| Licences | S.no | Liscence name | Present or not /NA | Licence No | Issuing authority | Valid From | Valid Upto |
| A | MTP | | | | | |
| B | PNDT | | | | | |
| C | Hospital Registration | | | | | |
| D | Bio medical waste | | | | | |
| E | Aerb- C-arm | | | | | |
| F | Aerb- Ct | | | | | |
| G | Aerb- X-ray (mobile) | | | | | |
| H | Aerb -X-ray(fixed) | | | | | |
| I | Aerb- X-ray (dental) | | | | | |
| j | Shop and establishment | | | | | |
| K | Pharmacy Licence | | | | | |
| L | Narcotics Licence | | | | | |
| MOU | S.no | MOU name | Present or not /NA | On Stamp Paper Yes/ No | MOU with | Valid From | Valid Upto |
| A | Ambulance | | | | | |
| B | Radiology | | | | | |
| C | Laboratory | | | | | |
| D | Bio medical waste | | | | | |
| E | Linen and laundary | | | | | |
| F | Pharmacy Licence | | | | | |
| G | Physiotherapy | | | | | |
| H | Kitchen | | | | | |
| I | Blood bank | | | | | |
| j | Eye bank | | | | | |
| K | Pest control | | | | | |
| L | Security | | | | | |
| | m | Housekeeping | | | | | |
| 2 | Files | S.no | Documents | Present or not /NA | Remarks |
| 1 | Doctors Plan of care | | |
| 2 | Initial Assessment by doctors | | |
| 3 | Bilingual Consents with Risk, Benfits and Patient and doctor signature | | |
| 4 | Nursing Initial assessment | | |
| 5 | Vitals, Input and output, Blood sugar and investigation monitoring | | |
| 6 | Treatment chart- With dose, frequency, route, time and signature | | |
| 7 | Pre- aneasthesia notes | | |
| 8 | Aneasthesia notes | | |
| 9 | OT notes | | |
| 10 | Post aneasthesia notes | | |
| 3 infrastructure | S.no | Documents | Present or not /NA | Remarks |
| 1 | Grab rails in washrooms | | |
| 2 | Hand rails at stair case | | |
| 3 | OT zoning (uniflow) | | |
| 4 | CSSD zoning (uniflow) | | |
| 5 | Approach to Emergency is clear and unobstructed | | |
| 6 | Ramp if present has anti skid tiles | | |
| 7 | Nursing call bell at nusring stations | | |
| 8 | Bio medical waste room is under lock and key with seprate dustbins | | |
| 9 | Gas manifold is caged and cylinders are secured with chains | | |
| 10 | Elbow taps on washbasins | | |
| 11 | Hospital Curtains – Fibre made | | |
| 12 | Pedal operated Dustbins | | |
| 13 | Bilingual Signages | | |
| 14 | Fire escape route signages | | |
| 15 | Fire exit signages | | |
| 16 | patient right’s and responsibility | | |
| 17 | Scope of services signages | | |
| 18 | PCPNDT signages | | |
| 19 | Radiation signages | | |
| 20 | Fire extinghuishers | | |
| 21 | Fire Detectors and fire alarm | | |
| 22 | Sand Buckets for DG sets | | |
| 23 | Insulated Mats for DG and LT panel | | |
| 24 | Lead sheet for OT and Radiology Doors | | |
| 25 | Temerature meter for fridge | | |
| 25 | Temoerature and humidity meter for OT and ICU pharmacy | | |
| 4. MOM | S.no | Documents | Present or not /NA | Remarks |
| 1 | Multidose vials are lablled for date of opening | | |
| 2 | consumables are lablled for date of opening and date of expiry | | |
| 3 | look alike and sound Alike drugs ar seprated | | |
| 4 | High Risk Drugs are listed | | |
| 5 | Departments have access to emergency drugs | | |
| 6 | Intubation tray is present in ICU/ OT/ ER | | |
| 7 | Injection and cannula tray I present | | |
| 8 | Inventory registrors are present | | |
| 9 | Sterilized objects have Date of autoclaving and load number on them | | |
| 10 | Sterilization Indicators- Bowie dick, Chemical and biological indicators are used. | | |
| 11 | Hand rubs and hand wash liquids are used | | |
| 5. Manpower | S.no | Documents | Present or not /NA | Remarks |
| 1 | MBBS doctors Number : With Registration Number | | |
| 2 | Consultants Number: With Registration Number | | |
| 3 | Non MBBS Number | | |
| 4 | GNM Number : With Registration Number | | |
| 5 | Anm Number | | |
| 6 | Technician Number | | |
| 7 | OT Technician | | |
| 8 | Dialysis Technician | | |
| 9 | Radiology Technician | | |
| 10 | Lab Technician | | |
| 11 | Non Eligible Staff Number | | |
| 12 | BME incharge | | |
| 13 | HR person | | |
| 14 | MRD person | | |
| 15 | Quality person | | |
| 16 | FMS person | | |
| 17 | HIC nurse | | |
| 6.Process | S.no | Documents | Present or not /NA | Remarks |
| 1 | Registration Process is there or not For OP And IP | | |
| 2 | UHID generation Or not | | |
| 3 | Hims Using or not | | |
| 4 | mission and vision of the hospital | | |
| 5 | TLD Batches for radiographer | | |
| 6 | TLD batches for OT technicians | | |
| 7 | TLD batches for Surgeon and anesthetic | | |
