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Note:
Teacher student ratio should be 1:10 for student sanctioned strength.
STAFFING PATTERN AS PER INC NORMS
Collegiate Programme
Sl.No. Designation B.Sc.(N) B.Sc.(N)
40-60 61-100
(Students Intake) (Students Intake)
1 Professor cum PRINCIPAL 1 1
2 Professor cum 1 1
VICE- PRINCIPAL
3 Professor 0 1
4 Associate Professor 2 4
5 Assistant Professor 3 6
6 Tutor 10-18 19-28
The strength of tutors will be 10, and 6 will be as per sl. No.1 to 4)
2 Professor cum 1
VICE- PRINCIPAL
3 Professor 0 1*
4 Associate Professor 2 1*
/Reader
5 Assistant Professor 3 2 3*
/Lecturer
6 Tutor 6-18 10-18 2-10
1. Prof-Cum-Principal
5 years after M.Sc.,(N) with
2.Prof.-Cum Vice-Principal Total experience of 10 years after U.G.
:
4. Reader/
Asso.
Professor
5. Lecturer
6. Tutor/
CIinical
Instructor
Enclose the colour photograph duly signed by the faculty,copies of appointment order, a copy of relieving order of Last institution, UG & PG
Certificate, RN, RM & Addl. Qualn. Registration Certificates & Experience Certificates Encl --------
------
** Check the Relieving order & enclose the same; if joined within 6 months
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B) External Teachers Details (Part Time) (whichever subject applicable for the programme)
Sl. Subject Name Qualification Number of Hrs/ Year Remarks
No
As per norms Allotted
prescribed
1. Anatomy
2. Physiology
3. Bio –Chemistry
4. Nutrition
5. Micro – Biology
6. English
7. Computer
Science
8 Psychology
9 Sociology
10 Pharmacology
11 Pathology
12 Genetics
13 Bio-Statistics
14 Bio-Physics
15 Community
Medicine
16 Others
**(The above teachers should have post graduate qualification with teaching experience in respective area)
C) COLLEGE OFFICE STAFF:
SL. Designation No. No. in Vacant Since Remarks
No Required Position When
1. P.A to Principal 1
2. Sr.Assistant 1
3. Jr.Assistant 1
4. Accountant-cum- 1
Cashier
5. Librarian 2
6. Computer 1
Programmer
7. Peon/Office 2
Attendant
8. Security 2
9. Driver( As per the
No. of Vehicles)
* Enclose the list of articles for all the labs Enclosures :…….
Enclose copy of latest purchase bills:…………
*Proportionately the size of the built up area will increase according to the number of students admitted
( 10sq.ft for each student to be calculated for every additional seats)
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: Chair Cupboard
Remarks----------------------------------------------------------------------------------------------------------------
-11-
5. Whether the Hostel has provision for
a. Water Supply : Yes No
b. Electricity : Yes No
c. Safe Disposal of Wastes : Yes No
d. Laundry : Yes No
7. i) Is there facilities available for outdoor and : Yes No Play ground area …..…. sq.ft.
indoor games?
IV TRANSPORT DETAILS.
a)Vehicles available are : Own/ contract/ If both ……………….
:
2.Is the Institution having parent Medical College Hospital Yes No
Sl. Name of the Distance No. of Bed Occupancy Rate on the No. of No. of No. of
No Hospitals Beds day of Inspection Schools Colleges Registered
affiliated Affiliated Nurses
(Mention (Mention
the name) the name)
Last month On the day
of inspection
1
7
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4.Bed Distribution: (IP – No. of beds and OP – No. of patients per day)
Specialty Parent Affiliated Hospital Total Total
(Minimum Required Beds) Hospital Beds OP/
day
1 2 3 4 5 6
Medical–Surgical – 40 IP OP IP OP IP OP IP OP IP OP IP OP IP OP IP OP
Cardio Thoracic
Respiratory
Orthopedic -10
Neurology
Nephro & Urology – 10
Dermatology 5-10
Communicable&STD
ENT- 5
Eye – 5
Burns & Reconstructive
5-10
Oncology 5-10
Gynecology
ICU/CCU - 10
Geriatrics
Any other–Emergency -10
Rural (PHC)
Own / Adopted
(Enclose copy of the letter of agreement for affiliation & bills paid to the Hospital and Health Centers to be
attached. Inspectors to Visit the Hospital and Community Health Field and record their observation)
Encl:…………………..
VII ADMISSION DETAILS.
(i) Admission of students in current session : INC Norms / University Norms
(ii) Percentage of Admission : Management / Government
(Attach the copy of admission criteria) Encl:…………………….
Total No. of Students under Training in the current Programme:
Programme I year II year III Year IV year Total
ANM Male
Female
GNM Male
Female
B.Sc(N) Male
Female
Post Basic B.Sc (N)* Male
Female
M.Sc (N)* Male
Female
M.Phil (N) Male
Female
Post Basic Diploma Male
Programme Female
Any other Male
Female
Total
* I & II Year Post Basic B.Sc (N) & M.Sc (N) Students details to be enclosed as per table given below & the inspectors
should verify whether these students are present in the institute on the day of inspection.
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Sl. Name of State Nursing Council Residence Place & Address Board/University Duration of Does
the Registration No. Address of Work at the from where last Course this
No.
Student GNM B.Sc(N) time of exam qualified With Dates details
admission From…… updated
…….To In the
nurses
data
bank
(Kindly attach the enclosure as per the column given below for each program conducted at your institution)
System of supple.
Year –wise Paper
Theory Practical
Name of the
Programme
Completion of
Attendance %
the principal
Report from
exam
Practical
Conduct
External
External
Records
Internal
Internal
Prescribed
Prescribed
Total
Total
Allotted
Allotted
Practical
Yes/No
Theory
Freq
-19-
b] I Teaching Plan
Sl. Program Master Unit Plan Lesson Learning Learning Plan of Time
No Plan Plan Objectives Experiences Evaluation Table
1 H.V.
2 ANM
3 GNM
4 Basic B.Sc N
5 P.B.B.Sc N
6 M.Sc N
7 P.B. Diploma
Programmes
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
ANM
I Year II Year
i. Number and size of student Groups
ii. Number of Rotation
iii. Duration of each Rotation
iv. Graphic rotation plan (attach copy) 1.Yes
Appendix no. 2.No
GNM
I Year II Year III Year IV Year
i. Number and size of student Groups
ii. Number of Rotation
iii. Duration of each Rotation
iv. Graphic rotation plan (attach copy) 1.Yes
Appendix no. 2.No
Basic B.Sc.(N)
I Year II Year III Year IV Year
i. Number and size of student Groups
ii. Number of Rotation
iii. Duration of each Rotation
iv. Graphic rotation plan (attach copy) 1.Yes
Appendix no. 2.No
P.B. B.Sc.(N)
I Year II Year
i. Number and size of student Groups
ii. Number of Rotation
iii. Duration of each Rotation
iv. Graphic rotation plan (attach copy) 1.Yes
Appendix no. 2.No
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M.Sc.(N)
I Year II Year
i. Number and size of student Groups
ii. Number of Rotation
iii. Duration of each Rotation
iv. Graphic rotation plan (attach copy) 1.Yes
Appendix no. 2.No
P. B. Diploma in:
I Year
i. Number and size of student Groups
ii. Number of Rotation
iii. Duration of each Rotation
iv. Graphic rotation plan (attach copy) 1.Yes
Appendix no. 2.No
(N.B. : Inspector to make observation of the rotation plan discuss the adequacy and inadequacy and record their observation)
f) System of Examination:
X WELFARE ACTIVITIES
A.STUDENT:
1.Professional Association / Activities
N.S.S. / SNA/ TNAI/any other – specify
B] FACULTY
1. Is there any Professional Organization for Faculty? : Yes No
If yes, name the Organization
S.No ACTIVITIES
1.
2.
3.
4.
Address :
Pin :
Tel : _____________ Fax _________________
Email :
Web site :
6. Are the faculty eligible for Provident Fund : Yes No
c) Inspectors to verify the rectification of the past deficiencies & write the report ……………..
………………………………………………………………………………………………………………………………………………………………………………………
……………………………………………
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AFFIDAVIT
FORM - II
Total Experience
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8. Residential Address : _____________________________________
_____________________________________
_____________________________________
_____________________________________
Phone No : _____________ Mobile No.------------------
Office Phone No : _____________
9. Voter card Number : _____________ Place of issue ___________
Date of issue ____________
12. T.D.S for the last three years &Place of filing income, Tax Return (attach photocopy)
:___________________________________________________________________
2.
3.
Signature of the principal of the college
With seal & date
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b.Hostel
(Land, Building, Furniture, etc,)
2. Transport
3. Clinical Facilities
a. Hospital
b. Community
4. Staffing
a. Nursing
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5. Admission of Students
(b) Examination
10 Performance indictors
11 Miscellaneous
EXECUTIVE SUMMARY
1)
2)
3)
Date:
-32-
b. Hostel
(Land, Building, Furniture, etc,)
2. Transport
3. Clinical Facilities
a. Hospital
b. Community
4. Staffing
a.Nursing
5 Admission of Students
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b. Examination
10 Performance indicators
11 Miscellaneous
REGISTRAR i/c,
TAMILNADU NURSES AND
MIDWIVES COUNCIL, CHENNAI