SELECTION OF MONTHLY CONCURRENT AUDITORS- … Health Mission...Format for Submission of Technical Bid Form- T-1 Expression of Interest for hiring of Chartered Accountant Firm for Concurrent

SELECTION OF MONTHLY CONCURRENT AUDITORS- REQUEST FOR PROPOSAL

HIRING SERVICES OF CHARTERED ACCOUNTANT FIRM FOR MONTHLY CONCURRENT AUDIT OF STATE

HEALTH SOCIETY (SHS) & DISTRICT HEALTH SOCIETY (DHS) FOR THE FINANCIAL YEAR 2018-19 UNDER

NATIONAL HEALTH MISSION (NHM).

To facilitate implementation of NHM, State and District level entities (Health Societies) have been

registered which work under the administrative control of the Department of Health & Family Welfare.

The Uttarakhand Health & Family Welfare Society, invites “Proposal for Audit” from firms of Chartered

Accountants fulfilling below given eligibility criteria:- a) firm should be empanelled with C&AG for the

year 2018-19/2017-18, b) firm should have existence of at least ten years as per ICAI certificate (as on

01.01.2018), c) firm should have at least two FCA associated with it as full time partners for last 10

years, d) firm should have average turnover of minimum Rs.25 Lacs of last three years, e) firm should have

conducted at least two Assignments of Statutory Audit in Social Sector Projects/External Aided Projects & also

minimum five Statutory Audit Assignments of Corporate/Commercial Sector firms having turnover of more than

20 crores(excluding bank branch audit) f) firm should have their Head Office in Uttarakhand.

Note : 1- CA firms shall provide their latest Certificate of Firm Constitution as on 01st January of the current year issued by ICAI certificate/other documentary evidence ( appointment letters from audited organizations).

2- CA firms should provide Audited Balance Sheet/Certificate from CA firm . 3- All documents submitted should be duly self attested.

Detailed RFP: Detailed Request for Proposal (RFP) comprising Background, Terms of Reference (ToR)

and Guidelines for submitting the Proposal can be either downloaded from the state’s website

“www.ukhfws.org from 08th August’2018 to 23rd August’2018 . Proposal for only State Health

Society should be submitted to State Health Society office on or before 24th August’2018 upto 3.30

PM positively.And also Proposal for District Health Societies should be submitted to Respective

Districts (Chief Medical Officer ) office on or before 24th August’2018 upto 3.30 PM positively.

Correspondence Address of State Health Society-Concurrent Audit for the FY 2017-18 is :- Mission Director, National Health Mission, Dte. Of MH&FW, Near Rajeev Gandhi Krida Sthal, P.O.Gujrada, Sahastradhara Road, Dehradun.

Correspondence Address of Respective District Health Societies -Concurrent Audit for the FY 2017-18 is

:-

Chief Medical Officer, District-Dehradun,Uttarakhand.

Chief Medical Officer, District-Haridwar,Uttarakhand.

Chief Medical Officer, District-Tehri,Uttarakhand.

Chief Medical Officer, District-Pauri,Uttarakhand.

Chief Medical Officer, District-Rudrapriyag,Uttarakhand.

Chief Medical Officer, District-Chamoli,Uttarakhand.

Chief Medical Officer, District-Uttarkashi,Uttarakhand.

Chief Medical Officer, District-Almora,Uttarakhand.

Chief Medical Officer, District-Bageshwer,Uttarakhand.

Chief Medical Officer, District-Champawat,Uttarakhand.

Chief Medical Officer, District-Pithoragarh,Uttarakhand.

Chief Medical Officer, District-Nainital,Uttarakhand

Chief Medical Officer, District-U.S.Nagar, Uttarakhand

Important date:- Date of publishing Advertisement - 08th August’2018

Last Date for Submission of Proposals - 24th August’2018 upto 3.30 PM

Date and time of opening of Tender at State Health Society/District Health Societies - 24th August’2018 at

4.00 PM

Date and time of opening of Technical bids at State Health Society/District Health Societies - 25th

August’2018 at 11.30 AM

Mission Director-NHM

Address:- 1. Mission Director-NHM, Dte. Of MH&FW,Near Rajiv Gandhi Krida Sthal,Danda Lakhaund, Post –

Gujrada, Sahastradhara Road, Dehradun (Uttarakhand).

Form- F-1

Format for Financial Bid for Monthly Concurrent Audit for State & District Health Societies for the FY

2018-19

Bid submitted for ( ------Insert Name of State or District for which bid is submitted)

Item or Activity Total Amount per month (In Rupees)

Audit Fee (Inclusive of TA/DA + All Taxes) Note: Percentage of funds involved shall not be a basis of quoting the Audit Fee)

Both in numeric and in words per month (Rs. ---------------------/- Rupees------------------------------------------)

Date:

Place:

Signature of Authorized Signatory of the firm along with seal.

Format for Submission of Technical Bid

Form- T-1

Expression of Interest for hiring of Chartered Accountant Firm for Concurrent Audit of the Accounts of

State Health Society or District Health Societies on Monthly basis

Status of Firm - Partnership / Sole Proprietorship

1. a) Name of the Firm (In capital letters)_______________________________________________________________

b) Address of the Head Office______________________________________________________________________

Telephone No. & E-Mail. ID______________________________________________________________________

c) C&AG Empanelment No. _______________________________________________________________________

2. ICAI Registration No.___________________Region Name__________________Region Code____________________

3. Date of Establishment of the firm :-

S.No. Criteria Number in figures

1 No. of Partners- FCA

2 Years of Partners (FCAs) association with the firm Partner A + Partner B + Partner C + Partner D……..(total of all partners (as per ICAI Certificate as on 01.01.2018)

Name of Partners & Partner wise details

Enclose ICAI Certificate as on 01.01.2018

3 No. of Staff

i) Qualified (Certified CA)

Name of Qualified Staff

Enclose ICAI Certificate

ii) Semi Qualified ( CA Inter)

Name of Semi Qualified Staff

Enclosed documentary proof.

4 Nature of Experience (giving Turnover/Project Cost/year of experience of the entities /projects audited)

i) Statutory Audit assignments in Social Sector Projects/External Aided Projects

Name of Organisation,turnover & year of audit.

Enclose Appointment Letter of Audited Organization

ii) Corporate/Commercial sector statutory audit assignments of firms having turnover of more than 20 crores

Name of Organisation,turnover & year of audit.

Enclose Appointment Letter of Audited Organization

5 Total Average Annual Turnover of the firm in last three years

Enclose Audited Balance Sheet/Certificate form CA Firm

6 Head Office in Uttarakhand HO Address AS per ICAI Certificate

Note :

1- CA firms shall provide their latest Certificate of Firm Constitution as on 01st January of the current year issued by ICAI in support of 1,2,6

above, ICAI certificate/other documentary evidence in support of 3 and appointment letters from audited organizations in support of 4 (I,ii).

2- CA firms should provide Audited Balance Sheet/Certificate from CA firms in support of pt. 5.

3- Firm shall provide an self attested affidavit on Rs.100 Stamp Paper in this regard.

Supporting Documents for Eligibility Criterion : Following supporting documents must be submitted by the firm along with the technical proposal:

1. C&AG Empanelment Certificate for the FY 2017-18/18-19.

2. Firm must submit an attested copy of Certificate of ICAI as on 01.01.2018 in support of establishment of CA firm and Head Office in

Uttarakhand.

Important :- The Firm or any of its Partners should not have been blacklisted by any organization.

Firm shall provide an self attested affidavit on Rs.100 Stamp Paper in this regard.

Firm must obtain at least 65 Marks and also meet minimum eligibility criteria to qualify in technical evaluation. Total Marks for T echnical evaluation will

be 100. Financial bids of only those CA firms who meet minimum eligibility criteria and obtain minimum of 65 marks in Technical Evaluation will be

opened.

L-1 Bidder of financial bid will be awarded the contract under two bid system.

Date:

Place:

Signature of Authorized Signatory of the firm along with seal.

Previous Yr. At

31-03-14Expenditure Sch.

Ref.

Current Yr. At

31-03-15

Previous Yr. At

31-03-14Income Sch.

Ref.

Current Yr. At

31-03-15Grant Received

RCH-I I-A Figure C of Sch. RCH-I I-A Figure C of Sch.

EC SIP I-E1 NRHM-RCH Flexible Pool NRHM-RCH Flexible Pool

RCH Flexipool I-B Figure C of Sch. RCH Flexipool I-B Figure C of Sch.

RI Strengthening Project I-D Figure C of Sch. RI Strengthening Project I-D Figure C of Sch.

Pulse Polio (PPI) I-D Figure C of Sch. Pulse Polio (PPI) I-D Figure C of Sch.

Iodine Deficiency (NIDDCP) I-F Figure C of Sch. Iodine Deficiency (NIDDCP) I-F Figure C of Sch.

2Health System Strenghening under

NRHM 2 Health System Strenghening under NRHM

HSS including NPPCD,NOHP, NPPC, Asstt. To state for Capacity Building (Burn Injury & Trauma), NPF. I-C Figure C of Sch.


3National Urban Health Mission-Flexible Pool


NUHM I-K Figure C of Sch. NUHM I-K Figure C of Sch.

4Flexible Pool for Communicable

Diseases4

Flexible Pool for Communicable Diseases

IDSP I-G Figure C of Sch. IDSP I-G Figure C of Sch.

NVBDCP I-H Figure C of Sch. NVBDCP I-H Figure C of Sch.

NLEP I-I Figure C of Sch. NLEP I-I Figure C of Sch.

RNTCP I-J Figure C of Sch. RNTCP I-J Figure C of Sch.

5Flexible Pool for Non Communicable

Diseases 5Flexible Pool for Non

Communicable DiseasesNPCB I-L Figure C of Sch. NPCB I-L Figure C of Sch.

NMHP I-M Figure C of Sch. NMHP I-M Figure C of Sch.

National Programme for Health Care of the Elderly (NPHCE) I-N Figure C of Sch.


NTCP I-O Figure C of Sch. NTCP I-O Figure C of Sch.

National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) I-P Figure C of Sch.


Non-NHM Funds I-T Non-NHM Funds I-T

Interest Earned VIII Figure B of Sch.

Income Over Expenditure (Surplus)Expenditure Over Income

15 Total 0 14 Total 00

Place : Date :

Chartered Accountants State Finance Officer

STATE HEALTH SOCIETY

Income & Expenditure For The Year Ending 31-03-2016Amount in Rupees

Others (Please specify)

All Societies are advised to follow Cash Basis of Accounting System

To be shown only to the extent of grant amount utilised during the year

APPENDIX - A

FEATURES OF ANNUAL FINANCIAL STATEMENTS:-

1 The format has been designed to consolidate the audited balance sheet of all the programms for the respective state and all districts of the state.

2 Any amount released from the state to district is to be treated as advances given for the implementation of the programme.

7 Any formats/instructions issued by any programme division like RNTCP are to be strictly followed in accordance with these formats.

8 Heads of Expenditures in Schedule I-A,B,C….. are to be given as per the latest Financial Management Report (FMR)

9 Name of State Health Society, given in the format is only an indicative.

3

5

6

In Schedule-II-A of Fixed Assets - only those assets are to be shown which are purchased for use in the office of the SHS/DHS like Computers, Furnitures, Laptop etc. Other fixed assets which are purchased for the programme and transferred to the State or District Authoritues like Mobile Medical Van, Ambulance, Microscope etc. purchased under any programme of RNTCP, Additionalities under NRHM, IDSP etc. are to be booked as expenditure of the relevant programme and not to be included in the Schedule of Fixed Assets.

10

Grant in aid released/sanctioned by the Govt. of India at the fag end of the year are to be shown as grant received during the year and if not received during the same year, the same is to be shown as grant in aid/remmittance in transit.

In the balance sheet, a fixed assets reserve fund has to be created by the state as well as districts for the amount of fixed assets purchased out of the grant received during the year. Accordingly, unspent grant of the respective programme will get reduced by the amount of fixed assets purchased.

In the Income & Expenditure a/c, in the income side grant received is to be shown equivalent to the amount of expenditures for each programme seperately.

Previous Yr. At

31-03-15

Sch.Ref.

Current Yr. At

31-03-16

Previous Yr. At

31-03-15Assets Sch.

Ref.

Current Yr. At

31-03-16Reserve & Surplus

Opening Balance (Surplus) Figure A of Sch. I Figure A of Sch. Fixed Assets II-A Figure D of Sch.

Add/Less :Surplus/Deficit for theyear Figure B of Sch. I Total

Figure A of Sch.

Figure E of Sch.

Unspent Grant Figure A of Sch. Loan & AdvancesFigure E of Sch.

Figure A of Sch. RCH-I Figure E of Sch. I-A Figure A of Sch. RCH-I IV-AFigure E of Sch.

Figure A of Sch. EC SIP Figure E of Sch. I-E Figure A of Sch. EC SIP IV-EFigure E of Sch.

1 NRHM-RCH Flexible Pool 1 NRHM-RCH Flexible Pool

Figure A of Sch. RCH Flexipool Figure E of Sch. I-B Figure A of Sch. RCH Flexipool IV-BFigure E of Sch.

Figure A of Sch. RI Strengthening Project Figure E of Sch. I-D Figure A of Sch. RI Strengthening Project IV-DFigure E of Sch.

Figure A of Sch. Pulse Polio (PPI) Figure E of Sch. I-D Figure A of Sch. Pulse Polio (PPI) IV-DFigure E of Sch.

Figure A of Sch. Iodine Deficiency (NIDDCP) Figure E of Sch. I-F Figure A of Sch. Iodine Deficiency (NIDDCP) IV-FFigure E of Sch.

2Health System Strenghening

under NRHM 2Health System Strenghening under

NRHM

Figure A of Sch.

HSS including NPPCD,NOHP, NPPC, Capacity Building (Burn Injury & Trauma) & NPF.

Figure E of Sch. I-C Figure A of Sch.

HSS including NPPCD,NOHP, NPPC, Capacity Building (Burn Injury & Trauma) & NPF. IV-C

Figure E of Sch.



Figure A of Sch. NUHM Figure E of Sch. I-K Figure A of Sch. NUHM IV-KFigure E of Sch.


Diseases4


Figure A of Sch. IDSP Figure E of Sch. I-G Figure A of Sch. IDSP IV-GFigure E of Sch.

Figure A of Sch. NVBDCP Figure E of Sch. I-H Figure A of Sch. NVBDCP IV-HFigure E of Sch.

Figure A of Sch. NLEP Figure E of Sch. I-I Figure A of Sch. NLEP IV-IFigure E of Sch.

Figure A of Sch. RNTCP Figure E of Sch. I-J Figure A of Sch. RNTCP IV-JFigure E of Sch.

5Flexible Pool for Non

Communicable Diseases 5Flexible Pool for Non Communicable

Diseases

Figure A of Sch. NPCB Figure E of Sch. I-L Figure A of Sch. NPCB IV-LFigure E of Sch.

Figure A of Sch. NMHP Figure E of Sch. I-M Figure A of Sch. NMHP IV-MFigure E of Sch.

Figure A of Sch.

National Programme for Health Care of the Elderly (NPHCE) Figure E of Sch. I-N Figure A of Sch.

National Programme for Health Care of the Elderly (NPHCE) IV-N

Figure E of Sch.

Figure A of Sch. NTCP Figure E of Sch. I-O Figure A of Sch. NTCP IV-O Figure E of Sch.

Figure A of Sch.

National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) Figure E of Sch. I-P

Figure A of Sch.

National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) IV-P

Figure E of Sch.

Non-NHM Funds I-T Figure A of Sch. Non-NHM Funds IV-TFigure E of Sch.

Figure A of Sch. Fixed Assets Reserves Fund A/C II Figure D of Sch.

Other Current Assets V Closing Balances :

Figure A of Sch. Current Liabilities III Figure D of Sch. Figure A of Sch. Cash in Hand VIFigure C of Sch.

Figure B of Sch. Bank Balance VI Figure D of Sch.

Cheques/Draft in Hand VII Figure A of Sch.

15 0 15 Total 00

Place : Date :

State Finance OfficerChartered Accountants Mission Director


Balance Sheet as on 31-03-2016

Liabilities

Amount in Rupees

Total

Attach head wise schedule (Should be equal to Capital Fund)

Attach detail of each cash a/c and Bank Account

Balance in Grant Fund after deducting expenditures

Previous Yr. At

31-03-15Expenditure Sch.

Ref.

Current Yr. At

31-03-16

Previous Yr. At

31-03-15Income Sch.

Ref.

Current Yr. At

31-03-16Grant Received

RCH-I I-A Figure C of Sch. RCH-I I-A Figure C of Sch.

EC SIP I-E1 NRHM-RCH Flexible Pool NRHM-RCH Flexible Pool

RCH Flexipool I-B Figure C of Sch. RCH Flexipool I-B Figure C of Sch.

RI Strengthening Project I-D Figure C of Sch. RI Strengthening Project I-D Figure C of Sch.

Pulse Polio (PPI) I-D Figure C of Sch. Pulse Polio (PPI) I-D Figure C of Sch.

Iodine Deficiency (NIDDCP) I-F Figure C of Sch. Iodine Deficiency (NIDDCP) I-F Figure C of Sch.

2Health System Strenghening under

NRHM 2 Health System Strenghening under NRHM





NUHM I-K Figure C of Sch. NUHM I-K Figure C of Sch.


Diseases4


IDSP I-G Figure C of Sch. IDSP I-G Figure C of Sch.

NVBDCP I-H Figure C of Sch. NVBDCP I-H Figure C of Sch.

NLEP I-I Figure C of Sch. NLEP I-I Figure C of Sch.

RNTCP I-J Figure C of Sch. RNTCP I-J Figure C of Sch.

5Flexible Pool for Non Communicable

Diseases 5Flexible Pool for Non

Communicable DiseasesNPCB I-L Figure C of Sch. NPCB I-L Figure C of Sch.

NMHP I-M Figure C of Sch. NMHP I-M Figure C of Sch.



NTCP I-O Figure C of Sch. NTCP I-O Figure C of Sch.



Non-NHM Funds I-T Non-NHM Funds I-T

Interest Earned VIII Figure B of Sch.

Income Over Expenditure (Surplus)Expenditure Over Income

15 Total 0 14 Total 00

Place : Date :

42.5625



Income & Expenditure For The Year Ending 31-03-2016Amount in Rupees

Others (Please specify)

All Societies are advised to follow Cash Basis of Accounting System

Sl. No. Name of the district Cash Bank Sub-Total

Grant-in-aid received during the year (including cheque received or to be

received from GOI) Other GrantsState

Contribution

Misc. Receipts (includes refund of EMD/SD)

Amount of Advances

refunded/adjusted against

exp.during the year Interest Grand Total

1 2 3 4 5 6 7 8 9 10 11

District Level:1 District A2 District B3 District C4 District D

Grand Total

Sl. No. Name of the district

Funds utilized/expenses during

the year (other than

fixed assets) as shown in the Income & Expenditue

a/c

Purchase of fixed assets

Advances given during

the year Refund of EMD/SD

Grant Refunded to

GOI : Cash Bank

Cheques/Draft in Hand

Total1 2 3 4 5 6 7 8 9 10 11

District Level:1 District A2 District B3 District C4 District D

Grand Total


Receipts & Payments Account for the Year Ended 31-03-2016Amount in Rupees

State Level:

RECEIPTSOpening Balance

State Level:

PAYMENTSClosing Balance

PARTICULARS AMOUNTOPENING BALANCE AS ON 1.4.2014

ADD/LESS:

SURPLUS/DEFICIT FOR THE YEAR AS PER INCOME & EXPENDITURE A/C

CLOSING BALANCE AS ON 31.3.2016

Schedule I


SCHEDULE OF RESERVE & SURPLUS FUND As on 31-03-2015

In Rs.S.No. Name of Scheme Opening

Balance 01-04-2015

Fund Received during Year (including Funds in Transit)

Expenditureas per State

Level

Expenditureas per District

Level

Total Expenditureat State & District

Level

Refunded to GOI

Unspent Balance as at

31-03-2016

1 24 hrs Delivery2 Salary to Lab Tech.3 MTP Training4 NSVT5 Urban Health Project6 Urban Parivar Kalyan7 IEC8 Salary to ANM9 Computer Assistant10 Major Civil Work11 EAG Activities12 Minilap13 MNGO14 Others (Please specify)

Total Figure A Figure B Figure C Figure D Figure ENote : Please reconcile the balance of RCH lying with Districts as well State Level, and refund to GOI

Chartered Accountants State Finance Officer Mission Director

S.No. Name of District Activity - 1 Activity - 2 Activity - 3 Activity - 4 Activity - 5 Total

1 District A2 District B3 District C4 District D5 District E6 District F7 District G8 District H9 Total

CHART OF EXPENSES AT DISTRICT LEVEL

As per Chart given below

Schedule I-A

SCHEDULE OF EXPENDITURE, UNSPENT BALANCE UNDER RCH-I AS ON 31-03-2016


Original Format

Amount (In Rs.)

A) Opening Balance as on 01-04-2015 Figure A

B) Fund Received During The Year :Date Sanction No Amount

Figure BSub-total

D) EXPENDITURE DURING THE YEAR

S.NO Major Head State Level Districts Level Total1 Maternal Health2 Child Health3 Family Planning Services4 Rashtriya Kishore Swasthya

Karyakram5 RBSK6 Tribal RCH7 PNDT Activities8 Human Resources9 Training

10 Programme Management 11 Vulnerable Groups12 Others (Please specify)

Sub Total Figure C Of Sch IV-B Figure C

as per schedule IV A,B….

Figure C1 Total

Figure DE) REFUNDED TO GOI

F ) Unspent Balance as on 31-03-2016 (C-C1-D-E) Figure E




D) BIFURCATED EXPENDITURE DURING THE YEAR (SUB HEAD WISE)S.NO Sub Head State Level Districts Level Total

A.1.1.1 Operationalise FRUs √ √A.1.1.2 Operationalise 24x7 PHCs √ √A.1.3 Integrated Outreach camps √ √A.1.4 Janani Surksha Yojana √ √

A.2.1 IMNCI √ √A.2.4 School Health Program √ √A.2.6 Care of sick children and severe MN √ √

A.3.1.2 Female Sterilisation Camp √ √A.3.1.3 NSV camps √ √A.3.1.4 Compensation forFemale sterilisation √ √A.3.1.5 Compensation for Male sterilisation √ √


√

√

√

Like these other sub heads will also come here as per requirements


Maternal Health

Child Health

Family Planning


C) Total Fund Available For Spending (A+B)

Purchase of Fixed Assets:

Schedule I-B

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER RCH-II Flexiblepool AS ON 31-03-2016


As Per Chart given below

NIOTE: Detailed sub-head wise expenditure is also required to be given as an Annexure.

The figures will be plotted here are the total figure of sub heads as per newly prepared annex format in below.

(In Rs.)S.No.

Name of Scheme Opening Balance 01-04-2015

Expenditure at State Level

Expenditure at District Level

Total Expenditure at

State & District Level

Refunded to GOI


31-03-2016

1 ASHA From GOI From state level

2Untied Funds/Annual Maintenance Grants /Corpus Grants to HMS/RKS

3 Rollout of B.Sc ( Community Health)

4 Hospital Strengthening

5 New Constructions/ Renovation and Setting up

6 Implementation of Clinical Establishment Act

7 District Action Plans (Including Block, Village)

8 Panchayati Raj Initiative9 Mainstreaming of AYUSH

10 IEC-BCC NRHM

11National Mobile Medical Vans (smaller vehicles) and specialised Mobile Medical Units

12 National Ambulance Service13 PPP/ NGOs14 Innovations( if any)

15 Planning, Implementation and Monitoring

16 PROCUREMENT17 Drug Ware Housing

18New Initiatives/ Strategic Interventions (As per State health policy)

19 Health Insurance Scheme20 Research, Studies, Analysis

21 State level health resources centre(SHSRC)

22 Support Services

23 Other Expenditures (Power Backup, Convergence etc)

24 Collaboration with Medical Colleges and Knowledge partners

25National Programme for Prevention and control of deafness

26 National Oral Health Programme27 National Program for Palliative Care (New Initiatives under NCD)28 Assistance to State for Capacity building ( Burns & injury)29 National Programme for Fluorosis

Purchase of Fixed Assets: as per schedule IV A,B….

Figure C1

Total Figure A Figure B Figure C Figure D Figure E





Schedule I-C

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NRHM Additionalites AS ON 31-03-2016



Fund Received during Year

(In Rs.)S.No. Name of Scheme Opening Balance

01-04-2015Expenditure at District Level

Expenditure Refunded to GOI


31-03-2016From GOI From state level

1 RI strengthening project (Review meeting, Mobility support, Outreach services etc)

2 Salary of Contractual Staffs3 Training under Immunisation4 Cold chain maintenance 5 ASHA Incentive

6 Pulse Polio operating costs

7Other activities (if any, pls. specify)

as per schedule IV

A,B….

Figure C1



S.No. Name of District Activity - 1 Activity - 2 Activity - 3 Total


Schedule I-DSTATE HEALTH SOCIETY


DETAIL OF EXPENDITURE, UNSPENT BALANCES UNDER IMMUNIZATION AS ON 31-03-2016


As Per Chart given

below

Fund Received during Year

Amount (In Rs.)



--- Figure B

Sub-total


S.NO Major Head State Level Districts Level Total1 -2 -3 -4 -5 -6 -7 -8 -9 -

10 -as per schedule

IV A,B….

Figure C1

Sub Total Figure C Total

E) REFUNDED TO GOI Figure DF) Unspent Balance as on 31-03-2016 (C-C1-D-E) Figure E




Schedule I-E

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER EC - SIP AS ON 31-03-2016






Amount (In Rs.)



--- Figure B

Sub-total


S.NO Major Head State Level Districts Level Total1 Establishment of IDD Control Cell2 Lab3 Health Education and Publicity4 IDD Surveys/Re-surveys5 kind grant)6 ASHA Incentive7 Other activities (if any, pls. specify)


Figure C1








Schedule I-FSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NIDDCP AS ON 31-03-2016



Amount (In Rs.)



--- Figure B

Sub-total


S.NO Major Head State Level Districts Level Total1 REMUNERATION FOR

CONTRACTUAL HUMAN RESOURCE

2 TRAINING3 LABORATORY SUPPORT4 OPERATIONAL COSTS5 ANY STATE SPECIFIC ACTIVITY (Pl.

Specify)


Figure C1








Schedule I-GSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER IDSP AS ON 31-03-2016



Amount (In Rs.)



--- Figure B

Sub-total


S.NO Major Head State Level Districts Level Total1 Malaria

2Dengue & Chikungunya

3 Acute Encephalitis Syndrome (AES)/ Japanese Encephalitis (JE)

4 Lymphatic Filariasis

5Kala-azar

5 Externally aided component(EAC)World Bank Project

6 GFATM Project

7 Any Other item (Please Specify)8 Operational Costs (Mobility, Review

Meeting,communication,formats &reports)9 Cash grant for decentralized commodities


Figure C1








Schedule I-HSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NVBDCP AS ON 31-03-2016



Amount (In Rs.)



--- Figure B

Sub-total


S.NO Major Head State Level Districts Level Total1 Improved early case detection

2 Improved case management

3 Stigma Reduced

4 Development of Leprosy Expertise sustained

5 Monitoring, Supervision and Evaluation System improved

5 Programme Management ensured

6 Others


Figure C1








Schedule I-ISTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NLEP AS ON 31-03-2016



Amount (In Rs.)



--- Figure B

Sub-total


S.NO Major Head State Level Districts Level Total1

Civil works2

Laboratory materials3

Honorarium/Counselling Charges4

ACSM5

Equipment Maintenance6

Training7 Vehicle Operation( POL &

Manitainance)8

Vehicle hiring9

Public Private Mix(PP/NGO Support)10

Medical Colleges11

Office Operation ( Miscellaneous)12

Contractual Services13

Printing14

Research & Studies & Consultancy15

Procurement of Drugs16

Procurement of Vehicles17

Procurement of Equipments18 Patient Support & Transportation

Charges19

Supervision and Monitoring


Figure C1








Schedule I-JSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER RNTCP AS ON 31-03-2016



Amount (In Rs.)

--0

Sl. No. Major Head State Level Districts Level Amount1 Planning & Mapping2 Programme Management 03 Training & Capacity Building 04 Strengthening of Health Services 05 Regulation & Quality Assurance 06 Community Processes 07 Innovative Actions & PPP 08 Monitoring & Evaluation 09 Other, if any (Please specify) 0D) Total Expenditure during the Year 0 0 0

Central Share ExpenditureState Share Expenditure

E) REFUNDED TO GOI

F) Unspent Balance as on 31-03-2018 (C-D) 0

Chartered Accountants Director-Finance Mission Director

National Urban Health Mission (NUHM)Schedule I-K

A) Opening Balance as on 01-04-2017

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER National Urban Health Mission (NUHM) AS ON 31-03-2018



B) Fund Received During The Year :

State Share Contribution


Central Contribution

Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Reimbursement for cataract operation for

NGO and Private Practitioners

2 Assistance for consumables/drugs/medicines to the Govt./District Hospital for Cat sx etc

3 Diabetic Retinopathy 4 childhood Blindness 5 Glaucoma 6 Keratoplastiy 7 Vitreoretinal Surgery 8 Screening and free spectacles for school

children & Old Person9 Recurring GIA to Eye Bank & Eye Donation

Centre10 Training of PMOA11 State level IEC12 Procurement & Maintenance of Ophthalmic

Equipment 13 Grant-in-aid for strengthening of Distt.

Hospitals, Divisional Hospitals, Vision Centre, Eye Bank, Eye Donation Centre ,

14 GIA to NGOs for setting up/expanding eye care unit in semi-urban/ rural area

15 Construction of Eye Wards and Eye OTS16 Mobile Ophthalmic Units

17 Fixed tele- ophthalmic network unit in Got. Set up/ internet based ophthalmic consultation unit18 CONTRACTUAL MAN POWER

TotalPurchase of Fixed Assets: as per

schedule IV A,B….

Figure C1


Figure D

Figure E



1 District A2 District B3 District C4 District D5 District E6 District F7 District G8 District H


E) REFUNDED TO GOI

Unspent Balance as on 31-03-2016 (C-C1-D-E)


Schedule I-LSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NPCB PROGRAMME AS ON 31-03-2016



9 Total

Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Salary

2 Infrastructure for District DMHP Centre, Counseling Centre under psychology deptt. In a selected college including crisis helpline : setting up the centre, furniture, computer facilities, telephone etc.

3 Recruitment of DMHP staff and development of district plan

4 Training of PHC Medical Officers, Nurses, Paramedical Workers & Other Health Staff working under the DMHP

5 IEC and community mobilization activities6 Targeted interventions at community level

Activities & interventions targeted at schools, collegesetc.

7 Drugs8 Equipments9 Operational expenses of the district centre :

rent, telephone expenses, website etc.10 Ambulatory Services11 Miscellaneous/ Travel/ Contingency


schedule IV A,B….

Figure C1


Figure D

Figure E





F) Unspent Balance as on 31-03-2016 (C-C1-D-E)

E) REFUNDED TO GOI


Schedule I-MSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NMHP PROGRAMME AS ON 31-03-2016



9 Total

Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Machinery & Equipment

2 Drugs and Consumable

3 Training of doctors and staff

4 Human Resource

5 Construction/renovation/extension of the existing building and Furniture of Geriatrics Unit withand OPD facilities


schedule IV A,B….

Figure C1


Figure D

Figure E


S.No. Name of District Activity - 1 Activity - 2 Activity - 3 Activity - 4 Activity - 5


E) REFUNDED TO GOI




Schedule I-NSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NPHCE PROGRAMME AS ON 31-03-2016



Total

Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Manpower at State Level

2 Public Private Partnership

3 Manpower at District level

4 IEC Activities

5 Training to staff

6 Procurement of Equipment


schedule IV A,B….

Figure C1


Figure D

Figure E





E) REFUNDED TO GOI



ScheduleSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NPPCD PROGRAMME AS ON 31-03-2016



Total

Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Training/ Sensitization Prog.

2 SBCC/IEC campaign

3 School Programme

4 Pharmacological Treatment

District level Coordination Committee, Monitoring Committee & Enforcement Squads

5 Manpower Suppot

Procurement of equipment

6 Training & Outreach

7 Mobility support

8 Office Expenses

9 Other (if any. Please specify)


schedule IV A,B….

Figure C1


Figure D

Figure E





E) REFUNDED TO GOI



Schedule I-OSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NTCP PROGRAMME AS ON 31-03-2016



Total

Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Contractual Manpower-HR

2 Consumables

3 Grant-in-aid for strengthening of Disttt. Hospitals (Renovation, Dental Chair, Equipment)



schedule IV A,B….

Figure C1


Figure D

Figure E





E) REFUNDED TO GOI



Schedule STATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NOHP PROGRAMME AS ON 31-03-2016



Total

Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Infrastructure

2 Human Resources

3 Laboratories , Drugs & Consumables

4 Mobilty , Miscellaneous & Contigencies

5 Information, Education & Communication&Training

6 Outreach activities



schedule IV A,B….

Figure C1


Figure D

Figure E





E) REFUNDED TO GOI



Schedule I-PSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER NPCDCS PROGRAMME AS ON 31-03-2016



Amount (In Rs.)



--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 Salary2

Training of PHC Medical Officers, nurses, Paramedical Workers & Other Health Staff

3Miscellaneous including Travel/POL/Stationary/Communiations/Drugs etc.

4Infrastructure strengthening including renovation of PC unit/OPD/Beds/Miscellaneous equipments etc. Non-Recurring



schedule IV A,B….

Figure C1


Figure D

Figure E





E) REFUNDED TO GOI



ScheduleSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER National Program for Palliative Care (NewInitiatives under NCD AS ON 31-03-2016



Total

Amount (In Rs.)


B) Fund Received During The Year :UNICEF

DFIDUSAID

IPP GlobalIHBP

Any other

Date Sanction No Amount--- Figure B

Sub-total

S.NO Major Head State Level Districts Level Amount1 UNICEF

2 DFID

3 USAID

4 IPP Global

5 IHBP


schedule IV A,B….

Figure C1


Figure D

Figure EDFID

USAID

IPP Global

IHBP



E) REFUNDED


Schedule I-TSTATE HEALTH SOCIETY

DETAIL OF EXPENDITURE, UNSPENT BALANCE UNDER Non NHM Funds AS ON 31-03-2016



PARTICULARS AT STATE AT DISTRICT TOTALOPENING BALANCE AS ON 1.4.2014

ADD:

ASSETS AQUIRED DURING THE YEAR

LESS:

ASSETS SOLD / DISCARDED DURING THE YEAR

CLOSING BALANCE AS ON 31.3.2016

Schedule II-ASTATE HEALTH SOCIETY

SCHEDULE OF FIXED ASSETS RESERVE FUND As on 31-03-2016

S.No. Assets LIST (Detail of individual

assets)

Opening Balance 01-04-2015

Purchased During the Year

Disposed off During the Year

Closing Balance 31-03-16

Balance as on 31.03.16 at District

level

Total as on 31.03.16

A RCH-I STATE LEVEL A

Sub Total List BB RCH Flexipool

STATE LEVEL A

Sub Total List BC NRHM

STATE LEVEL A

Sub Total List BD Immunisation (RI Strength.)

STATE LEVEL A

Sub Total List BE PPI

STATE LEVEL A

Sub Total List BF EC SIP

STATE LEVEL A

Sub Total List BG RNTCP

STATE LEVEL A

H NVBDCPSTATE LEVEL A

Sub Total List BI NIDDCP

STATE LEVEL A

Sub Total List BJ NLEP

STATE LEVEL A

Sub Total List BK IDSP

STATE LEVEL A

Sub Total List BL NPCDCS

STATE LEVEL A

Sub Total List BM NPCB

STATE LEVELN NMHP

STATE LEVEL

O NPHCESTATE LEVEL

P NPPCDSTATE LEVEL

Q NTCPSTATE LEVEL

R NOHPSTATE LEVEL

S NUHMSTATE LEVEL

T Others (please Specify)STATE LEVEL

A

Total (A to T) Figure A Figure B Figure C Figure D

Chartered Accountants Mission Director

LIST - AName of the Programme:RCH-1/RCH Flexible Pool/Immunization/NRHM/any NDCPs Programme(Separate Schedule for each programme)

Sl. No. Name of the AssetsOpening Balance

01-04-2015

Purchased During the Year

Disposed off During the Year

Closing Balance 31-03-16

1 Air Condition2 Computers3 Furnitures & Fixtures

Total

Sl. No. Name of the DistrictsAir Condition as

on 31.03.16Computers as on

31.03.16Furnitures &

Fixtures as on 31.03.16

Total Balance 31-03-16

1 A2 B3 C4 D5 E6 F7 G8 H

Grand Total

LIST - B

Schedule II-ASTATE HEALTH SOCIETY

SCHEDULE OF FIXED ASSETS As on 31-03-2016


SCHEDULE OF Current Liabilities as on 31-03-2016

S.No. Particular Opening Balance

01-04-2015

Addition Settled Balance As on 31-03-2016

Balance at Districts As

on 31-03-2016 (as per chart

below)

TOTAL

A RCH-IAdd detail (Such as TDS Payable)

Sub TotalB RCH Flexipool

Add detailSub Total

C NRHM Add detail

Sub TotalD Immunisation (RI Strength.)

Add detailSub Total

E PPIAdd detail

Sub TotalF EC SIP

Add detailSub Total

G RNTCPAdd detail

Sub TotalH NVBDCP

Add detailSub Total

I NIDDCPAdd detail

Sub TotalJ NLEP

Add detailSub Total

K IDSPAdd detail

Sub TotalL NPCDCS

Add detailSub Total

M NPCBAdd detail

Sub Total

N NMHPAdd detail

Sub TotalO NPHCE

Add detailSub Total

P NPPCDAdd detail

Sub TotalQ NTCP

Add detailSub Total

R NOHPAdd detail

Sub Total

S NUHMAdd detail

Sub Total

T Others (please Specify)Add detail

Total (A to K) Figure A Figure B Figure C Figure D


S.No. Name of DistrictRCH-I RCH Flexipool NRHM

Immunisation (RI Strength.) PPI EC SIP ……. ……. ……. …….


Total

Schedule III

CHART OF Closing Balance of Current Liabilities as on 31.03.2016 AT DISTRICT LEVEL

Opening Balance

Advance Given during

the year

Refunded during the

year

Closing Balance

Revenue Capital(A) (B) (C) (D) (A+B-C-D)

1234567891011121314151617181920

1 Name of Agencies etc.234



Sl. No. Name of District Amount of Rev Exp (Rs.)

√

Total revenue Expenses of the district D1

Schedule IV-ASTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under RCH-I as on 31-03-2016

B2B1

At State level:

Expenditure during the year

SL. NO.

RCH-Phase I

1

Name of Districts

Particulars of Rev. Exp.Name of Blocks

B5B4

D1 B3

SUM TOTAL OF REVENUE EXPENSES OF THE DISTRICTS

B4B5

Total revenue Expenses of the district D2

2 D2

B1B2B3

For more clarity and details another similar kind of chart may be plotted as under

Opening Balance Fund Release Refund BalanceRevenue Capital

(A) (B) (C) (D) (A+B-C-D)1 Dehradun 02 Haridwar 03 Tehri 04 Pauri 05 Rudraprayag 06 Chamoli 0 7 Uttarkashi 08 Almora 09 Bageshwar 010 Champawat 011 Pithoragarh 012 Nainital 013 USNagar 014 Sub Total 0 0 0 0 0 0 0 0 0 0 01516 Loan rch to nuhm at Nainital17 Loan to IMM. 01819

1 Choudhary Estates Pvt.Ltd 02 Director IPGME&R 03 EMRI-108 04 EPF Account 05 HIHT Jolly Grant 06 Nidhi Mehra 07 NICSI DDN 08 Principal of Nursing 09 RHFWTC Dehradun 010 Advance Under Review(rch) 011 RHFWTC Haldwani 012 Main kitty13 Sub Total 0 0 0 0 0 0 0 0 0 0 014 Total151617



Expenditure

At State level

Schedule IV-BSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under RCH Flaxipool as on 31-03-2016

SL. NO. Name of Districts/Agencies

RCH-Flexipooluser charge stale

ChequePP

AdjustmentInterest Earned

or Other Reciept

loan given to other Progr

by DHS

Similar chart , as shown in Sch-IV-A , may be plotted here.

Opening Balance Fund Release Interest Refund Loan Given /Refund

Adjustment Stale Cheque

Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)1 Dehradun 02 Haridwar 03 Tehri 04 Pauri 05 Rudraprayag 06 Chamoli 07 Uttarkashi 08 Almora 09 Bageshwar 0

10 Champawat 011 Pithoragarh 012 Nainital 013 USNagar 0




Expenditure

At State level

Schedule IV-CSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under Mission Flaxipool as on 31-03-2016

SL. NO.

Name of Districts/Agencies

Mission-Flexipool


Opening Balance Fund Release Interest and other receipts

Refund Adjustment Stale Cheque

Balance

Revenue Capital

(A) (B) (C) (D)1 Dehradun 02 Haridwar 03 Tehri 04 Pauri 05 Rudraprayag 06 Chamoli 07 Uttarkashi 08 Almora 09 Bageshwar 010 Champawat 011 Pithoragarh 012 Nainital 013 US Nagar 0

Total 0 0 0 0 0 0 0 0 0 0

1 SPO-Immunization 02 UAHFWS-NRHM Addit. 03 Advance Under Review 0

1 Main Kitty 0Total 0 0 0 0 0 0 0 0 0 0

Total Figure A Figure C Figure D Figure E

Chartered Accountants

Expenditure

At State level

Schedule IV-DSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under Immunization as on 31-03-2018

SL. NO.


Immunizationloan given to other Progr

by DHS

Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV-ESTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under Flaxipool, Immunization as on 31-03-2016

SL. NO.


EC-SIP


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV-FSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NIDDCP as on 31-03-2016

SL. NO.


RCH-Flexipool


Opening Balance

Fund Release Refund Balance

Revenue Capital

loan given to other

programe

loan receive Stale Cheque

(A) (B) (C) (D) (A+B-C-D)1 Almora 02 Bageshwar 03 Chamoli 04 Champawat 05 Dehradun 06 Haridwar 07 Nainital 08 Pauri 09 Pithoragarh 0

10 Rudra Pryag 011 Tehri 012 U.S. Nagar 013 Uttarkashi 014 Sub Total 0 0 0 0 0 0 0 0 0 0 6E+06

1 State Programme office 0 20000002 Medical College Haldwani 03 Medical College Srinagar 04 HIHT Jolly Garnt 05 Advanced Under Review 0

0 0 0 0 0 0 0 0 0 0Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Figure E


Expenditure

At State level

Schedule IV-GSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under IDSP as on 31-03-2016

SL. NO. Name of Districts/Agencies

IDSPInterst and

other receipt


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV-BSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NVBDCP as on 31-03-2016

SL. NO.


NVBDCP


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV-ISTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NLEP as on 31-03-2016

SL. NO.


NLEP


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV- JSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under RNTCP as on 31-03-2016

SL. NO.


RNTCP



(A) (B) ( C ) ( D) (E) (F) (G) H=(A+B+C+D-E-F-G)1 UAHFWS-Dehradun 02 UAHFWS-Haridwar 03 UAHFWS-Tehri 04 UAHFWS-Pauri 05 UAHFWS-Rudrapriyag 06 UAHFWS-Chamoli 07 UAHFWS-Uttarkashi 08 UAHFWS-Almora 09 UAHFWS-Bageshwer 010 UAHFWS-Champawat 011 UAHFWS-Pithoragarh 012 UAHFWS-Nainital 013 UAHFWS-U.S.Nagar 0

Total Dist. 0 0 0 0 0 0 0 0

01 DHFWTC-Dehradun 02 NIHFW-New Delhi 03 UAHFWS-NRHM Addit 04 UAHFWS-RCH FP 0

0State Lavle 0 0 0 0 0 0 0 0

SPO Bank(Main Kitty) 0

00

Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00


Expenditure

At State level

Schedule IV-KSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NUHM Flaxipool as on 31-03-2016

SL. NO.


NUHMInterest &

Other Receipts

User Charges



(A) (B) (C) (D) (A+B-C-D)

1 Dehradun 02 Haridwar 0 NPPCD(286000+529147+260000)3 Tehri 04 Pauri 05 Rudraprayag 06 Chamoli 07 Uttarkashi 08 Almora 09 Bageshwar 010 Champawat 011 Pithoragarh 012 Nainital 013 USNagar 014 Advance Under Review 015 Total 0 0 0 0 0 0 0 0 0 0

1 State Programme Office 02 main kitty 03 total 0 0 0 0 0 0 0 0 0

Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0

Chartered Accountants State Finance Officer0.00

0.00+

#VALUE!

0.00

Expenditure

At State level

Schedule IV-LSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NPCB as on 31-03-2018

SL. NO.Name of

Districts/Agencies

NPCBInterst or other

incomeloan given/recivefund recive

from other programme


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV- MSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NMHP as on 31-03-2016

SL. NO.


NMHP


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV-NSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NPHCE as on 31-03-2016

SL. NO.


NPHCE


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level


Schedule of Advances lying at State & Districts under NPPCD as on 31-03-2016

SL. NO.


NPPCD


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level

Schedule IV-OSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NTCP as on 31-03-2016

SL. NO.


NTCP


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)12345678910111213141516171819




Expenditure

At State level


Schedule of Advances lying at State & Districts under NOHP as on 31-03-2016

SL. NO.


NOHP


Opening Balance

Fund Release Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)123456789

10111213141516171819




Expenditure

At State level

Schedule IV- PSTATE HEALTH SOCIETY

Schedule of Advances lying at State & Districts under NPCDCS as on 31-03-2016

SL. NO.


NPCDCS


Opening Balance

Fund Release

Refund Balance

Revenue Capital

(A) (B) (C) (D) (A+B-C-D)123456789

10111213141516171819




Expenditure

At State level


Schedule of Advances lying at State & Districts under National Program for Palliative Care (New Initiatives under NCD) as on 31-03-2016

SL. NO.


National Program for Palliative Care (New Initiatives under NCD)


S.No. PARTICULAR Opening Balance 01-04-2015

GIVEN During 2014-15

Refunded/Settled

Balance as on 31-03-2016

1 Name of Staff etc.

Total Figure B Figure E

S.No. Name of District Opening Balance 01-04-2015

GIVEN During 2015-16

Refunded/Settled

Balance as on 31-03-2016


Schedule IV- T


SCHEDULE OF Advance Given to Staff at State & District Level


State Level:

District Level: (as per chart below)

S.No. PARTICULAR State Level District Level (as per chart below)

Balance District + State as on 31-03-

2016A RCH-I

Add detail (Such as Security depostit


Add detailSub Total

C NRHM Add detail


Add detailSub Total

E PPIAdd detail

Sub TotalF EC SIP

Add detailSub Total

G RNTCPAdd detail

Sub TotalH NVBDCP

Add detailSub Total

I NIDDCPAdd detail

Sub TotalJ NLEP

Add detailSub Total

K IDSPAdd detail

Sub TotalL NPCDCS

Add detailSub Total

M NPCBAdd detail

Sub Total

N NMHPAdd detail

Sub TotalO NPHCE

Add detailSub Total

P NPPCDAdd detail

Sub TotalQ NTCP

Add detailSub Total

R NOHPAdd detail

Sub Total

S NUHMAdd detail

Sub Total

T Others (please Specify)Add detail

Total (A to T) Figure A Figure B Figure D


S.No. Name of District

RCH-I RCH Flexipool NRHM Immunisation (RI Strength.) PPI EC SIP ……. ……. …….


Total

CHART OF Closing Balance of Current Assets as on 31.03.2016 AT DISTRICT LEVEL

Schedule V

SCHEDULE OF OTHER Current ASSETS As on 31-03-2016


Cash Bank Cash BankA RCH-I

State LevelDistrict Level AS PER LIST A



Sub TotalC NRHM




Sub TotalE PPI


Sub TotalF EC SIP


Sub Total

G RNTCPState LevelDistrict Level AS PER LIST A

Sub TotalH NVBDCP


Sub TotalI NIDDCP


Sub TotalJ NLEP


Sub TotalK IDSP


Sub TotalL NPCDCS


Sub TotalM NPCB


Sub Total

N NMHPState LevelDistrict Level AS PER LIST A

Sub TotalO NPHCE


Sub Total

P NPPCDState LevelDistrict Level AS PER LIST A

Sub TotalQ NTCP


Sub TotalR NOHP


Sub Total

S NUHMState LevelDistrict Level AS PER LIST A

Sub Total

T Others (please Specify)State LevelDistrict Level AS PER LIST A

Sub TotalTotal (A to K) Figure A Figure B Figure C Figure D


Name of the Programme:RCH-1/RCH Flexible Pool/Immunization/NRHM/any NDCPs Programme(Separate Schedule for each programme)

List of District wise Opening & Closing balances of Cash & Bank

Sl. No. Name of the Districts

Cash Bank Cash Bank1 A2 B3 C4 D5 E6 F7 G

Grand Total

NOTE: District Bank Balances may be merged with the Advances to the Districts.

List A

Opening Balance as on 01.04.15

Closing Balance as on 31-03-2016

Schedule VISTATE HEALTH SOCIETY

Schedule of Cash & Bank Balance AS ON 31-03-2016

Opening Balance as on 01.04.15

Closing Balance as on 31-03-2016

Sl. No. Particular of Bank/Cash

Sl. No. Cheque/DD No DateReceived

From Amount (Rs.)

1 District-A2 District-B3 District-C4 District-D5 District-E

Total Total A


At District Level:

Schedule VIISTATE HEALTH SOCIETY

Schedule of Cheques/DD in Hand AS ON 31-03-2016

At State Level:

Sl. No. Bank Used forBank Balance as on 31st March, 2016

(as per Books)

State Level :

A Bank - 1 RCH / NRHMB Bank - 2 TBC Bank - 3 BlindnessD Bank - 4 IDSPE Bank - 5 LeprosyF Bank - 6

District Level:

G Bank - 1 as per List A as per List A

Grand Total Figure C

Chartered Accountants State Finance OfficerMission Director

Sl. No. Name of the DistrictsBank Balance as on 31st March, 2016 (as per

Books)

1 A2 B3 C4 D5 E6 F7 G

Grand Total

Schedule VIIISTATE HEALTH SOCIETY

Schedule of Interest Earned at State & Districts during the year 2015-16

List A

PARTICULARS OF AUDITOR: NAME ADDRESS AND PHONE NO. AMOUNT (Rs.)

Schedule IXSTATE HEALTH SOCIETY

SCHEDULE OF OF AUDIT FEE FOR STATE & DISTRICTS FOR THE YEAR ENDING on 31-03-2016

Op. Balance Recvd during year As per I&E A/C As per B/S Refunded to GOI Closing BalanceSanction No Date RECIEPT TOTAL UTILISATION DURING YEAR

A new format may be introduced to get a details of UCs at a glance:

TOTAL