Empanelment of Dental Clinic - ECHS
Empanelment of Dental Clinic - ECHS Empanelment of Dental Clinic - ECHS
1. Applied for Empanelment as18PART IV: FACILITIES APPLIED FORGeneral DentistrySpecial Dental procedures – specially specifiedDiagnostic procedures/investigations for Dental2. Dental Care Centre (Infrastructure and technical specifications).(a) (i) For General Dental Clinic(Availability of recovery bed for Dental Clinic)(if available, specify the number of beds)(ii)For Specialized Dental Clinic(Whether beds are available for Specialized Yes NoDental Clinic)If, yes Number(b)Whether separate O.T available for aseptic/septic cases(for Specialized Dental Clinics) Yes No(c) Alternative Power supply Yes NoGive details(d) (i) Laboratory facilities for routine Clinical Pathology, Biochemistry,Microbiology …………. Yes No(ii) Routine facilities for X-ray OPG Dental X-ray Yes No(e)No of visiting Specialists/Consultants(For Dental Care Centre)(Name and Qualifications Specialty wise)(i)Oral & Maxillo facial Surgeon(ii)Periodontist(iii)Prosthodontist(iv)EndodontistSIGNATURE OF THE AUTHORIZED APPLICANT
19(v)Orthodontist(vi)Paedodontist(f)Dental X-ray MachineIOPA 60-70 Kv, 8MA, Exposure Yes No(with minimum radiation leakage) time selection 0.01 to 3 secondsO.P.G. Machine 60-70 Kv8 MA Yes No* All Specialists employed on regular and visiting basis must possess Dental Council ofIndia’s recognized qualifications. A Post Graduate should head each speciality.Remarks of QCI (NABH)SIGNATURE OF THE AUTHORIZED APPLICANT
- Page 1 and 2: INTRODUCTIONOn behalf of the Presid
- Page 3 and 4: SECTION ICHAPTER 1GENERAL INFORMATI
- Page 5 and 6: 3S/No Town/City Name of Regional Ce
- Page 7 and 8: 5Ser Type of City Minimum Bed Stren
- Page 9 and 10: 719. Non-NABH accredited hospitals
- Page 11 and 12: 9CHAPTER 3TERMS AND CONDITIONSCashl
- Page 13 and 14: 11(e)(f)(g)(h)(j)(k)(l)(m)(n)(o)(p)
- Page 15 and 16: 13(c) Copy of legal status, place o
- Page 17 and 18: 15SECTION IIAPPLICATION FORMAT FOR
- Page 19: 17PART III: HOSPITAL INFORMATIONSer
- Page 23 and 24: AnnexureCHECK LIST FOR DOCUMENTS FO
19(v)Orthodontist(vi)Paedodontist(f)<strong>Dental</strong> X-ray MachineIOPA 60-70 Kv, 8MA, Exposure Yes No(with minimum radiation leakage) time selection 0.01 to 3 secondsO.P.G. Machine 60-70 Kv8 MA Yes No* All Specialists employed on regular and visiting basis must possess <strong>Dental</strong> Council <strong>of</strong>India’s recognized qualifications. A Post Graduate should head each speciality.Remarks <strong>of</strong> QCI (NABH)SIGNATURE OF THE AUTHORIZED APPLICANT
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