued to
Client, Consultant, workmen attending complaint and complainant after
attending the complaint for acceptance for its satisfactory completion.
Copy of job card is to be attached with monthly bills for having attended
the complaints.
10.Contractor shall take up Emergency repair as per occurrence of incident

e.g. Blockage of sewer, disruption of regular water, water logging due
to rains. On written order from the Engineer, Contractor shall take
alternative emergency measures as per Contract. Separate register
should be maintained for such occurrence and shall be verified by PIA.
11.Contractor shall arrange Insurance policies as per Contract e.g. CAR

policy, Workmen compensation policy, third party liability and shall be
kept valid during currency of contract.
12. Contractor shall attend faults within prescribed time limits and the same
shall be recorded in the register. In case of abnormal delay, amount is
to be recovered as per provisions of Contract.
13.Contractor shall make necessary arrangements so that User can make

Complaint on phone / SMS/ E-Mail or written format. Contactor shall
appoint a nodal officer to receive and handle the complaints.
MATERIAL
Following duties shall be performed by Contractor for timely availability

of material / Consumables at site:
14.Contractor shall maintain stock register at site for recording material,

fixtures, consumables etc. separately. PIA official shall verify the
register on random basis. Stock register shall be updated daily.
Minimum inventory of 2 months is to be maintained by Contractor. The
material consumed in previous month is to be replenished.
15.In the event of procurement of material, Contractor shall submit

required documents e.g. Catalogues/ Test reports etc and seek prior
approval of Engineer. Make of material shall be either existing make or
superior make as per approval of Engineer.
178
16.In case material / component is found to be defective, prior approval
shall be taken from Engineer for replacement of material / components.
17.For items having limited shelf life, Contractor shall procure after written
instructions from Engineer.
18.Contractor shall provide within 15 days, schedule of periodic and

preventive maintenance of all equipments. Technical service reports
shall be provided by CAMC provider regularly.
19.AMC register shall be maintained at site for maintenance activities

containing name, contact nos, address of OEM / service provider etc.
20.Emergency breakdowns etc shall be attended by OEM / service provider

within prescribed time limits as per contract. Wherever time limit is not
specified, same shall be as per mutually agreed time limits.
The provision for O&M for five year @ 2% of the civil cost has been
made; this will be a part of recurring cost and to be capitalized while
preparing the EFC document.
Note: This CAMS does not include security services, housekeeping, operation and
maintenance of medical equipment & systems and fire suppression.
179
18. ANNEXURE
 MANPOWER REQUIREMENT DETAILS

 DETAILS OF COST ESTIMATES
180
MANPOWER REQUIREMENT DETAILS
A. MEDICAL COLLGE & SPECIALITY HOSPITAL
I. Requirement of Administration Staff
S.No. Department/Staff 100

Admission
A. College Staff
Director, Principal 1
Academic Section
Dean 1
Assistant Registrar 1
Assistant (with computer knowledge) 2
Accounts Section
Chief Accounts Officer 1
Assistant Accounts Officer 1
Establishment Section
Under Secretary/ Chief Administration 1

Officer
Superintendent 1
Assistants (with computer knowledge) 1
Stores
Stores Officer 1
Assistant 2
B Hospital
Medical Superintendent 1
Assistant Medical Superintendents/Medical 3

Officers
Total 25
Note: 1. Minimal workable ministerial staff has been suggested which are not mentioned in the MCI
guidelines.
2. Minimum standard ICU/ICCU staff has been suggested with are not given in the MCI
guidelines.
181
II: Department-wise Requirement of Medical Professionals
S.No Faculty Professor Associate Asstt. Sr.

Professor/ Professor/L Resident/
Reader ecturer Tutor
A. College
1. Anatomy 1 2 3 4
2. Physiology 1 2 3* 4
3. Biochemistry 1 1 1 2
4. Pharmacology 1 1 2 4
5. Pathology 1 3 3 4
6. Microbiology 1 1 1 2
7. Forensic Medicine 1 - 1*** 2
8. Community Medicine 1 1 4** 4
9.****  Rural Health Training
Centre
- Assistant Professor - - 1 -
- Lady Medical Officer 1
 Urban Health Centre
- Assistant Professor - - 1 -
- Lady Medical Officer 1
Sub Total (A) 8 11 22 26
* Included one in Biophysics, ** i) Including Epidemiologist, Statistician, *** Associate Professor/
Assistant Professor, ****Will be under the Dean/Director of Institute
Each department shall have HOD of the rank of Professor who shall exercise full
control.
S.No Faculty Professor Associate Asstt. Sr. Jr.

Professor/ Professor/ Resident/ Resident
Reader Lecturer Tutor
B. Hospital
1. Medicine 1 3 4 4 12
2. Respiratory Diseases 1* - 1 1 3
3. Dermatology, 1 - 1 1 3
Venerology& Leprosy
4. Psychiatry & Drug 1* - 1 1 3
De-addition
5. Paediatrics 1 1 2 2 6
6. Surgery 1 3 4 4 12
7. Orthopaedics 1 1 2 2 6
8. Otolaryngology 1 1 - 1 3
9. Ophthalmology 1 - 1** 1 3
10. Gynae&Obst. 1 2 3*** 2 6
11. Radiodiagnosis 1 1 2 8 1
12. Radiotherapy 1 - 1 1 -
13. Anaesthesiology 1 2 3 5 -
14. Physical Medicine & 1 - 1 2 1
Rehabilitation
15. Dentistry 1 - 1** 1 -
16. Casualty Service - - - 4**** -
17. Blood Bank 1* - 1 - -
Sub Total (B) 16 14 27 40 59
Grand Total (A + B) 24 25 49 66 59
* Professor/Associate Professor, ** Associate/ Assistant Professor,*** Including Assistant Professor for
Antenata/ Maternity and Child Welfare,**** Casualty Medical Officer/ Senior Residents
Note: Additional staff i.e. Professor/ Associate Professor/ Assistant Professor of critical care management
– one each for 100 students’ admission.
182
III: Requirement of Nursing Staff (Medical College & Hospital)
S.No. Department/Staff No.

A. Administrative
Nursing Superintendent 1
Deputy Nursing Superintendent 3
Asstt. Nursing Superintendent 6
Sisters (Wards & OT) 24
Sub Total 34
B. Staff Nurses
100 Admission – 500 beds- Ratio 1 : 3 498
Leave Reserve 30%l 151
Total Staff Nurses 649
Appendix
Recommended Norms for Hospital Nursing Service
Nursing Staff
(STAFF) (TEACHING HOSPITAL)
Staffing: 1. Nursing Superintendent 1 (for minimum of 150 beds)
2. Deputy Nursing Superintendent 1
3. Assistant Nursing Superintendent 2

(For every additional 50 beds one more Assistant Nursing Superintendent)
Description Staff Nurse Sister Department Sister/ANS
Medical ward 1:3 1:25 Each shift 1 for 3-4 wards
Surgical wards 1:3 1:25 “ - do -
Orthopaedic wards 1:3 1:25 “ - do -
Paediatric ward 1:3 1:25 “ - do -
Gynaecology ward 1:3 1:25 “ - do -
Maternity ward 1:3 1:25 “ - do -

(including new borns)
Intensive Care Unit 1:1 (24 hrs.) 1 Departmental : Sister/
1 each shift Assistant Nursing
Superintendent For 3-4 units
Coronary Care Unit 1:1 (24 hrs.)
Special wards Eye, ENT 1:1 (24 hrs.)

etc. 1 Departmental Sister/
1 each shift Assistant Nursing
Superintendent for 4-5
Operation Theatres
Operation Theatre 3 for 24 hrs. per
table
Casualty & Emergency 2-3 S.N. 1 each shift 1 Departmental Sister/ ANS
Unit depending on the for emergency, casualty etc.
no. of beds.
183
Out Patient Department - Base on Actual Observation
Minor Operation Theatre 1 Staff Nurse for every 13 Patients

Injection Room 1 Staff Nurse for every 86 Patients
Surgical 1 Staff Nurse for every 120 Patients
Medical 1 Staff Nurse for every 140 Patients
Gynae. 1 Staff Nurse for every 35 Patients
Children (Paediatric) 1 Staff Nurse for every 85 Patients
Orthopaedic 1 Staff Nurse for every 120 Patients
Dental 1 Staff Nurse for every 120 Patients
ENT 1 Staff Nurse for every 120 Patients
Eye 1 Staff Nurse for every 86 Patients
Skin 1 Staff Nurse for every 100 Patients
Similarly other out patient department need to be staffed based on actual observation.
JUSTIFICATIONS:
1. Needs may vary from hospital to hospital depending on the size of hospital and service
rendered more staff than anticipated will be required.
2. Special attention is needed for supervision of patient care on the evening & night shift.
3. 30% leave reserve is suggested because nurses get 2 off, 30 Earned Leave and 12
Casual leave/ 24 days off in a year. Also it has been observed that on any working day
25% of the staff is off duty, on casual leave etc.
A nurse works for 240 days in a year whereas hospital require nursing services for 365 days,
for 24 hours, which means to depth work for 1/3 nurse is required that is why 30% leave
reserve is needed.
4. Dieticians : In order to prescribe diet on the scientific lines for different types of
patients the services of qualified dietician are essential in all the teaching
hospitals.
5. Pharmacists : As required for Hospital.
6. Class III and IV personnel - as required for hospital.
184
IV: Minimal Paramedical and Other Staff Requirement: Department-wise
Department/ Staff No.
A. College
Department of Anatomy
Technical Assistants/ Technicians 4

Modeller 1
Dissection Hall Attendants 6
Steno Typist/ Computer Operator 1
Store Keeper cum clerk 1
Sweepers 6
Department of Physiology
Technical Assistants/ technicians 4

Laboratory Attendants 3
Steno Typist 1
Sweepers 2
Department of Biochemistry
Technical Assistants/ technicians 4

Stone Typist 1
Sweepers 2
Department of Pathology
Artist 1
Lab. Attendants 5
Steno Typist 1
Clerks 2
Store Keeper 1
Record Clerk 1
Sweepers 4
185
Department of Microbiology

Lab. Attendants 3
Store Keeper 1
Record Clerk 1
Steno Typist 1
Sweepers 3
Department of Pharmacology
Pharm. Chemist 1
Store Keeper cum Clerk 1
Steno Typist 1
Sweepers 2
Department of Forensic Medicine

Steno Typist 1
Sweepers 2
Department of Community Medicine
Medical Social Workers 2

Technical Asstts./ Technicians 2
Stenographers 1
Record Clerk 1
Store Keeper 1
Sweepers 2
Staff for Rural Training Health Centre

Public Health Nurse 1
Health Inspectors 2
Health Educator 2
186

Peon 1
Van Driver 1
Store Keeper 1
Record Clerk 1
Sweepers 2
Urban Training Health Centre

Public Health Nurse 1
Health Inspectors 2
Health Educator 1
Peon 1
Van Driver 1
Store Keeper 1
Record Clerk 1
Sweepers 2
Total 132
B. Hospital
Department of Medicine RespiratoryDiseases, Dermatology etc
ECG Technician 1
Lab. Attendants 4
Store Keeper 1
Steno Typist 1
Record Clerks 2
T.B. and Chest Diseases Health Visitors 2
Psychiatric Social Workers 2
Department of Paediatrics
Child Psychologist 1
Health Educator 1
Technical Assistant/ Technician 1
187
Lab. Attendant 1
Store Keeper 1
Steno Typist 1
Record Clerk 1
Social Worker 1
Department of General Surgery

Store Keeper 1
Steno Typist 1
Record Clerks 2
Department of Orthopaedics

Lab Attendant 1
Store Keeper 1
Steno Typist 1
Record Clerk 1
Department of OTO-RHINO-LARYNGOLOGY

Lab Attendant 1
Store Keeper 1
Steno Typist 1
Record Clerk 1
Audiometry Technician 1
Speech Therapist 1
Department of Ophthalmology

Lab Attendant 1
Steno Typist 1
Store Keeper 1
Record Clerk 1
Refractionist 1
188
Department of Obstetrics and Gynaecology
Social Workers 2
Lab. Attendants 2
Stenographer 1
Record Clerk 1
Store Keeper 1
Department of Radio-Diagnosis
Radiographic Technicians 8
Dark Room Assistants 4
Stenographer 1
Store Keeper 1
Record Clerk 1
Department of Radio-Therapy (Optional)
Physicist 1
Radiotherapy Technicians 2
Dark Room Assistant 1
Stenographers 1
Store Keeper 1
Record Clerks 2
Department of Anaesthesiology

Steno Typist 1
Record Clerk 1
Store Keeper 1
Department of Physical Medicine and Rehabilitation (Optional)
Physiotherapists 2
Occupational Therapists 2
Speech Therapist 1
Prosthetic and Orthotic Technicians 2
Workshop Workers 6
Clinical Psychologist 1
Medico-Social Worker 1
189
Public Health Nurse/ Rehabilitation Nurse 1
Vocational Counsellor 1
Multi-rehabilitation Workers/ (MRW)/

Technicians/Therapists 4
Stenographer 1
Record Clerk 1
Store Keeper 1
Class IV Workers 4
Department of Dentistry
Dental Technicians 4
Total 129
V: Ancillary Staff : Minimal Requirements
Ancillary Services - Minimal Staff
I. Central Record Section
Medical Record Officer 1

Statistician 1
Coding Clerks 4
Record Clerks 6
Daftaries 2
Peons 2
Steno Typist 1
II. Central Animal House
Veterinary Officer 1
Animal Attendants 2
Technicians for animal
operation room 1
Sweepers 2
III. Central Library
Librarian with a degree

in Library Science 1
Deputy Librarian 1
190
Documentalist 1
Cataloguer 1
Library Assistants 4
Daftaries 2
Peons 2
IV. Central Photographic Cum Audiovisual Unit
Photographer 1
Artist/ Modellers 2 (1 each)
Dark Room Assistant 1
Audiovisual Technician 1
Attendant 1
V. Medical Education Unit
Stenographer 1
Computer Operator 1
Photographer and Artist 2
VI. Central Sterilization Services Department
Matron 1
Staff Nurses 4
Technical Assistants 8
Technicians 8
Ward Boys 8
Sweepers 4
VII. Laundry
Supervisors 2
Dhobi/ Washermen/ Women 12
Packers 12
VIII. Blood Bank
Technicians 6
Store Keepers 6
Record Clerks 2
191
IX. Central Casualty Services
Stretcher Bearers 6
Receptionist-cum-Clerks 2
Ward Boys 6
Nursing and Para-medical Staff 6
X. Central Workshop
Superintendent (Qualified Engineer) 1

Senior Technicians 4
(Mechanical, Elect.,
Electronic Refrigeration)
Junior Technicians 2
Carpenter 1
Blacksmith 1
Attendants 4
Total 158
Note:
1. For Steno Typist computer knowledge is mandatory

2. Matron (Nursing Superintendent will be in-charge and post staff nurses, if desired.
192
B. SUPER SPECIALITY HOSPITAL & TRAUMA CENTRE
Requirement has been planned unit-wise of 20 beds as per MCI guidelines and further
strengthened as per HSCC experiences.
Administration: This will be independent for better management.
Addl Medical Superintendent 1

Director Admin 1
Administrative Officer 1
Account Officer 1
Asst Account officer 1
Personal Assistants 2
Assistant with computer knowledge for various 25
sections including Receptionist, Cashier
Total 32
Faculty and Residents
Super-Specialities Professor Associate Assistant Senior Junior

Professor Professor Resident Resident
Cardiology 2 1 2 6 6
CTVS 1 2 4 3 3
Neurology 1 1 2 3 3
Neuro Surgery 1 2 4 6 6
Gastroenterology 1 1 2 3 3
Gastro Surgery 1 1 2 3 3
Nephrology 1 2 2 3 3
Urology 1 2 2 3 3
Oncology (Medical & 2 2 6 6 6
Surgical)
Paediatric Surgery 1 1 2 4 4
Burns & Plastic 1 1 2 3 3
Surgery
Clinical Hematology 1 1 1 2 -
Endocrinology 1 1 2 3 3
Total 14 18 33 48 46
193
Other Staff
Nutrition (Kitchen)
- Senior Dietician 1
- Junior Dietician 1
Blood Bank Blood Bank Officer 1
*Nursing Staff Requirement
A. Administration
 Deputy Nursing Superintendent 2
 Assistant Nursing Superintendent 4
---------------
Total 6
---------------
B. Staff Nurses
 Wards – (370 Beds) 1:3/Bed/Shift 370
 ICU (220 Beds) 1:2/shift 330
 Out Patents 12
 Operation Theatre (16 Nos.) 48
 Pre & Post Operative 10
-----------------
Sub Total 770
Leave Reserve 30% 230
------------------
Total 1000
------------------
* Based on Nursing Council Recommendation
194
Technical Staff
Super Speciality Technician Attendant
Cardiology 11 03
CTVS 08 02
Neurology 06 02
Neurosurgery 04 02
Gastroenterology 04 02
Gastro Surgery 06 06
Nephrology& Transplantation 08 04
Urology 08 04
Paediatric Surgery 06 06
Oncology (Radiotherapy) 06 02
Radiology 15 09
Anesthesia 18 06
ICUs (SSB & Trauma) 15 15
Laboratories 16 08
Kitchen 10 07
Laundry 11 05
CSSD 10 07
Waste Management 04 07
Gas Manifold System 08 03
Transport System 09 09
Mortuary - 05
Medical Record 6 4
Burns & Plastic Surgery 6 6
Clinical Hematology 6 6
Total 201 130
Promotional /Leave Reserve 20 13
10%
Grand Total 221 143
195
DETAILS OF COST ESTIMATES
196
HOSPITAL & ALLIED FACILITIES
Hospital Block
(Based on CPWD, Plinth Area Rates 01.10.2012 and Cost Index 106 )
GF 17222 sqm
1st 13322 sqm
2nd 14553 sqm
3rd 13784 sqm
4th 13719 sqm
5th 12785 sqm
6th 12785 sqm
7th 10159 sqm
Total 108329 sqm
S.No. Description Area Unit rate Amount Normal Normal

Bldg Rate Building Cost
1.1 RCC Framed Structure upto Six
Storey (Floor Height 4.00 mtr)
1.1.1 Floor Ht. 3.35 mt. 108329.00 Sqm 23500.00 2545731500.00 19000.00 2058251000
1.2 Extra for
1.2.1 Every additional storey over six 10159.00 Sqm 560.00 5689040.00 560.00 5689040
storeys upto nine storeys
1.2.3 Every 0.3m additional height of floor 108329.00 Sqm 585.00 63372465.00 585.00 63372465.00
above normal floor height of
3.35m(270X0.65/0.30)
1.2.4 Every 0.3 mt. Higher plinth over 17222.00 Sqm 270.00 4649940.00
normal plinth height of 0.6 mt. (on
G.F. Area only)
1.2.5 Every 0.3 mt. Deeper foundations 17222.00 Sqm 540.00 9299880.00
over normal depth of 1.20 mt. (on
G.F. area only
1.2.8 Resisting earth quake forces 108329.00 Sqm 1140.00 123495060.00
1.2.9 RCC Raft Foundations 17222.00 Sqm 6450.00 111081900.00
1.2.12 Larger modules over 35 sqm 21665.80 Sqm 1500.00 32498700.00
sub total(Building Cost) 2127312505.00
3.0 Services
3.1 Internal water Supply & Sanitary % of Building Cost 10.00 212731250.50
Installations
3.2 External Services connections % of Building Cost 5.00 106365625.25
3.3 Internal electric Installations % of Building Cost 12.50 265914063.13
3.6.1 Power wiring and Plugs % of Building Cost 4.00 85092500.20
3.6.3 Lightning Conductors
3.6.3.2 5 to 8 storey Building % of Building Cost 0.33 7020131.27
3.6.4 Telephone conduits % of Building Cost 0.50 10636562.53
3.6.6 Computer conduiting % of Building Cost 0.50 10636562.53
3594215180.39
Add for Cost Index @6% 0.06 215652910.82
TOTAL 3809868091.21
Cost per sqm 35169.42
1.3 Basement Floor (Floor Ht 5.0mtr)
1.3.1 5171.00 Sqm 19000.00 98249000.00
Floor height 3.35 mtr with normal water
proofing.
1.3.2 Extra for basement with
1.3.2.1 Every 0.30 mtr additional height(for 5171.00 Sqm 12760.00 65981960.00
1.65 Mtr)(1.65/0.30*2320)
184759830.00
TOTAL 195845419.80
Note: The normal building cost is worked out for services cost
only.
Services
GF Area 2750.00
1st 2750.00
Total Area 5500.00 G+1
S.No. Description Area Unit rate Amount Normal

Normal
Building
Bldg Rate
Cost
1.1 RCC Framed Structure upto Six Storey (Floor Height
4.00 mtr)
1.1.1 Floor Ht. 3.35 mt. (Offfice/College) 5500.00 Sqm 19000.00 104500000.00 19000.00 104500000.00
1.2 Extra for
1.2.3 Every 0.3m additional height of floor above normal floor 5500.00 Sqm 585.00 3217500.00 585.00 3217500.00
height of 3.35m(270X0.65/0.30)
1.2.4 Every 0.3 mt. Higher plinth over normal plinth height of 2750.00 Sqm 270.00 742500.00
0.6 mt. (on G.F. Area only)
1.2.5 Every 0.3 mt. Deeper foundations over normal depth of 2750.00 Sqm 540.00 1485000.00
1.20 mt. (on G.F. area only

3.0 Services
3.1 Internal water Supply & Sanitary Installations % of Building Cost 4.00 4308700.00

3.6.3.1 up to 4 storey Building % of Building Cost 0.50 538587.50
142640025.00
TOTAL 151198426.50
Note: The normal building cost is worked out for services cost only.
WATER TANKS
S.No. Description Qty Unit Rate Amount
5.0 WATER TANK
5.1 Overhead tank
Terrace Tank 1075900.00 Ltr 15.00 16138500.00
Fire Terrace Tank 20000.00 Ltr 15.00 300000.00
5.5 Underground tank 2313000.00 Ltr 15.00 34695000.00
51133500.00
Add for Cost Index 0.06
@6% 3068010
Total cost 54201510.00
FIRE FIGHTING AND FIRE ALARM

S.No. Name of Building Area Rate (Rs)
Wet Automatic Amount
Riser Sprinkler Fire Alarm Total (Rs)
Sqm System System System Rate
1 Hospital Block 113500.00 750.00 500 1250.00 141875000

141875000
Add for Cost Index 0.06
@6% 8512500
Total
cost 150387500
ELECTRICAL WORK
Total Area
(sqm): 113500 Total Load in KVA 12000
CCTV Area (sqm) 113500 Access Control 131000
Occupancy Sensor
Area (sqm) 113500
Sr. Amount (in
PAR Code Description Area Unit Rate
No. lacs)
1 1 ESS 12000 KVA 7500 900.00

2 2 DG sets with control cable, Earthing 6000 KVA 10000 600.00
3 5.1 UPS 10% of Load 1200 KVA 20000 240.00
4 11 CCTV 113500 sqm 300 340.50
5 12 Access Control System 113500 sqm 190 215.65
6 15 Occupancy Sensor 113500 sqm 75 85.13
7 9 Solar photovoltaic for power generation 120 KWp 100000 120.00
8 13.1, 13.2 BMS (@48 lacs for 1st 10,000sqm area + @160/sqm) 113500 sqm 160 213.60
9 Cables ( LT & Telephone) 10% of ESS+DG 10% of ESS+DG 162.00
10 EPABX including telephone sets, wiring etc. 113500 sqm 200 227.00
11 Nurses Call bell 1000 beds 25000 250.00
12 Synchnization Panel (PLC based) 6000 KVA 2000 120.00
13 Escalators 26 Nos 2576000 669.76
14 26 Passanger Lifts 9 Stop 9 opening 21 Nos 4255000 893.55
132/11 KV Grid Sub-station including 132 kV
15 Transmission Line 2000.00
16 Street Light 353.91
Total 7391.10
HVAC
AC
Area AC area
S.No. Description Airconditioning/Ventilation area Estimated Amount
(Sqm) percentage
(Sqm) TR (in lakh)
1 Hospital Block Airconditioning 108329 50% 54165 3885
3431.75
2 Basement Ventilation 5171 83.46
3 Other Ventilation 5500
Services 44.39
Sub Total 3559.60
1. Rates for centralised airconditioning are as per CPWD PAR 2012 (Rs. 75000 per TR and Rs. 40000 for
Note standby TR)
2. Rates of VRV airconditioning @ Rs. 55000 per HP
S.No. Description Area Unit Rate Amount
Development Works
6.0 DEVELOPMENT OF SITE
6.1 Levelling 404700 Sqm 95.00 38446500.00
6.2 Internal roads and paths 404700 Sqm 145.00 58681500.00
6.3 Sewer 202350 Sqm 110.00 22258500.00
119386500.00
Total cost 126549690.00
Water Supply System
6.4 Filter Water Supply
6.4.1 Distribution lines 100mm dia. And below 202350 Sqm 80.00 16188000.00
6.4.2 Peripheral grid 150 mm to 300 mm dia 202350 Sqm 60.00 12141000.00
6.4.3 Unfiltered water supply distribution lines 202350 Sqm 45.00 9105750.00
37434750.00
Storm Water Drains
6.5 Storm water drains 202350 Sqm 85.00 17199750.00
17199750.00
Horticulture operations
6.6 Horticulture Operations 202350 Sqm 80.00 16188000.00
16188000.00
Signages
6.7.4 Exit sign board incl. electric signage 202350 Sqm 85.00 17199750.00
Add for internal and parking signage 108329 Sqm 85.00 9207965.00
26407715.00
Street Lighting
6.7.3 with HPSV lamps 202350 Sqm 165.00 33387750.00
33387750.00
204
System & Services
S.No. Description
Qty Rate Amount
1 Integrated Modular OT 4 22000000 88000000.00
2 Modular OT
19 10000000 190000000.00
3 Minor OT 3 2000000 6000000.00
4 CSSD
1 90000000 90000000.00
5
MGMS 1 150000000 150000000.00
6
Kitchen 1 17000000 17000000.00
7
Laundry 1 35000000 35000000.00
8
Bio Medical Waste Management 1 20000000 20000000.00
9
Mortuary Chamber 2 2500000 5000000.00
Total 601000000.00
IT SERVICES (Estimated at Rs.30 crore)

S.No. Description
1 HMIS (Hospital Management & Infromation System) including Call

Centre, Helpdesk, Hospital Portal for online appointment system.
2 Server Hardware and System Software including common storage

& NAS for HMIS & PACS, Data Center infrastructure
3 Picture Archival and Communication System (PACS) including
Workstations
4 Library Management System
5 Education Management System
6 Local Area Network (LAN) & Wi-Fi System
7 Desktop, Printer, UPS & Hardware etc.
8 Queue Management System (QMS)
205
Medical college & Allied Facilities
Summary-Civil
Area(Sqm) Total Cost

Cost per Sqm
S.No Name of Building
(Rs)
Total (Rs in Lac)
1 Teaching Block 17390 34613.40 6019.27
2 Auditorium 7380 37913.71 2798.03
3 Admin Block 4600 32560.62 1497.79
4 Nursing College 4650 32629.93 1517.29
5 Animal house 760 32773.03 249.08
6 Night Shelter 3700 23893.25 884.05
7 Guest House 2300 23964.80 551.19
Total Cost 40780 13516.70
TEACHING BLOCK
GF Area 4490
1st 3490
2nd 3240
3rd 3240
4th 2930
Total Area 17390 G+4
Normal
PAR Normal
Description Area Unit rate Amount Building
Code Bldg Rate
Cost
1.1 RCC Framed Structure upto Six Storey
(Floor Height 4.00 mtr)
1.1.1 Floor Ht. 3.35 mt. (Office/College) 17390.00 Sqm 23500.00 408665000.00 19000.00 330410000
1.2 Extra for
1.2.3 Every 0.3m additional height of floor above 17390.00 Sqm 585.00 10173150.00 585.00 10173150.00
normal floor height of 3.35m(270X0.65/0.30)
1.2.4 Every 0.3 mt. Higher plinth over normal plinth 4490.00 Sqm 270.00 1212300.00
height of 0.6 mt. (on G.F. Area only)
1.2.5 Every 0.3 mt. Deeper foundations over normal 4490.00 Sqm 540.00 2424600.00
depth of 1.20 mt. (on G.F. area only

3.0 Services
3.1 Internal water Supply & Sanitary Installations % of Normal Building Cost 4.00 13623326.00
3.2 External Services connections % of Normal Building Cost 5.00 17029157.50
3.3 Internal electric Installations % of Normal Building Cost 12.50 42572893.75
3.6.1 Power wiring and Plugs % of Normal Building Cost 4.00 13623326.00
3.6.3.2 5 to 8 storey Building % of Normal Building Cost 0.33 1123924.40
3.6.4 Telephone conduits % of Normal Building Cost 0.50 1702915.75
3.6.6 Computer conduiting % of Normal Building Cost 0.50 1702915.75
Sub Total 567855609.15
Add for Cost Index @ 6% 0.06 34071336.55

TOTAL 601926945.69
AUDITORIUM
GF Area 3968 sqm
1st 2761 sqm
2nd 651 sqm
Total Area 7380 sqm G+2

Normal
Building
Bldg Rate
Cost
1.1.1 Floor Ht. 3.35 mt. (Office/College) 7380.00 Sqm 23500.00 173430000.00 19000.00 140220000
1.2 Extra for
1.2.3 Every 0.3m additional height of floor above 6247.00 585.00 3654495.00 585.00 3654495.00
1.2.5 Every 0.3 mt. Deeper foundations over 3968.00 Sqm 540.00 2142720.00
normal depth of 1.20 mt. (on G.F. area only


3.0 Services


Sub Total 263965246.50
TOTAL 279803161.29
ADMIN BLOCK
GF Area 1162
1st 1146
2nd 1146
3rd 1146
Total Area 4600 G+3

Normal
Building
Bldg Rate
Cost
1.1 RCC Framed Structure upto Six Storey (Floor
Height 4.00 mtr)
1.1.1 Floor Ht. 3.35 mt. (Office/College) 4600.00 Sqm 23500.00 108100000.00 19000.00 87400000.00
1.2 Extra for
1.2.3 Every 0.3m additional height of floor above normal 4600.00 Sqm 585.00 2691000.00 585.00 2691000.00
floor height of 3.35m(270X0.65/0.30)

3.0 Services


Sub Total 141300790.00
TOTAL 149778837.40
Nursing College
GF Area 1550
1st 1550
2nd 1550
Total Area 4650 G+2

Normal
Building
Bldg Rate
Cost
1.2 Extra for

3.0 Services


Sub Total 143140717.50
TOTAL 151729160.55
Animal house
GF Area 380
1st 380
Total Area 760 G+1

Normal
Building
Bldg Rate
Cost
Height 4.00 mtr)
1.2 Extra for
floor height of 3.35m(270X0.65/0.30)
1.2.4 Every 0.3 mt. Higher plinth over normal plinth height 380.00 Sqm 270.00 102600.00
of 0.6 mt. (on G.F. Area only)
1.2.5 Every 0.3 mt. Deeper foundations over normal depth 380.00 Sqm 540.00 205200.00
of 1.20 mt. (on G.F. area only

3.0 Services


Sub Total 23497642.00
TOTAL 24907500.52
Night Shelter
GF Area 925
1st 925
2nd 925
3rd 925
Total Area 3700 G+3

Normal
Building
Bldg Rate
Cost
1.1.1 Floor Ht. 2.90 mt. 3700.00 Sqm 16500.00 61050000.00 15000.00 55500000.00
1.2 Extra for
normal floor height of 2.90 m(270X0.30/0.30)

3.0 Services

Sub Total 83400960.00
TOTAL 88405017.60
Guest House
GF Area 766.67
1st 766.67
2nd 766.67
Total Area 2300 G+2

Normal
Building
Bldg Rate
Cost
Height 3.20 mtr)
1.1.1 Floor Ht. 2.90 mt. 2300.00 Sqm 16500.00 37950000.00 15000.00 34500000.00
1.2 Extra for
floor height of 2.90 m(270X0.30/0.30)

3.0 Services


Sub Total 51999090.00
TOTAL 55119035.40
Water Tanks
S.No. Description Qty Unit Rate Amount
5.0 WATER TANK
5.1 Overhead tank
Terrace Tank 197500.00 Ltr 15.00 2962500.00
Fire Terrace Tank 75000.00 Ltr 15.00 1125000.00
5.5 Underground Sump 495000.00 Ltr 15.00 7425000.00
Sub Total 11512500.00
Fire Fighting and Fire Alarm
S.No. Name of Building Area Rate (Rs)
Wet Automatic Amount
Riser Sprinkler Fire Alarm Total (Rs)
Sqm System System System Rate
1 Teaching Block 17390 500 500 1000.00 17390000

2 Auditorium 7380 750.00 500 1250.00 9225000
3 Admin Block 4600 500 500 1000.00 4600000
4 Nursing College 4650 500 500 1000.00 4650000
5 Animal house 760 500 500 1000.00 760000
6 Night Shelter 3700 500 500 1000.00 3700000
7 Guest House 2300 500 500 1000.00 2300000
Sub Total 42625000
Add for Cost Index @ 6% 0.06 2557500
Total
cost 45182500
ELECTRICAL WORK
Occupancy Sensor
Total Area (sqm): 40780 Area (Sqm) 31930
CCTV Area (Sqm) 12740 Total Load in KVA 4000
Sr.
PAR Code Description Area Unit Rate Amount
No.
1 1 ESS 4000 KVA 7500 300.00

3 5.1 UPS 10% of Load 400 KVA 20000 80.00
4 11 CCTV 12740 sqm 300 38.22
5 15 Occupancy Sensor 31930 sqm 75 23.95
6 9 Solar photovoltaic for power generation 40 KWp 100000 40.00
BMS (@48 lacs for 1st 10,000sqm area +
7 13.1, 13.2 @160/sqm) 40780 160 97.25
of
Cables ( LT & Telephone) 10% of ESS+DG
8 10% ESS+DG 54.00
9 EPABX including telephone sets, wiring etc. 40780 sqm 200 81.56
Specialised Service for Auditorium (PA
System, Lighting System i.e. Dimmer,
11 curtain, stage light etc.) LS 100.00
1054.98
Lift Detail
S.no Building Name Type of Lift No. of No. Of Qty of lift Rate as per PAR/ Market Amount
passenger floors
4.1.5 Teaching Block Passenger Lift 13 G+4 3 2200000 6600000
4.1.5 Admin Block Passenger Lift 13 G+3 2 2200000 4400000
4.1.5 Nursing College Passenger Lift 13 G+2 1 1950000 1950000
4.1.5 Night Shelter Passenger Lift 13 G+3 2 2200000 4400000
4.1.5 Guest House Passenger Lift 13 G+2 1 1950000 1950000
Sub Total 19300000

Add for Cost Index @ 6% 0.0600 1158000
Total 20458000
HVAC
AC area AC
S.No Airconditioning/Ventilatio Area
Description percentag area Estimate Amount
. n (Sqm)
e (Sqm) d TR (in lakh)
1 Teaching Block Airconditioning 17390 40% 6956 535
508.25
2 Auditorium Airconditioning 7380 60% 4428 397.00 377.15
3 Administratio Airconditioning 4600 50% 2300 165.00
n 156.75
4 Animal House Airconditioning 760 70% 532 114.00 131.10
5 Nursing Airconditioning 4650 20% 930 67.00
College 63.65
6 Night Shelter Non AC 3700 0% 0 0.00 0.00
7 Guest House VRV Airconditioning 2300 40% 920 66.00
45.38
1282.2
Sub Total 8
Note 1. Rates for centralised airconditioning are as per CPWD PAR 2012 (Rs. 75000 per TR and Rs. 40000 for standby TR)
S.No. Description Area Unit rate Amount
Development Works
6.0 Development of site
6.1 Levelling 202350 Sqm 95.00 19223250.00
6.3 Sewer 101175 Sqm 110.00 11129250.00
Sub Total 59693250.00
Water Supply System
Sub Total 18717375.00
Storm Water Drains
Sub Total 8599875.00
Add for Cost Index @ 6% 0.06 -515992.50
Sub Total 8094000.00
Signages
Add for internal and parking signage 40780 Sqm 85.00 3466300.00
Sub Total 12066175.00
Street Lighting
Sub Total 16693875.00
225
RESIDENTIAL FACILITIES (CONSTRUCTION COST DETAILS)
Summary of civil and internal services estimates
Area(Sqm) Total Cost

Cost per Sqm
S.No Name of Building
(Rs)
Total (Rs in Lac)
1 TYPE II RESIDENCES 6894.00 24642.29 1698.84
2 TYPE III RESIDENCES 1464.00 24642.29 360.76
3 TYPE IV RESIDENCES 2206.00 24642.29 543.61
4 TYPE V RESIDENCES 4199.00 24642.29 1034.73
5 Director Bungalow 301.00 23817.03 71.69
6 Guest House 650.00 22913.70 148.94
7 PG Hostel - D1 7414.00 25130.91 1863.21
8 PG Hostel - D2 4043.00 25130.91 1016.04
9 PG Hostel - D3 4043.00 25130.91 1016.04
10 Dinning Hall - I 772.00 24931.52 192.47
11 Dinning Hall - II 958.00 24931.52 238.84
12 UG HOSTEL GIRL 3558.00 25130.91 894.16
13 UG HOSTEL BOYS 1 2733.00 25130.91 686.83
14 UG HOSTEL BOYS 2 4277.00 25130.91 1074.85
15 NURSES STUDENT HOSTEL D 4746.00 25130.91 1192.71
16 NURSES STUDENT HOSTEL E 4673.00 25130.91 1174.37
Total Cost 52931.00 24953.41 13208.09
TYPE II RESIDENCES
FLOOR Area 383 Sqm
Total Area 6894 Sqm G+5

Normal
Building
Bldg Rate
Cost
Height 3.2 mtr)
1.1.1 Floor Ht. 2.9 mt. 6894.00 Sqm 16000.00 110304000.00 14500.00 99963000
1.2 Extra for
floor height of 2.9m (270X0.30/0.30)


3.0 Services

3.6.4 Telephone Conduits % of Building Cost 0.50 509121.90

3.6.5 Centralized Intercom System % of Building Cost 1.00 1018243.80
TOTAL 160267858.25
Add Cost Index @ 6% 6.00% 9616071.50
169883929.75
TYPE III RESIDENCES
FLOOR Area 244 Sqm

Normal
Building
Bldg Rate
Cost
1.1.1 Floor Ht. 2.9 mt. 1464.00 Sqm 16000.00 23424000.00 14500.00 21228000
1.2 Extra for
normal floor height of 2.9m (270X0.30/0.30)

3.0 Services

TOTAL 34034253.62
Add Cost Index @ 6% 6.00% 2042055.22
36076308.84
TYPE V RESIDENCES
FLOOR Area 699.83 Sqm

Normal
Building
Bldg Rate
Cost
Height 3.2 mtr)
1.1.1 Floor Ht. 2.9 mt. 4199.00 Sqm 16000.00 67184000.00 14500.00 60885500
1.2 Extra for

3.0 Services

TOTAL 97616004.76
Add Cost Index @ 6% 6.00% 5856960.29
103472965.04
Director Bungalow
GF Area 151 Sqm
FF Area 150 Sqm

Normal
Building
Bldg Rate
Cost
Height 3.2 mtr)
1.1.1 Floor Ht. 2.9 mt. 301.00 Sqm 16000.00 4816000.00 14500.00 4364500
1.2 Extra for
height of 2.9m (270X0.30/0.30)

3.0 Services
3.1 Internal water Supply & Sanitary Installations % of Building 12.00 533492.40
Cost
3.2 External Services connections % of Building 5.00 222288.50
Cost
3.3 Internal electric Installations % of Building 12.50 555721.25
Cost
3.6.3.1 Upto 4 storeyed Building % of Building 0.50 22228.85
Cost
3.6.4 Telephone Conduits % of Building 0.50 22228.85
Cost
3.6.5 Centralized Intercom System % of Building 1.00 44457.70
Cost
TOTAL 6763137.55
Add Cost Index @ 6% 6.00% 405788.25
7168925.80
Guest House
GF Area 216.67 Sqm
Total 650.00 Sqm G+2

Normal
Building
Bldg Rate
Cost
Height 3.2 mtr)
1.1.1 Floor Ht. 2.9 mt. (Hostel) 650.00 Sqm 16500.00 10725000.00 15000.00 9750000
1.2 Extra for
height of 2.9m (270X0.30/0.30)

3.0 Services

3.6.3.1 Upto 4 storeyed Building % of Building Cost 0.50 49627.50
TOTAL 14893905.00
Add Cost Index @ 6% 6.00% 893634.30
15787539.30
UG HOSTEL GIRL

Normal
Building
Bldg Rate
Cost
3.2 mtr)
1.2 Extra for
` Every additional storey over 6 storeys up to 9 storeys 889.50 Sqm 560.00 498120.00 560.00
498120
1.2.3 Every 0.3m additional height of floor above normal floor 3558.00 Sqm 270.00 960660.00 270.00
height of 2.9m (270X0.30/0.30)
960660
1.2.4 Every 0.3 mt. Higher plinth over normal plinth height of 0.6 444.75 Sqm 270.00 120082.50
mt. (on G.F. Area only)

3.0 Services

TOTAL 84354497.87
Add Cost Index @ 6% 6.00% 5061269.87
89415767.75
UG HOSTEL BOYS 1

Normal
Building
Bldg Rate
Cost
3.2 mtr)
1.2 Extra for
1.2.1 Every additional storey over 6 storeys up to 9 storeys 683.25 Sqm 560.00 382620.00 560.00
382620
height of 2.9m (270X0.30/0.30)
737910

3.0 Services


TOTAL 64795065.40
Add Cost Index @ 6% 6.00% 3887703.92
68682769.32
UG HOSTEL BOYS 2

Normal
Building
Bldg Rate
Cost
3.2 mtr)
1.2 Extra for
1.2.1 Every additional storey over 6 storeys up to 9 storeys 1069.25 Sqm 560.00 598780.00 560.00
598780
height of 2.9m (270X0.30/0.30)
1154790

3.0 Services


TOTAL 101400839.63
Add Cost Index @ 6% 6.00% 6084050.38
107484890.01
PG Hostel - D1

Normal
Building
Bldg Rate
Cost
Height 3.2 mtr)
1.2 Extra for
1.2.1 Every additional storey over 6 storeys up to 9 1853.50 Sqm 560.00 1037960.00 560.00 1037960.00
storeys

3.0 Services


TOTAL 175774099.84
Add Cost Index @ 6% 6.00% 10546445.99
186320545.83
PG Hostel - D2

Normal
Building
Bldg Rate
Cost
Height 3.2 mtr)
1.2 Extra for
1.2.1 Every additional storey over 6 storeys up to 9 storeys 1010.75 Sqm 560.00 566020.00 560.00 566020.00

3.0 Services


TOTAL 95853073.33
Add Cost Index @ 6% 6.00% 5751184.40
101604257.73
PG Hostel - D3

Normal
Building
Bldg Rate
Cost
3.2 mtr)
1.2 Extra for
height of 2.9m (270X0.30/0.30)

3.0 Services

TOTAL 95853073.33
Add Cost Index @ 6% 6.00% 5751184.40
101604257.73
NURSES STUDENT HOSTEL D

Normal
Building
Bldg Rate
Cost
Height 3.2 mtr)
1.2 Extra for

3.0 Services


TOTAL 112520080.64
Add Cost Index @ 6% 6.00% 6751204.84
119271285.48
NURSES STUDENT HOSTEL E

Normal
Building
Bldg Rate
Cost
1.1 RCC Framed Structure upto Six Storey (Floor Height 3.2
mtr)
1.2 Extra for
height of 2.9m (270X0.30/0.30)
1.2.5 Every 0.3 mt. Deeper foundations over normal depth of 1.20 584.13 Sqm 540.00 315427.50
mt. (on G.F. area only

3.0 Services


TOTAL 110789367.22
Add Cost Index @ 6% 6.00% 6647362.03
117436729.25
Dinning Hall - I

Normal
Building
Bldg Rate
Cost
3.6 mtr)
1.2 Extra for
height of 2.9m (270X0.70/0.30)

3.0 Services


TOTAL 18157671.60
Add Cost Index @ 6% 6.00% 1089460.30
19247131.90
Dinning Hall - II
FLOOR Area 479 Sqm

Normal
Building
Bldg Rate
Cost
1.1 RCC Framed Structure upto Six Storey (Floor Height 3.6
mtr)
1.2 Extra for
height of 2.9m (270X0.70/0.30)
1.2.5 Every 0.3 mt. Deeper foundations over normal depth of 1.20 479.00 Sqm 540.00 258660.00
mt. (on G.F. area only

3.0 Services


TOTAL 22532447.40
Add Cost Index @ 6% 6.00% 1351946.84
23884394.24
LIFT DETAIL
No of Qty of No. of No. Of Rate as
S.no Building Name Type of Lift Speed Amount
Block lift passenger floors per PAR
1 TYPE II RESIDENCES Passenger Lift 3 2 8 1.0 Mps G+5 1925000 11550000

2 TYPE III RESIDENCES Passenger Lift 1 2 8 1.0 Mps G+5 1925000 3850000
3 TYPE IV RESIDENCES Passenger Lift 1 2 8 1.0 Mps G+5 1925000 3850000
4 TYPE V RESIDENCES Passenger Lift 1 2 8 1.0 Mps G+5 1925000 3850000
5 PG Hostel - D1 Passenger Lift 2 2 8 1.5 Mps G+7 2775000 11100000
8 UG HOSTEL GIRL Passenger Lift 1 2 8 1.5 Mps G+7 2775000 5550000
9 UG HOSTEL BOYS 1 Passenger Lift 1 2 8 1.5 Mps G+7 2775000 5550000
10 UG HOSTEL BOYS 2 Passenger Lift 1 2 8 1.5 Mps G+7 2775000 5550000
NURSES STUDENT
11 Passenger Lift 1 2 8 1.5 Mps G+7 2775000 5550000
HOSTEL D
NURSES STUDENT
12 Passenger Lift 1 2 8 1.5 Mps G+7 2775000 5550000
HOSTEL E
73050000
Add Cost Index @ 6% 6.00% 4383000.00
HVAC
AC
Area AC area
S.No. Description Airconditioning/Ventilation area Estimated Amount
(Sqm) percentage
(Sqm) TR (in lakh)
1 Director Bungalow VRV Airconditioning 301 50% 151 11.00
7.56
2 Guest House VRV Airconditioning 650 60% 390 28.00
19.25
3 Dining Hall I VRV Airconditioning 772 50% 386 42.00
28.88
4 Dining Hall II VRV Airconditioning 958 50% 479 52.00
35.75
Sub Total 91.44
Note 1. Rates for centralised airconditioning are as per CPWD PAR 2012 (Rs. 75000 per TR and Rs. 40000 for standby TR)
Electrical Work
Total Area (sqm): 52931 Total Load in KVA 2500
Sr.
PAR Code Description Area Unit rate Amount
No.
1 1 ESS 2500 KVA 7500 187.50

of
Cables ( LT & Telephone) 10% of ESS+DG
3 10% ESS+DG 30.75
Total 338.25
S.No. Description Area Unit rate Amount
Development Works
6.0 DEVELOPMENT OF SITE
6.1 Levelling 202350 Sqm 95.00 19223250.00
6.3 Sewer 101175 Sqm 110.00 11129250.00
Add Cost Index @ 6% 6.00% 3581595.00
Water Supply System

Add Cost Index @ 6% 6.00% 1123042.50
Storm Water Drains

Add Cost Index @ 6% 6.00% 515992.50
Add Cost Index @ 6% 6.00% 485640.00
Signages
Add Cost Index @ 6% 6.00% 515992.50
Street Lighting
Add Cost Index @ 6% 6.00% 1001632.50
259

Project Report AIIMS - Guntur - April 2015

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C O N T E N T S Page

2. APPROACH & METHODOLOGY 16

3. ANDHRA PRADESH: A BRIEF 19

 Division-wise Distribution of District

 The National Scene

 Health Infrastructure of Maharashtra

5. PROPOSED FACILITIES AT AIIMS- GUNTUR 51

6. CAPITAL OUTLAY ESTIMATES 58

 Details of Construction Cost

 Summary of Civil & Internal Services

8. EQUIPMENT PLANNING- Department-wise 68

- LAN & Wi-Fi

13. PHE & FIRE-FIGHTING CONCEPT 109

To facilitate governance issues, AIIMS-Act 1956 was amended by enactment of AIIMS

Government of India’s initiative in setting up new AIIMS-like institutes in different states,

SUPER SPECIALITY DEPARTMENTS

Sl.No. Description of Block 171 Dwelling Units (DUs)

Sl.No. Description of Block 1400 Occupancy

Institutional (Hospital & Teaching)

Hospital (A) Teaching (B)

Sl.No Facility (Sq.m)

Total Area (A+B+C) = 2,12,711 Sq.m

INSTITUTION BUILDINGS Hospital Medical Residential Total

MEDICAL EQUIPMENT Including 285.00

Total Project Cost (Say) Rs. 1618 Crores

Pre-construction Phase (12 Months)

Construction & Stabilisation Phase (42 Months)

Description Medical College Super- Speciality Nursing AYUSH

Increased Demand for Super Speciality Care

Six new AIIMS like institutes (at Bhopal-MP, Bhubaneshwar-Orissa,

Up gradation of 39 existing Govt. Medical Colleges across various locations

In July, 2014, Government accorded approval for setting up five new

Announcement for six more new AIIMS-like institutions, to be set up in

To facilitate governance issues, AIIMS-Act 1956 was amended by

These new AIIMS-like institutions are being established by an Act of

Bridging Healthcare Infrastructure gap

Year Population Served for Doctor

This Project Report pertains to setting up a new AIIMS-like institution at

The Salient features of site are broadly as under:

It is around 20 km from Guntur and 10 km from Vijaywada; National

Nearest airport, at Vijaywada is around 30 km away, while nearest Railway

Site is within the municipal limits

institution at Guntur, Andhra Pradesh broadly as under:

 Nomination of a Project Manager and constitution of a multi-disciplinary

team of professionals comprising medical doctors, architects, civil

 Desk Research by the in-house team.

 Visit of Central Team, constituted for the purpose to select site,

those offered by the state government, and the data made

 Collation of data & study of preliminary site information

 Preparation of Project Report

 Submission of Project Report

 Presentation of Project Report

The process, so adopted, is depicted in the chart attached:

THE WORK PLAN

Nomination of a Project Coordinator &

Central Team Visit Desk Study/Research

Collation & Study of Data

Concept Plan Presentation/Discussion