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Format for listing empaneled providers for uploading in State/UT website
State
Year
Empanelment List for (Prepare separate list for Minilap, Lap and Vasectomy and
indicate the same)
SNo. Name of District
Name of
Empanelled
Sterilization
Provider
Qualification
(MBBS/MS-
Gynae/DGO/DNB/MS-
Surgery/Other
Specialty Designation
Type of Facility
Posted
(PHC/CHC/
SDH/DH)
Postal address
of facility where
empaneled
provider is
posted Contact number
Panchkula Lapro
1
Dr. Rani
Singh
MD(Gynae) SMO CH PKL Civil Hospital
Sec-6 Panchkula
9417797844
2
Dr. Sangeeta
Singhal MD(Gynae)
SMO CH PKL Civil Hospital
Sec-6,Panchkula 9812351558
3
Dr. Poonam
Bhargav MD(Gynae)
SMO CH PKL Civil Hospital
Sec-6,Panchkula 9888036657
4
Dr. Anita
Soni DGO
SMO CH PKL Civil Hospital
Sec-6,Panchkula 9417600700
5
Dr.Devender
Kaur MD(Gynae)
MO CH PKL Civil Hospital
Sec-6,Panchkula 9855100166
6
Dr. Rajdeep
Kaur MD(Gynae)
MO CH PKL Civil Hospital
Sec-6,Panchkula 9914936111
7
Dr. Uma
Bindal MS( Surgery)
MO CH PKL Civil Hospital
9779013210
Sec-6,Panchkula
8
Dr. Hardeep
Singh MS( Surgery)
MO CH PKL Civil Hospital
Sec-6,Panchkula 8813915234
9
Dr. Jyoti
Sahu MD(Gynae)
MO
CHC Kalka CHC Kalka 9812645910
10
Dr.
Khushboo
Bhagat DGO
MO
CHC Kalka CHC Kalka 8699757192
11
Dr. Roopa
Jain DGO
MO CHC Raipur
Rani
CHC Raipur
Rani 9729256102
12
Dr. Rekha
Goyal DGO
MO Govt. Poly-26
PKL
Govt. Poly-26
PKL 9569698234
NSV
13
Dr. Sanjeev
Goyal MBBS
SMO CHC Raipur
Rani
CHC Raipur
Rani 9417095466
14
Dr.
Dharminder MBBS
MO CHC Raipur
Rani
CHC Raipur
Rani 9812129334
15
Dr. Manish
Garg MBBS
MO
PHC Nanakpur PHC Nanakpur 9729213552
16
Dr. Vikas
Gupta MBBS
MO
GD-25 PKL GD-25 PKL 9996619110
Line Listing Of Sterilization Trained/Empaneled Providers
S.N
o
Nam
e of
Dis
tric
t
Nam
e of
train
ed/
Em
pan
elle
d
pro
vid
er
Qu
ali
fica
tio
n
Pla
ce o
f P
ost
ing (
Na
me
of
Faci
lity
an
d L
evel
)
Con
tact
Nu
mb
er
Trained/
Empaneled for Services provided in last one year
Rem
ark
s
Min
ilap
Lap
aro
scop
ic
Ste
rili
zati
on
NS
V
Nu
mb
er o
f M
inil
ap
per
form
ed
If n
ot
per
form
ed
surg
ery , p
lease
qu
ote
the
reaso
n f
or
non
-
per
form
an
ce
N
um
ber
of
Lap
aro
scop
ic
Ste
rili
zati
on
per
form
ed
If n
ot
per
form
ed
surg
ery , p
lease
qu
ote
the
reaso
n f
or
non
-
per
form
an
ce
N
um
ber
of
NS
V
per
form
ed
If n
ot
per
form
ed
surg
ery , p
lease
qu
ote
the
reaso
n f
or
non
-
per
form
an
ce
Panchk
ula
Dr. Rani Singh MD(Gynae) CH PKL 941779784
4
Y 65 77
Dr. Sangeeta
Singhal MD(Gynae)
CH PKL
9812351558 Y 50 71
Dr. Poonam
Bhargav MD(Gynae)
CH PKL
9888036657 Y 72 67
Dr. Anita Soni DGO CH PKL 9417600700 Y 52 54
Dr.Devender Kaur MD(Gynae) CH PKL 9855100166 Y 24 58
Dr. Rajdeep Kaur MD(Gynae) CH PKL 9914936111 Y 61 97
Dr. Uma Bindal
MS(
Surgery)
CH PKL
9779013210
Y
0
0
6
Dr. Hardeep Singh
MS(
Surgery)
CH PKL
8813915234
Y
0
0
2
Dr. Jyoti Sahu MD(Gynae)
CHC
Kalka 9812645910
Y
30
93
Dr. Khushboo
Bhagat DGO
CHC
Kalka 8699757192
Y
16
107
Dr. Roopa Jain DGO
CHC
Raipur
Rani 9729256102
Y
0
Dr. Rekha Goyal DGO
Govt.
Poly-26
PKL 9569698234
Y
172
Dr. Sanjeev Goyal MBBS
CHC
Raipur
Rani 9417095466
Y
0
Dr. Dharminder MBBS
CHC
Raipur
Rani 9812129334
Y
0
Dr. Manish Garg MBBS
PHC
Nanakpur 9729213552
Y
0
Dr. Vikas Gupta MBBS
GD-25
PKL 9996619110
Y
0
Posti
ng in
DIsp
Format for listing SQAC/SISC/DQAC and DISC members in State/UT website
State/District Panchkula
Year 2017
Type of Committee (Prepare separate list for SQAC,SISC,DQAC and DISC and indicate the same)
SNo. Name of
Member
Designation in the
Committee
(Chairperson/Vice
Chairperson/
Convener/Member
Secretary/ Member)
Designation in the state
(Secretary/MD/Director/
Joint Director/Deputy
Director/Empaneled
Gynaecologist/Surgeon
etc)
Member
Since
(Month/year) Address Contact
number
DISC
1
Dr.
Ashwani
Kumar
Ahuja Civil Surgeon
(Chairperson) --- 2017
Temporary
Address
(SIHFW) 9812157507
2
Dr. Saroj
Aggarwal DFWO (Member
Secretary) --- 2017 #1756, Sec-4,
Panchkula 9779903450
3
Dr. Rani
Singh
Empanelled
Gynecologist
(Member) -----
2017 #583, Sec-2,
Panchkula 9417797844
4
Dr. Vivek
Bhadoo Empanelled Surgeon
(Member) -----
2017 #1, Civil Hospital
Campus, Sec-6,
Panchkula 9417333637
Annual /Biannual Report Format
State Haryana District Panchkula
Report Type: (Annual /Biannual)
Reporting period April, 2017 to Dec, 2017
I. Family Planning performance
Services Q1 Q2 Q3 Q4 Total
Interval Minilap 92 49 49 ------ 190
Laparoscopy 487 170 316 ------ 973
PPS 72 125 122 ------ 319
Female Sterilization 651 344 487 ------ 1482
Male sterilization 15 7 10 ------ 32
IUCD 795 738 727 ------ 2260
PPIUCD 989 1342 1403 ------ 3734
PPIUCD Acceptance
(Out of total public
health institutional
deliveries)
39% 47% 40% ------ ------
ASHA Scheme Performance:
Services Q1 Q2 Q3 Q4 Total
HDC (percentage
distribution of
CC-86% CC-72% CC-85% ------------ ------
condoms, OCP and
ECP)
OCP-98%
ECP-18%
OCP-40%
ECP- 23%
OCP-36%
ECP- 32%
ESB Schemes (To be
filled by states where
scheme is implemented)
367 450 400 -------------- 1217
PTK Utilization 4432 6641 6208 -------------- 17281
Status of Functionality of QAC
Number of meetings held- 02
Frequency of meetings held(Quarterly/half yearly):- Quarterly
Minutes of the meeting prepared (Yes/No)- Yes
Number of deaths ,complication and failure reported - 09
Number of Enquiries conducted for each category—Nil
Remedial steps taken
Status of FPIS Claims
S.N
o
STA
TE
FRESH/NEW CLAIMS
SUBMITTED IN 2017-18
( April 2017 to Dec 2017)
OUTSTANDING CLAIMS
from previous years (2016-17
& earlier)
CLAIMS PAID IN ( April 2017 to Dec 2017 CLAIMS REJECTED
( April 2017 to Dec 2017 Outstanding Claim Paid in 2017-2018
Co
mp
licat
ion
De
ath
Failu
re
Co
mp
licat
ion
De
ath
Failu
re
Complication Death Failure
COMPLICATION DEATH FAILURE
no
. o
f F
res
h/N
ew
co
mp
lic
ate
d cla
ims
su
bm
itte
d in
20
17
-20
18 p
aid
To
tal A
mo
un
t
no
. o
f o
uts
tan
din
g c
om
pli
ca
ted
cla
ims
fro
m
pre
v y
ear
in 2
016
-201
7 &
earl
ier
pa
id
To
tal A
mo
un
t
no
. o
f F
res
h/N
ew
de
ath
cla
ims s
ub
mit
ted
in
2017-2
01
8 p
aid
To
tal
Am
ou
nt
no
. o
f o
uts
tan
din
g d
ea
th
cla
ims
fro
m p
rev
ye
ar
in 2
01
6-2
01
7 &
earl
ier
paid
To
tal A
mo
un
t
no
. o
f F
res
h/N
ew
fa
ilu
re c
laim
s s
ub
mit
ted
in
2017-2
01
8 p
aid
To
tal A
mo
un
t
no
. o
f o
uts
tan
din
g f
ailu
re c
laim
s f
rom
pre
v
ye
ar
in 2
01
6-2
01
7 &
earl
ier
paid
To
tal
Am
ou
nt
Co
mp
licat
ion
Am
ou
nt
De
ath
Am
ou
nt
Failu
re
Am
ou
nt
no
. of com
plic
atio
n cla
ims s
ubm
itte
d in 2
017
-
20
18 n
ot p
aid
Tota
l A
mo
un
t
no
. of
ou
tsta
ndin
g c
om
plic
ate
d cla
ims fro
m p
rev
ye
ar
in 2
01
6-2
01
7 &
ea
rlie
r p
aid
Tota
l A
mo
un
t
no
. of F
resh/N
ew
de
ath
cla
ims s
ubm
itte
d in
2017-2
01
8 p
aid
Tota
l A
mo
un
t
no
. of
ou
tsta
ndin
g d
eath
cla
ims fro
m p
rev y
ea
r in
2016
-20
17 &
ea
rlie
r pa
id
Tota
l A
mo
un
t
no
. o
f F
res
h/N
ew
fa
ilu
re c
laim
s s
ub
mit
ted
in
2017-2
01
8 p
aid
To
tal A
mo
un
t
no
. o
f o
uts
tan
din
g f
ailu
re c
laim
s f
rom
pre
v
ye
ar
in 2
01
6-2
01
7 &
earl
ierp
aid
To
tal A
mo
un
t
0 0 9 0 0 30
0 0 0 0 0
0 0 0 0 0
5
150000
0 0 0 0 0 0 0 0 0 0 0 0 0 0
9
270000 25
750000
Specify reasons for claim rejection (Death/complication/failure) Nil
Status of Death Audit
Name of State Number of Death
reported
Number of death audits
conducted
Number of deaths
attributed to sterilization
Reason of death Action taken
Nil Nil Nil Nil Nil Nil
Format for listing empaneled providers for uploading in State/UT website
State
Year
Empanelment List for (Prepare separate list for Minilap, Lap and Vasectomy and
indicate the same)
SNo. Name of District
Name of
Empanelled
Sterilization
Provider
Qualification
(MBBS/MS-
Gynae/DGO/DNB/MS-
Surgery/Other
Specialty Designation
Type of Facility
Posted
(PHC/CHC/
SDH/DH)
Postal address
of facility where
empaneled
provider is
posted Contact number
Panchkula Lapro
1
Dr. Rani
Singh
MD(Gynae) SMO CH PKL Civil Hospital
Sec-6 Panchkula
9417797844
2
Dr. Sangeeta
Singhal MD(Gynae)
SMO CH PKL Civil Hospital
Sec-6,Panchkula 9812351558
3
Dr. Poonam
Bhargav MD(Gynae)
SMO CH PKL Civil Hospital
Sec-6,Panchkula 9888036657
4
Dr. Anita
Soni DGO
SMO CH PKL Civil Hospital
Sec-6,Panchkula 9417600700
5
Dr.Devender
Kaur MD(Gynae)
MO CH PKL Civil Hospital
Sec-6,Panchkula 9855100166
6
Dr. Rajdeep
Kaur MD(Gynae)
MO CH PKL Civil Hospital
Sec-6,Panchkula 9914936111
7
Dr. Uma
Bindal MS( Surgery)
MO CH PKL Civil Hospital
9779013210
Sec-6,Panchkula
8
Dr. Hardeep
Singh MS( Surgery)
MO CH PKL Civil Hospital
Sec-6,Panchkula 8813915234
9
Dr. Jyoti
Sahu MD(Gynae)
MO
CHC Kalka CHC Kalka 9812645910
10
Dr.
Khushboo
Bhagat DGO
MO
CHC Kalka CHC Kalka 8699757192
11
Dr. Roopa
Jain DGO
MO CHC Raipur
Rani
CHC Raipur
Rani 9729256102
12
Dr. Rekha
Goyal DGO
MO Govt. Poly-26
PKL
Govt. Poly-26
PKL 9569698234
NSV
13
Dr. Sanjeev
Goyal MBBS
SMO CHC Raipur
Rani
CHC Raipur
Rani 9417095466
14
Dr.
Dharminder MBBS
MO CHC Raipur
Rani
CHC Raipur
Rani 9812129334
15
Dr. Manish
Garg MBBS
MO
PHC Nanakpur PHC Nanakpur 9729213552
16
Dr. Vikas
Gupta MBBS
MO
GD-25 PKL GD-25 PKL 9996619110
Line Listing Of Sterilization Trained/Empaneled Providers
S.N
o
Nam
e of
Dis
tric
t
Nam
e of
train
ed/
Em
pan
elle
d
pro
vid
er
Qu
ali
fica
tio
n
Pla
ce o
f P
ost
ing (
Na
me
of
Faci
lity
an
d L
evel
)
Con
tact
Nu
mb
er
Trained/
Empaneled for Services provided in last one year
Rem
ark
s
Min
ilap
Lap
aro
scop
ic
Ste
rili
zati
on
NS
V
Nu
mb
er o
f M
inil
ap
per
form
ed
If n
ot
per
form
ed
surg
ery , p
lease
qu
ote
the
reaso
n f
or
non
-
per
form
an
ce
N
um
ber
of
Lap
aro
scop
ic
Ste
rili
zati
on
per
form
ed
If n
ot
per
form
ed
surg
ery , p
lease
qu
ote
the
reaso
n f
or
non
-
per
form
an
ce
N
um
ber
of
NS
V
per
form
ed
If n
ot
per
form
ed
surg
ery , p
lease
qu
ote
the
reaso
n f
or
non
-
per
form
an
ce
Panchk
ula
Dr. Rani Singh MD(Gynae) CH PKL 941779784
4
Y 65 77
Dr. Sangeeta
Singhal MD(Gynae)
CH PKL
9812351558 Y 50 71
Dr. Poonam
Bhargav MD(Gynae)
CH PKL
9888036657 Y 72 67
Dr. Anita Soni DGO CH PKL 9417600700 Y 52 54
Dr.Devender Kaur MD(Gynae) CH PKL 9855100166 Y 24 58
Dr. Rajdeep Kaur MD(Gynae) CH PKL 9914936111 Y 61 97
Dr. Uma Bindal
MS(
Surgery)
CH PKL
9779013210
Y
0
0
6
Dr. Hardeep Singh
MS(
Surgery)
CH PKL
8813915234
Y
0
0
2
Dr. Jyoti Sahu MD(Gynae)
CHC
Kalka 9812645910
Y
30
93
Dr. Khushboo
Bhagat DGO
CHC
Kalka 8699757192
Y
16
107
Dr. Roopa Jain DGO
CHC
Raipur
Rani 9729256102
Y
0
Dr. Rekha Goyal DGO
Govt.
Poly-26
PKL 9569698234
Y
172
Dr. Sanjeev Goyal MBBS
CHC
Raipur
Rani 9417095466
Y
0
Dr. Dharminder MBBS
CHC
Raipur
Rani 9812129334
Y
0
Dr. Manish Garg MBBS
PHC
Nanakpur 9729213552
Y
0
Dr. Vikas Gupta MBBS
GD-25
PKL 9996619110
Y
0
Posti
ng in
DIsp
Format for listing SQAC/SISC/DQAC and DISC members in State/UT website
State/District Panchkula
Year 2017
Type of Committee (Prepare separate list for SQAC,SISC,DQAC and DISC and indicate the same)
SNo. Name of
Member
Designation in the
Committee
(Chairperson/Vice
Chairperson/
Convener/Member
Secretary/ Member)
Designation in the state
(Secretary/MD/Director/
Joint Director/Deputy
Director/Empaneled
Gynaecologist/Surgeon
etc)
Member
Since
(Month/year) Address Contact
number
DISC
1
Dr.
Ashwani
Kumar
Ahuja Civil Surgeon
(Chairperson) --- 2017
Temporary
Address
(SIHFW) 9812157507
2
Dr. Saroj
Aggarwal DFWO (Member
Secretary) --- 2017 #1756, Sec-4,
Panchkula 9779903450
3
Dr. Rani
Singh
Empanelled
Gynecologist
(Member) -----
2017 #583, Sec-2,
Panchkula 9417797844
4
Dr. Vivek
Bhadoo Empanelled Surgeon
(Member) -----
2017 #1, Civil Hospital
Campus, Sec-6,
Panchkula 9417333637
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