Charitable Hospital Project Report

Proposal for a Hospital charitable Cardiology Institute BY: PANKAJ MOHAN SHARMA

TABLE OF CONTENTS 1. Promoter’s Background 2. Objectives of Study 3. Healthcare in India Medical Tourism Scenario 4. Health Insurance Scenario 5. Location Analysis of Jaipur 6. SWOT Analysis 7. Proposed Hospital Profile 8. Budgetary Considerations

9. Expected Revenue and break – even Analysis

PROMOTER’S BACKGROUND Dr PANKAJ MOHAN SHARMA, MBA, MHA A CARDIOLOGIST and health care Market leader, presentably works as a Cardiology Innovative Business Consultant in India. He proposed to set-up a Multi speciality Tertiary Health care Hospital with Cardiology main focus ground to cater to the Population of Jaipur (RAJASTHAN) India. He is specialist In Cardiology and Business Management consultant. He has seven years experience in cardiology innovation, marketing, hospital development and Business planning. Mrs Sosan - An Eminent Business woman and cardiology nurture The Global cardiology consultant The Group is interested in conducting a detailed exploratory market research and financial feasibility to understand the demand and supply of health care and relevant market opportunities to make a conclusion for the upcoming proposed project in JAIPUR.

We need fund raisers , Volunteers for our charitable hospital from all over world ,If you want to be part of our Volunteer Team Please send us your latest resume ,

volunteering for us We need volunteer from all over world for 1 Fund raising for start up project . 2 For Free Medical Treatment In India for the poor patients of your country, 3 To promote Medical Tourism in india, 4 For working in the hospital , 5 For Opening Our local office in Your city and in your country This is the greatest opportunity for helping those who could not help them self , You will help millions of people all over world who are not able to get medical treatment due to poverty , Please join us as our International Director , Volunteer , Fund raiser , and Help us to build a world class charitable hospital for patients of all over the world, Please send us your resume and donation to Global Health care Dr PANKAJ MOHAN SHARMA Q-3 FRU 1, RCH HOSPITAL SECTOR 30 , FARIDABAD , HARYNA INDIA BANK DETAILS-- A/C NO- 629401539781 ICICI BANK BRANCH FARIDABAD

The Detailed Project Report comprises primarily of two main parts: Market Research: understanding the need gap and requirement for a multi specialty hospital; assess the healthcare delivery systems of competitors, and a review of all stake holders on the lacunae and strengths. Financial Feasibility: To derive the Project cost details, Income and Expenditure estimates, Break –Even Analysis and other important projections, a comprehensive Feasibility study was done.

OBJECTIVES OF STUDY

1. To perform feasibility analysis for a hospital at the Jaipur Rajasthan. 2. To give an estimate of budget required for the project. 3. To calculate the expected profits and the break – even point for the project. 4. To Emphasis on expansion of the project. To establish a charitable Hospital in Cardiology excellence in India for health healing and learning of humanity. This is a multispeciality hospital which will cover all the speciality of medicine Surgeries, paediatrics, ophthalmology and Surgery Our Prime focus is to establish a global cardiac care centre for the cardiology Excellence,

Which will provide lowest cost but higest quality world class medical services to everyone, It will adopt poor patients from all over world for free medical and surgical treatment,

WE NEED YOU AS A VOLUNTEER , AS A INTERNATIONAL DIRECTOR , which will provide world class cardiac care, angioplasties, bye pass operation, Open heart surgeries with latest advancement in cardiology treatment This will be first hospital in India which will provide Interventional Cardiac Radiology services during cardiac procedures, Apart from cardiology our aim is to provide world class neurology services, world class ophthalmology services, Infertility centre, world class nephrology and dialysis centre, rhematology centre, world class paediatric Neonatology centre with excellence, World class critical care services, world class laproscopic and key hole surgeries centre, world class orthopaedic surgeries and trauma treatment centre in our hospital premise. With the hospital we will run a Nursing college for production of speciality nurses, Our Nursing College will be art of nursing institution and will work with the hospital from the start up date. Second phase is to establish a Medical college of capacity 100 students in a year with the attached hospital and to extend the hospital to 700 beds capacity.

This Project Report is presented for the start up funding.

HEALTH CARE IN INDIA

 Indian Healthcare Industry to Double in Value by 2012  Rising income levels  Changing demographics  Shift in disease profile from chronic to lifestyle diseases to propel the

growth  The health infrastructure across Indian states is projected to grow by an average of 5.8 percent per annum between 2009-2013, taking the total expenditure in 2013 to USD 14.2 billion  Of the 32 Indian states that the report considered, the six states of Rajasthan, Maharashtra, West Bengal, Uttar Pradesh, Tamil Nadu and Andhra Pradesh are forecasted to represent approximately 50 percent of the expenditure for 2009-2013 period.  While the Indian healthcare system has grown manifold over the past few years, it has yet not been able to keep pace with the rapid rise in the population. One example of that is the availability of hospital beds in our country —against a world average of four beds per 1,000 population, India lags behind at just over 0.7 presently.” There is a growing need to deal with the issues of urban healthcare infrastructure as rural to urban migration has significantly increased the demand for these services.  The Indian healthcare industry is estimated to double in value by 2012 and more than quadruple by 2017. The main factors propelling this growth are rising income levels, changing demographics and illness profiles, with a shift from chronic to lifestyle diseases. This is likely to result in considerable infrastructure. The healthcare sector in India is undergoing a phase of reform propelled by rapid economic growth. Apart from the healthcare providers, emerging markets such as diagnostic chains and medical device manufacturers are attracting increasing amounts of investment.  In comparison to all 32 states, Rajasthan forecasted to maintain its dominance as the state with highest cumulative healthcare infrastructure expenditure, with spend of $ 7.3 billion between 2009 - 201cture challenges and opportunities. The Indian Healthcare Industry-An Overview  India's healthcare sector has been growing rapidly and estimated to be worth US$ 40 billion by 2012  Revenues from the healthcare sector account for 5.2 per cent of the GDP, making it the third largest growth segment in India.  The sector's growth will be driven by the country's growing middle class, which can afford quality healthcare.

Growth drivers  Medical Tourism  Telemedicine  Healthcare services outsourcing  Diagnostic services  Increasing awareness  Medical insurance  Aging population  Growing urbanization



Low cost treatment

Pharmaceutical companies are going online to shorten the development and approval cycle of new drugs.

MEDICAL TOURISM IN INDIA OR HEALTHCARE TOURISM  Indian hospitals are fast becoming the first choice for foreign patients owing to easy access to visa facilities, coupled with the best emerging medical infrastructure, which will help India earn to an extent of US$ 1.86 billion in foreign exchange by 2012. Currently, India's earnings through medical tourism annually are an estimated US$ 821.40 million. Medical tourism can be broadly defined as the provision of 'cost effective' private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment. Jointly facilitated by the corporate sector involved in medical and healthcare as well as the tourism industry - both private and public. India has originated as one of the most important hubs for medical tourism. A nice blend of top-class medical expertise at attractive prices is helping more and more Indian corporate hospitals to lure foreign patients, including patients from developed nations such as the UK and the US, for high end surgeries like Cardiac By-Pass Surgery or a Knee/Hip Replacement.  A combination of many factors has lead to the recent increase in popularity of medical tourism.  Exorbitant cost of healthcare and medical facilities in advanced countries,  ease and affordability of international travel,  favourable currency exchange rates in the global economy, rapidly improving technology and high standards of medical care in the

developing countries Salient Features  Low cost medical treatment  High quality medical care  Low wait time for critical treatments  Fluent English speaking staff

HEALTH INSURANCE SCENARIO IN INDIA  With less than 10 per cent of the population having some sort of health insurance, the potential market for health insurance is huge.  Indian health insurance business is fast growing at 50 per cent and is expected to continue growing at this pace.  The sector is projected to grow to US$ 5.75 billion by 2010, according to a study by the New Delhi-based PHD Chamber of Commerce and Industry.  One-fifth of India's population is likely to have a medical insurance by 2015  Estimated increase in consumer spending on healthcare from US$ 2,054 per household in 2005 to US$ 3514 per household by 2015.  In some cases, the Government is partnering with the private sector to provide coverage at a low cost. The Yashaswini Insurance scheme, launched in 2002 in Karnataka by a public-private partnership. NEED FOR MULTI SPECIALITY HOSPITALS 100 Doctors interviewed  All facilities under one roof.  Most advanced facilities.    

Provides Basic Facilities at a rock bottom price with the same quality. They can attract talent. Indian Healthcare Industry-Growing and Innovating High Tech Area. Change in attitude towards healthcare.

LOCATION ANALYSIS OF JAIPUR

Jaipur is the last well planned city of India, located in the desert lands of India, Rajasthan. The city which once had been the capital of the royalty now is the capital city of Rajasthan. The very structure of Jaipur resembles the taste of the Rajputs and the Royal families. In the present date, Jaipur is the major business centre for the natives of Rajasthan with all requisites of a metropolitan city. No. of large and medium scale running units: 48 No. of small scale units: 19,544 No. of industrial areas: 19 (Bagru, Bassi, Bais Godam, Bindyaka, Dudu, Hirawala, Jetpura, Jhotwara, Kaladera, Kanakpura, Kartarpura, Malviya Nagar, Phulera, Renwal, Sanganer, Shahpura, Sitapura, Sudarshanpur and Vishwakarma) Jaipur district is a centre for both modern and traditional industries. The main industrial products include: acetylene gas, ACSR (Aluminium Conductor Steel Reinforced) cable, all-purpose flour (maida), atta flour, ball bearings, bottling of LPG, ceramics, pottery, cold roll strips, corrugated boxes, deoiled cakes, durries, dyeing and printing, edible oil, electronic items, engraving on brass items, ferrous and non-ferrous castings, gems and jewellery, general engineering and manufacturing, granite slabs and tiles, hand-made paper, handicraft items, halogen automobile headlamps, "hawai" chappals (sandals), household electrical appliances, HT steel strips, iodised salt, lamps, laminated springs for railways, marble statues, marble tiles & slabs, moulded plastic components for electronics, nitrochlorobenzene, oxygen gas, perfumes, pigments, plastic containers, P.P. multifilament yarn, PVC cables, PVC doors, PVC footwear, canvas shoes, Portland cement, ready made garments (clothing), re-roller products, semolina (suji), steel furniture, steel ingots, stone grits, synthetic leather, suits & shirts made of synthetic materials, tablets and capsules, two way radio and line, washing soap, wheat, woollen carpets, refined vegetable oil and vanaspati ghee heavy Steel fabrication, brass and

lacquer work, enamel work, gems and jewellery, granite tiles, handlooms, marble statues, printed cloth and textiles, ready made garments, woollen and silk carpets. Jaipur has been ranked 31 among the 50 Emerging Global Outsourcing cities. Genpact and Infosys have their BPO already established and running successfully. In fact Genpact has the fastest growing location in Jaipur. Real Estate business is flourishing well from last 2–3 years. Some of the companies already present here include MICO, Coca Cola, IBM, Ericsson and NEI popularly known as NBC Bearings. Jaipur also has Reserve bank of India and many other prominent international banks. India's largest integrated IT SEZ Mahindra World City is located in Jaipur. Master planned by Jurong Constructions Singapore it covers nearly 3,000 acres (12 km2) of land off Ajmer highway and has already attracted major companies like Infosys, TCS, Wipro, Tech Mahindra, Truworth and Bank. India’s one of a kind World Trade Park is also under construction in Malaviya Nagar. It will be having luxury hotel, business halls, five screen multiplex, underwater restaurant and many showrooms of international brands. In coming years it will be the hub for modern business development in Jaipur. Jaipur is soon planned to have an International Convention Centre and a Golf course. A film city near Agra highway is also in the pipeline. Tourism is a significant part of Jaipur's economy. Some of the world's best hotels are located here.

Hospitals in JAIPUR Page 11 of 27

HOSPITALS SMS Medical college Fortis S D M HOSPIAL GANDHI HOSPITAL SONY AMAR JAIN Birala Monilake

BED STRENGTH(APPROX) 700 350 300 100 200 150 200 780

APPLO

300

Total Population( JAIPUR) Bed ratio (present) Total Beds Required Beds Available Bed Deficit

3,300,000 (2009) 1.8 10,000(WHO recommendation 3 per 1000 population) 6000(APPROX) 4000

Disease prevalence’s in JAIPUR Heart attack, Blood Pressure, Angina, Unstable angina, COAD, TB.

Positive Factors

81% Literate population Densely Populated 7,214/ Km² Majority of High and Middle income group Good sewerage system Huge scope for further development Population of Jaipur city (2009) excluding suburbs is around 3,300,000 (approx). Total bed strengths (which includes Private and Government Hospitals) are 6000 approx. So number of beds per 1000 population is 1.8, but according to WHO standards it should be 3. So we are short of 4000 beds in Pune. And this shortage will increase in future. IT Services sector remains a major driver of the economy and jobs created here Rajasthan NRI Diaspora and first-generation of successful technology entrepreneurs are encouraging a renaissance of entrepreneurial activity. JAIPUR is emerging as a prominent location for tourism and manufacturing companies to expand. 25% of income of JAIPUR comes from Handy craft, export, semiprecious – Precious stones cutting, Apparels and IT sector. JAIPUR has the sixth largest metropolitan economy and the highest per capita income in the country.

Negative Factors

Reputed hospitals like Fortis, Apollo SDM, and Birla Market penetration not difficult for newcomer Page 12 of 27

High Real estate rates Scarcity of Trained Doctors, Specialist, Nursing staff (common problem of whole India) Congested space around hospital premises SWOT ANALYSIS Strengths: 1 JAIPUR is called as Pink City of India; it is as huge Tourist Destination from all over world. Also it is gallery of Export, hub of IT industry, thus we expect high employer base utilisation of insurance a hospital services. Medical Tourism is best Business Approach for Jaipur 2: Easy Availability of skilled doctors and trained Para-medical staff and investments required to uplift the current status of the healthcare. Jaipur is known for Education Hub for Medical Education in India Weakness-- No significant Opportunities: Changes in demography and socio-economic mix are altering the population's disease profile and increasing the incidence of lifestyle diseases thus increasing the demand for beds Threats: Steep population growth with lack of proper healthcare policies, Infrastructure and accessibility to the healthcare for all is challenge in the coming days.

LAND FEASIBILITY SURVEY A Land Feasibility Study is conducted to evaluate and determine the suitability of the soils relative to a parcel of land where an on-site sewage system would be used Erosion & Sediment The site is assessed according to its current erosion and sediment loss conditions and then a new plan is designed proposing a new topography for sediment control and erosion prevention. Proper Water Supply Proper Sewage System

PROPOSED HOSPITAL GLOBAL CARDIOLOGY INSTITUTE & MULTISPECIALITY HOSPITAL Colour: Red signifies the colour of life and the courage to deal with Page 13 of 27

emotionally disturbed customers Mission To serve and enrich the quality of life of patients suffering from diseases, through the efficient deployment of technology and human expertise, in a caring and nurturing environment with the greatest respect for human dignity and life. Vision Global Cardiology Hospital will strive with excellence to fulfil the needs of the community in its chosen field of medical treatment and grow to be the biggest and most respected name in quality healthcare business in the country. Global Cardiology Institute & Multispeciality Hospital It will be 200 bedded Research Hospital which will be accomplished in 3 phases Rationale: - Availability of land Availability of finances Competitors First Phase 200 beds; it will take one and half year to commence the Hospital after acquiring the land. (OCT 2009- MARCH 2010). Hospital + Angel Investors tie up (joint venture) Angel Investor will be investing 75 crores in three phases 25 crores into my business. Means- $ 15 million USD for first phase of hospital and nursing college 1. Purchase of land 2. Second Phase 100 beds hospital 3. Third Phase nursing paramedical college Final phase-- For the Second Year – development of Medical/ dental college-- $ 25 Million USD Here we will focus on First phase of hospital and nursing college, Nature of the Hospital (GLOBAL CARDIOLOGY INSTITUTE and NURSING COLLEGE) The Global cardiology Institute & Multispeciality Hospital will be a high end hospital with the following characteristics:  250 bedded acute care tertiary healthcare facility with specialty and super specialty services  Full outpatient department, inpatient department and primary care services  It will have a state of the art radiology imaging centre  It will be fully digitised and paperless with all clinicians and departments using an Electronic Patient Record system at all times  It will provide an intimate, friendly and caring environment  Its design and processes will be patient‐focussed  High staff to patient ratios for personalised care  Providing the highest standards of cleanliness, comfort, safety and convenience Page 14 of 27

 State of the art medical equipment and evidence based protocols It will be staffed by selected, highly‐qualified healthcare professionals to ensure highest quality practices THERAPEUTIC SPECIALITIES • Ortho •

Cardiology

•

Gynaecology

•

Paediatrics

•

ENT

•

Sex clinic/ counselling centre

•

Rehabilitation centre

•

Psychiatry

•

Dental

•

Wellness centre

•

Ophthalmology

•

Medicine

•

Surgery

SUPER SPECIALITY 1) Liver Transplant and Digestive Diseases 2) Joint Replacement 3) Women and Child Care 4) Trans Nasal Brain Tumour Surgery 5) PELD Minimal Access Slipped Disk Surgery 6) Urology and Andrology 7) Obesity Surgery DIAGNOSTIC SERVICESS o Radiology: CT scan, MRI, bone mineral densitometry, mammography, ultrasound, x‐ray o Laboratory: biochemistry, haematology, serology, microbiology, clinical pathology, histopathology Other support services o Endoscopies, blood bank and blood components, dialysis, non‐ invasive cardiology such as echo, stress testing, holter, and ECG IT Driven tools and service  Hospital management system  Billing Page 15 of 27

Inventory Accounts management Records management ERP solution Telemedicine and medical informatics Decision support system that improves diagnosis and treatment Healthcare players are establishing ways to give customers easy access to pertinent information  Pharmaceutical companies are moving to speed development and delivery of new drugs       

Hospital Peculiarities  Micro-processor based implant able in patients.  CPU-driven technology supported by artificial intelligence.  Robotics in OTs  Robotics in Path-labs / Research.  Laser Technology in surgery  Instrumentation in medical and surgical practices.  IT tools for net-working examination, diagnostics, treatment rooms and OTs.  IT Tools along with artificial intelligence and microprocessor technologies for equipment maintenance and trouble shooting.  IT tools for generation of disease specific data. USP • Quality healthcare services with state of the art medical facilities under one roof •

Well qualified staff

•

Excellent customer patients services

•

Easily accessible and competitively priced.

• Customized designs to suit the varying needs of different customers (patients) • Constant interaction with the patients and strong bonding with them •

Promoting healthy India

Floor Wise Design: Basement: 10 OPD’s  Diagnostics, Lab  Waiting lobby Page 16 of 27

Ground Floor  Lord Tara Temple  Reception,  ADT department  Billing Department  Blood Bank  Cafeteria  Children Play Area  Emergency Department  Admin Department  ATM First          

Floor OT SICU Labour Room NICU PICU ICCU CATH LAB CARDITHORACIC OT CTVS ICU HDU

Second Floor  General Ward  Twin Sharing  Semi -Deluxe Rooms  Library Third Floor  General Ward  Deluxe- Rooms  Suite Fourth Floor  Tele-Medicine Department  Conference Hall  Yoga Area  Ayurvedic Department ESTIMATED MANPOWER

Nurses in the Hospital

Department of Laboratory Medicine Page 17 of 27

Nurses in I.C.C,U/ ICU

12

Nurses in S.C.C.U

9

Nurses in I.C.C.U

0

Nurses in N.I.C.U Nurses in Special ward Nurses in Deluxe ward

7 12 4

Nurses in Double ward

7

Nurses Nurses Nurses Nurses Nurses Nurses

in Single ward in General ward in Day care in Operation Theatre in OPD in Casualty ward

Nurses in Labour Room Total Nurses in the Hospital(Including 30% of Relievers) Physiotherapy Department Physiotherapists Physiotherapists Aide/Junior Trainee Senior Physiotherapists Total Physiotherapists

19 8 4 5 7 7 1 90

Section Head Number of Technicians for fairly automated lab Number of Technicians manual/fairly automated lab Senior Technicians Total Technicians Relievers Attendants for Automated Lab Relievers for Attendants Reception cum Clerk Relievers for Clerks

1 6 9 1 10 3 6 0 1 0

Department of Imaging Sciences Section Head 1 Number of Technicians for 2 routine X-rays, Special procedures like myelography barium investigations, HSG etc. Relievers

4

1

1 0

Department of Ultra Sound

0 1

Number of Technicians Attendants for Ultra Sound Relievers

2 4 1

Pharmacy Department Pharmacists for Indoor Issues Pharmacists for OPD Issues Junior Pharmacists Senior Pharmacist Pharmacy Aide Chief Pharmacist Total Staff in Pharmacy

2

Technicians with Echo

5

0 0 0 1 4

Relievers

2

General Maintenance Manpower required

9

Relievers

3

Total Staff in General

1

Department of ECG & 2D ECHO

Special Services Blood Bank Health Check Up X-Ray Infection Control Nurse Nurse Clinical Specialist Total staff - special services

12 Page 18 of 27

0 1 0 1 1 3

Maintenance Security Department Security guards (Including gateways & Special areas) Relievers Security Supervisor Total Staff in Security Department

Food Service Department 5

Dietician

1

2 5

Cook

3

Cook Helper

3

Dishwasher/Attendant Storekeeper Total Staff in Food Service

3 1

12

Sterile Supply Department Technician required 3 including Relievers Supervisor shift 1 Total Staff in 4 Sterile Department Laundry Department Laundry Operator Laundry Orderly / Assistant Laundry Staff Relievers Total Laundry Staff Shift Supervisor / shift

11

5 2 7 2 9 1

Housekeeping Department

Primary Secondary Tertiary

Staff in Housekeeping Total Housekeeping Staff : (Including 30% Relievers) Total Manpower required in 315 Hospital : COMPETITOR ANALYSIS:FORTIS HOSPITAL • Department of medical genetics • Clinical Genetics • Cytogenesis • Molecular genetics • Metabolic genetics • Ayurveda/ Panchkarma • Homeopathy • Dentistry • Clear vision clinic • Voice clinic Page 19 of 27

0

0

77

0

0

100

• • • • • • • SDM • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

Obesity clinic Cardiology Neurology Kidney transplant Cancer treatment IVF centre Neuro Trauma Unit HOSPITAL Accident and Trauma Care Acupressure Clinic Anaesthesiology Button Hole Surgery for Gall Bladder removal Blood Bank Cancer Centre with facilities for Radiotherapy, Surgical Oncology and Chemotherapy Cardiac Centre Chest Medicine Corneal Transplants with Eye Bank facility Day Care Centre Dental Centre with laboratory and facilities for Maxilla Facial Surgery and Dental Implants Dermatology Eleven well equipped Operation Theatres including separate Operation Theatres for cardiac and neurosurgery Endocrinology and Dialectology ENT Department Gynaecology and Obstetrics Department with labour rooms I.C.U./ C.C.U./ P.I.C.U./ N.I.C.U. Intensive Care Unit for trauma and other cases Lithotripsy and Urology including Nd : YAG Surgical Laser Mobile 'C' Arm Units Neonatology for highly specialized infant care and Neonatal Surgery Neurology and Neurosurgery Ophthalmic Laser & Automated Perimetry Ophthalmology with facilities for radial keratotomy Orthopaedic Department Orthopaedics, Rheumatology and Physiotherapy Paediatric Intensive Care Unit Paediatrics , Paediatric Surgery and Paediatric Urology Physiotherapy Post Operative Recovery Room for Cardiac, Renal and Microsurgical cases Psychiatry Radiation Synovectomy Reconstructive Plastic Surgery Page 20 of 27

• • • • •

Renal Dialysis Unit Respiratory Care Unit for patients needing acute respiratory care facilities Speech Therapy with a Child Guidance Clinic Vascular Surgery Video-endoscopes Surgeries

MARKETING STRATEGIES Communication mix The aim of this exercise is to establish the brand in the minds of the customers so well that it becomes the first name that customers recall whenever discussing or thinking about healthcare. The product would be heavily advertised before launching and then we would involve in extensive sales promotion. The communication strategy of promoting and advertising the brand is as follows: 1. Magazines o Health o General o Lifestyle 2. Newspaper ads 3. Hoardings across various places in cities 4. Advertisements in local television shows 5. Sponsoring school events 6. Organising awareness camps and visiting schools 7. Mobile marketing Public Relations and Publicity We have chosen newspapers and magazines because of wide range of our target audience. Magazines and newspapers are always in the eye amongst public. Magazines are read for a period of a month, which brings more attention to an advertisement. We plan to advertise in • National and local newspapers • Health Magazines We further plan to utilise the non personal communications such as photographs, films and tapes showcasing the facilities of our hospital and the advantages that the local population will have by getting themselves Page 21 of 27

treated at a world class hospital as compared to the local nursing homes. Advertising 1. Internet: We would place display ads and interstitials on websites like makemytrip.com. This would target the customers who frequently visit such sites for planning their travel. Also we plan to place our advertisements on yellow pages. Promotion activities 1. Hoardings: Visual hoardings to be placed on prime locations of the city to increase visibility among masses. Also we would place hoardings in high density residential areas, industrial areas and on city outskirts. 2. Camps: Blood donation camps and free check up camps would be arranged in schools and colleges. 3. Event Sponsorships: We would try to grab attention of the prospects by sponsoring events such as cultural events, sports events etc. We can even organize marathons. 4. Advertisements to be placed on local and short route buses. Sales Promotion 11 Tie up with Insurance companies for devising various insurance cover plans. 11 Tie ups with corporate and educational institutions for annual health contracts. Special packages for economically backward patients, senior citizens, maternity package, annual health check up package, package for diabetic patients, physiotherapy package etc. Future Plan We have devised a plan which would be followed in case of future expansions. We are planning to implement a Hub and Spoke model which will help us in expanding our services to areas where we cannot currently reach due to infrastructure related issues. Issues like transportation, electricity, public sanitation facilities available in smaller towns and villages currently don’t allow us to open our super speciality hospitals in these areas. Even if these are ignored, there would be problems finding good doctors and other hospital staff who would be willingly ready to work in such areas. To circumvent these issues, we have come up with this model.

Page 22 of 27

As shown in the above diagram, we will have our fully equipped super speciality hospital in the cities (Tier 2) built and working successfully as envisioned in the current expansion plan. But we would not be able to provide quality health care to smaller towns where a good number of people reside and are in need of such facilities. This would also form a part of our Corporate Social Responsibility whereby we will go one step further than just providing free care in our hospitals by reserving 10% of our capacity for such cases. Here we will establish small nursing homes with minimal facilities and having interns and other less qualified staff (but competent enough to handle minor issues like flu, fever, basic orthopaedic and other basic services). These staff would be able to give proper diagnostic facility to the villagers and to the small town people and if they feel that the patient has some major disease, he/she will refer that patient to the nearest “HUB” where the person would be treated at subsidised cost (the exact amount of subsidy that would be provided can only be decided on regional basis). We would be cross subsidising such activities with the retained earnings from our business. These plans, would however, can be implemented only after we have attained a certain minimum level of competence and profitability which could take us few years.

Page 23 of 27

BUDGETARY CONSIDERATIONS Amount budgeted INR in Millions 1. Land cost 15000 Sq.Ft / * 1000 *12 2. Building and auxiliary cost 3. Cardiology set up

200.00 459.40 50.00

4. Equipment planning Echo – Colour Doppler Ventilator: 3 Cardiac Monitor (NIBP) 30 Defibrillator: 5 TMT-2 Central Line Oxygen ECG Machine : 10 Pulse Oxymetre : 5 Centralized Monitor Infusion Pump : 10 Pace Maker : 05 Computerized System X-Ray :3 Cardiac Fowler Bed

1.80 2.40 3.00 1.00 0.30 0.20 0.10 0.10 0.10 0.30 0.25 0.20 0.90 0.75

IITV USG : 2 Pathology Equipments Other material & Medicines CT scan MRI CSSD Lab Ambulance 4 nos Communication System IT system

0.90 0.80 1.50 0.20 10.00 15.00 15.00 20.00 2.00 2.00 10.00 Page 24 of 27

Amount expenditure INR in Millions

Miscellaneous Total CAPEX

10.00 808.20 Working Expenses Amount budgeted (Monthly) INR in Millions

Amount expenditure (Yearly) INR in Millions

1. Salaries NURSES @ Rs. 7000/ *90

0.06

Physiotherapist @ 30000/*1

0.03

Pharmacist @ 12000/* 4

0.05

Maintenance staff @ 6000/* 12

0.07

Security staff- outsourced

0.05

Technicians @ 7000/*63

0.04

Housekeeping -outsourced

0.05

dietary services @ 5000/ * 11

0.06

Administrative Heads @ 70000 /* 7

0.49

Med.Supr.

0.15

Assit.Med. Supr.@ 40000/ * 6

0.02

CEO

0.20

Administrations @ 20000 /* 12

0.24

Admin Others @ 8000 /*20

0.20

consultants @ 70000 /* 15

0.10

Surgeons' Visit @20000 / *7

0.14

RMO @ 15000/*18

0.27

Special Services @ 12000/*3

0.04

Disaster budget

2.00

Marketing budget

30.00

Fuel Charges (Ambulance and Generator) @ 35 / * 30* 30 *12

0.31

3.72

Other expenses

0.60

7.20

Page 25 of 27

TOTAL

70.04

EXPECTED REVENUE - Revenue estimation(1st Year) Sr. no.

1

particulars

OPD patients(20 patients* 30 days * 10 OPD )

Charges INR

revenue per revenue per month INR annum INR Millions Millions

500

3.00

36.00

50,000

6.00

72.00

70,000

4.90

58.80

4 Pharmacy( OPD)

3.00

36.00

5 Pharmacy( IPD)

1.20

14.40

IPD patients( 4 patients * 30 days ) surgery(70 surgeries per 3 month ) 2

6 USG( 20usg * 30 days )

700

0.42

5.04

7 X-ray(15 X-rays * 30 days )

400

0.02

0.24

2,200

0.11

1.32

500

1.50

18.00

800

1.20

14.40

200

0.60

7.2

8 CT (50 CT per month ) lab tests( 100 OPD tests * 30 days) lab tests( 50 IPD tests * 30 10 days) 9

11 ECG ( 100 ECG * 30 days ) 12 Cardiology set up

0.50

Total Revenue generation INR Millions

21.95

263.90

USD 5.28 Millions CAPEX Initial requirement - INR 808.20 Millions Will be equal to – $ 16.17 Millions Working capital Requirement – INR 70.04 Millions Will be equal to - $ 1.40 Million Revenue Revenue generation 1st year – INR 263.90 Millions Will be equal to - $ 5.28 Million Expected annual growth - 15 % per annum --------------------------------------------------------------------

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WE NEED VOLUNTEER , FUND RAISERS , INTERNATIONAL DIRECTORS , LEADERS You Are requested to contact Dr. PANKAJ MOHAN SHARMA Q-3, FRU 1, RCH HOSPITAL SECTOR 30, FARIDABAD, HARYANA INDIA E MAIL-- [email protected] For donation BANK AC NO- 629401539781 ICICI BANK FARIDABAD

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