nikhil ppt.pdf

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350 BEDDED GENERAL HOSPITAL AT SUSHANT GOLF CITY, LUCKNOW

Submitted By:Prachi Gupta

Roll No. - 817

IIA Part-IV-Group-B (2014-15)

ACKNOWLEDGEMENT

I would like to express my sincere gratitude to my thesis guide Ar. K.K. Asthana, for his concern, support and

guidance throughout my thesis. He sorted out all my problems and queries and gave valuable suggestions tobenefits my project.

I am grateful to our thesis coordinator Ar. Manoj Kumar for his unending and unritiring support

provided to me at all stages of my thesis. His invaluable knowledge was shared for my thesis.

Secondly I would like to thanks all those people who have been associated with this assignment and

have helped me in this project and made it a worthwhile experience.

Finally, I would also like to thank my parents and friends who helped me a lot in finishing this projectwithin the limited time. And also a big thanks to the various people who have shared their opinions and experiences

through which I received the required information beneficiary for my project.

Thank you!

PRACHI GUPTA


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Roll No. - 817


INTRODUCTION

The hospital is an integral part of a social & medical organization, the

function of which is to provide for the population complete health care, both

curative and preventive, and whose outpatient services reach out to the

family and its home environment, the hospital is a center for the training of

health workers and biosocial research.

WHO definition of Hospital

Hospital is a premise medical facilities of general or specialized nature for

treatment of indoor and outdoor patients. A hospital is a place which delivers

health services to the people and where the patients are cared for nurse and

treated. It is an integral part of social and medical organization, the function

of which is to provide for the population complete health care, both curative

and preventive. The modern concept goes beyond the conventional idea of ahospital as place for treatment of the sick. It visualize as hospital is one of

comprehensive system of preventive and curative medicine and as an

institution devoted not only to patients treatment but also to a ambulatory and

domiciliary care.

A hospital building is something difficult that is difficult to change when it has

been constructed. The methods of looking after the patients, nursing and

treatment however continually and rapidly due to the development of medical

science hence its challenge job for an architect to design such a building.

IndiasPublic Health System has been developed over the years as a 3-tier

system, namely primary, secondary and tertiary level of health care. Health

System is the fundamental basis for implementing various health policies,

delivery of healthcare and management of health services for defined

geographic area. Hospital is an essential component of the health system

and functions as a secondary level of health care which provides curative,

preventive and promotive healthcare services to the people.

TYPES OF HOSPITALS

1. TEACHING / RESEARCH HOSPITALS

2. GENERAL HOSPITALS3. TERTIARY CARE SPECIALTY HOSPITALS

FEATURES

1. Orientation

2. Planning of traffic & Circulation (Patients, Staffs, visitors, Service

deliveries, Garbage & Waste removal)

3. Easy traffic movement & promote efficiency of operation.


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Roll No. - 817


SITE LOCATION

Showing Lucknow in India

Location of Sushant Golf city on Lucknow City Map

Layout of Sushant Golf CityProposed site of Hospital

HOSPITAL BLOCK


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Roll No. - 817


30.0MT.WIDEROAD

9.0 MT. WIDE ROAD

COMMERCIAL

350 BEDDED

HOSPITAL BLOCK

63.14 m

244.82m

206.81m

225.41 m

SITE AREA

Hazaratganj 5 Kms.

Amausi Airport 13 Kms.

SGPGI 13 Kms.

Charbagh Railway Station 9 Kms.

Vidhan Sabha 6 Kms.

DISTANCES FROM IMPORTANT LANDMARKS

Total area of site

50909.37

Sq. mt.

12.58 Acres

5.09

Hectares

Permissible ground Coverage

30 %

15272.81

Sq. mt.

Permissible FAR 2.5

127,273

Sq. mt.

BYE LAWS

Site is allotted for health care facilities by Ansal Infrastructure pvt. Ltd.

SOCIO ECONOMIC ISSUES

The site is of private builder, Ansal

infrastructure pvt. Ltd. The hospital will

serve as general hospital facilities to

sushant golf city and near by adjacent

population.


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Roll No. - 817


SITE CONSIDERATION

APPROACH: Site is approached by 45.0 mt. wide

service road from front side adjacent to Amar

shaheed path road. Amar Shaheed Path is an

elevated road, and connects traffic from Kanpur to

Rae Bareli, Sultanpur and Faizabad, or vice versa.

The road starts at Faizabad Road passes through

Sultanpur Road (near Gomti nagar extension), Rae

Bareli Road and ends at Kanpur road, spanning astretch of approximately 23 km.

45 mt. wd service road

9.0mt. wd road

24.0mt. wd road30.0mt.Wdroad

Commercialland

Amar shaheed path road

N

S

W

E

TOPOGRAPHY: Site has little undulation with somemounds, can be considered as flat land.The site is Approx. 6 mt. below the highway.

EXISTING VEGETATION: There is no significantvegetation except some buses and shrubs.

SOIL CONDITION: The soil character istics foundhere are deep, moderately well drained to well

drained with loamy surface texture,

SURROUNDING: Green park in north west side. Muzhaffar nagar ghuswal village at south east side.

Commercial land on north east side.

30 mt wide road in west direction.

Existing site view

WATER SUPPLY:

DRAINAGE:

The rainfall water will be disposed-off in two

ways, one is through Internal drainage system,

which will carry rooftop water to recharge pit

and second External Drainage system, in

which the overflow from recharge pit will be

carried by drainage line proposed by ansal cityand ultimately terminating to the existing

natural pond.

The potable water supply of desired quality and

purity shall be ensured by tapping under ground

water.

Therefore, the sources of water identified for

water supply system in the project are:

1. Ground water as under ground tank.

2. Recycling of treated effluent form STP for

gardening.

POWER SUPPLY:

11 KV H.T. line is available from Ahemamau,

substation.

TELEPHONE:

Telephone line underlying by the telephone

department.


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CLIMATE AND RAINFALL

Climate of Lucknow can be summarized as warm

sub tropical climate with cool and dry winters from

December to February and Hot and Dry summers

from April to June.

Rainy season generally continues from mid June to

mid September, when Lucknow gets an average

rainfall of 1010 mm (40 inches) mostly from the South

West monsoon winds.Summers are generally quite hot with temperatures

rising from 40 to 45 degrees Celsius range, the

average high temperature being 31 degree Celcius.

In winters, the maximum temperature is around 21

degree Celsius and the minimum ranges from 3 to 4

degree Celsius. Fog is commonly observed from late

December to late January.

WIND DIRECTION

ANNUAL RAINFALL

Winds

Hot and dusty during summer

Dry and cold winds from in winter north east

Winds in monsoon from south east

Relative humidity:Dry period 20-55%

Wet period 55-95%

CLIMATIC INFERENCES:

Building should be designed to provide comfort, any

building surface such as window, walls and roof that is

exposed to sun can admit solar radiation, to avoid the

inwards flow of heat. either direct or indirect, The

surface on which the sun rays fall must be protected,

besides preventing direct radiation of sun as efficient control

system should take into consideration the following:

Maximum of solar heat entering room in winter.

Protection against and wind and rain

Provision of adequate ventilation at all times.

Control of insects ,dirt ,dust.

Adequate exterior vision.

ORIENTATION:

The prevailing flow towards the south

east direction through major part of the

year.

The building should be oriented in such a

way that a maximum no. of opening should

get the natural north light so, max. number

of opening should be north side.

FORM AND PLANNING:

Courtyard types buildings are very

suitable .it is the most pleasant space for

most of the year.

Because it allows wind and traps the sun.Deduction of surface exposed to solar

radiation.

Shading of external walls through

provision of louvers, fins and recessedwindow.


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ORIENTATION ACCORDING

TO SUN

ORIENTATION ACCORDING

TO WIND

MOST SUITABLE

ORIENTATION

SUN MOVEMENT DIAGRAM


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LITERATURE STUDY & STANDARDS

OPD

-Emergency/

casualty

-Consultancyservices

-Diagnostic

facilities

-Physiotherapy

-Pharmacy

IPD

-Surgical suites-

ICU/ CCU/ HDU

-Cath lab-Day care

-Pathology

-Wards

SERVICES

-CSSD

-Laundry & Linen

-Stores-Diet Kitchen

-Bio-medical

HOSPITAL PLANNING HAVE 3 MAIN AREAS:

ENTRANCE AREA :There can be 4 access points to the site, in order to

segregate the traffic.

1.Emergency: for patient in ambulances and other

vehicles for emergency department.

2.Service: for delivering supplies and collecting

waste.

3.Service: for removal of dead.4.Main : for all others.

ENTRANCE

EMERGENCY MAIN FOR ALL

SERVICE

DELIVERYSERVICE

FOR DEAD

ENTRANCE DIAGRAM

O.P.D. (OUT PATIENT DEPARTMENT):

OUT PATIENT ENTRANCERECPTION/ ENQUIRY

WAITING AREA

REGISTRATION/

MEDICAL RECORD

WAITING AREA

CONSULTATION/EXAMINATION

MINOR TREATMENT AND

PROCEDUREADMITTING OFFICE

HOSPITAL INPATIENT X-RAY LAB OTHER NVESTIGATION AND

THERAPEUTIC FACILITIES

DISPENSING PHARMACY INJECTION DRESSING

OUT PATIENT

O.P.D. LAYOUT CHART

It should also be easily accessible to the laboratories,

radiology, pharmacy and physical therapy department

since outpatients use practically all of the diagnostic and

therapeutic departments during every visit.


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EMERGENCY SERVICES :

LOCATION:Should be located on the ground floor.

Easy access for patient and ambulances.It should preferably have a distinct entry independent

of OPD main entry so that a very minimum time is lost

in giving immediate treatment to causalities arriving in

the hospital.

Should be marked with proper lighting and signs, andshould be easily visible.

Since it becomes the main entrance for the hospital

at night, it must relate to public and vehicular

transportation.

Close proximity to the radiology unit is essential to

facilitate the movement of accident cases and save

every precious minute.

DESIGN OF EMERGENCY:Entrance to emergency should be sheltered to protect

ambulance patients from the weather while unloading.Adequate reserved parking for ambulance and cars of

patients and medical staff.

Ambulance entrance should be large enough to admit

one or more negotiating with stretchers.

AUTOPSY ROOM AND MORTUARY:

Facilities and space required in autopsy room is

autopsy table work counter, storage room, cold

storage and doctors office.The location of mortuary should avoid public

movement.

Functional Relationship Diagram

Emergency Unit

DIAGNOSTIC FACILITIES:

DIAGNOSTIC AREA

IMAGING SERVICE LABORATORY

RADIOLOGY

ULTRA SOUND

C.T SCAN

RECEPTION

RECORD

CLINICAL LAB

FLOW CHART OF DIAGNISTIC

The lab should be situated in the ground

floorSo that it can serve emergency ,outpatient

and the in patient department.It should be close to surgery, I.C.U.

X RAY ROOM

ULTRASOUND CT SCAN M.R.I


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PHISIOTHERAPY:

The department is more frequently visited by out-

patients but should be located at a place which may

be at convenient access to both outdoor and indoor

patients with privacy. It should also have a physical

and electro-therapy rooms, gymnasium, office, store

and toilets separate for male and female.

ELECTROTHERAPY

PHYSICAL MEDICINE AND REHABILITATION

PHARMACY:

Pharmacy should have component of medical store

facility for indoor patients and separate pharmacy

with accessibility for OPD patients.

I.P.D. : OPERATION THEATRE

One ot for every 50 general inpatient beds One ot for every 25 surgical beds.

In the surgical department, treatment is given to the

patients whose conditions have been diagnosed but

cannot be cured solely with medication.

There may be four well defined zones of varying

degree of cleanliness/asepsis namely, Protective

Zone, Clean Zone, Aspectic or Sterile Zone andDisposal or Dirty Zone. Normally there are three types

of traffic flow, namely, patients, staff and supplies.

FLOW CHART OF SURGICAL DEPARTMENT Other hospital areas

PATIENT WARDS

Post Operative

recovery

I.C.U.

Operating rooms TSSU

Anaesthesia roomSrub up

Pre operative beds

Doctors

change

room

Nursess

change

room

Instrumentstore

CSSD

PatientsDoctors Nurses

OPERATION THEATRE

CSSD

PREPARATION ROOM

INSTRUMENT STORE I.C.U


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I.C.U & H.D.U:

It should be the ultimate medicare the hospital can

provide with highly specialized staff and equipment.

The number of patients requiring intensive care may

be about 5 to 10 percent of total medical and surgical

patients in a hospital. The unit shall not have less than

4 beds nor more than 12 beds.

LOCATION

This unit should be located close to operation theatredepartment and other essential departments, such as,

X-ray and pathology so that the staff and ancillaries

could be shared.

FACILITIESNurses StationClean Utility Area

Equipment Room

DAY CARE UNIT:

The unit is for patients who need a surgical operationor clinical procedure but do not need to stay in

hospital overnight, or who require an endoscopic

procedure either as an inpatient or a day patient.

PATIENT

DAY CARE UNIT FLOW CHART


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FLOW CHART OF LABORATORY

PATHOLOGY & BLOO BANK:

Every hospital must have a blood bank under the

drug and domestic rule 1974.

2 labs and blood collection room should be provided

and they all must be air conditioned.

BLOOD BANK

MICROBIOLOGY LAB

BACTERIOLOGY

VIROLOGY LAB

MEDIA PREPARATION &

STORAGE

SEROLOGY LAB

TOXICOLOGY

FORENSIC MEDICINE LAB


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WARD BLOCK:

The basic aim in planning a ward unit should be to

minimize the work of the nursing staff and provide

basic amenities to the patients within the unit. The

distances to be traveled by a nurse from bed areas to

treatment room, pantry etc. should be kept to the

minimum. Ward unit will include nursing station,

doctors duty room, pantry, isolation room, treatment

room, nursing store along with wards and toilets asper the norms.

Operation Theatre a. 1 OT for every 50

general in patient beds.

b. 1 OT for every 25

surgical beds.ICU beds = 5 to 10 % of total beds

Floor space for each ICU

bed = 25 to 30 sqm (this

includes support

services)Floor space for paediatric

ICU beds = 10 to 12 sqm per bed

Floor space for high

dependency Unit(HDU) = 20 to 24 sq m per bed

Floor space hospital

beds (general) =15 to 18 sqm per bed

Beds space = 7 sq m per bedMinimum distance between

centres of two beds = 2.5m (minimum)

Clearance at foot end of

each bed = 1.2 m (minimum)

Minimum area for aperture

(Window / ventilators opening

in Fresh air) = 20 % of the floor

area (if on same wall)

= 15 % of the floor area

(if on opposite walls)

GENERAL WARD

SERVICES:

CENTRAL STERILIZATION AND SUPPLY DEPARTMENT

(C.S.S.D):The sterilisation process may be carried out entirely or partially on-

site, the latter relying on an external supply source to regularly

restock the hospital sterile goods store/s. The scale of operation can

be small or large, dependent upon the requirements of the serviced

departments, for example, an Operating Unit requires the services of

a Theatre Sterile Supply Unit (TSSU) or a full Central Sterile SupplyUnit (CSSU), whereas an Acute Inpatient Unit requires only a basic

sterile supply service.

Location:

The cssd should be close to the casuality, operation theatre.In

multistoried buildings cssd may be planned in the lower floor right

under the operation theatre where vertical movement will be the

quickest possible movement of the material.

LAYOUT OF CSSD


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LAUNDRY:

It should be connected to the power plant as it is the

largest user of power, steam and water.

It should be near the service elevator.

FOOD SERVICE DEPARTMENT:

A ground floor location is preferable. As it is

convenient to deliver supplies.

The storage area should be close to the unloadingdeck.The cafeteria and dinning area should be close to the

food preparation and production area and within reach

to the hospital reach.

MEDICAL RECORDS:

It should be close to the administration block.It should be conveniently close to the corridor leading

to doctors lounge so that the staff can be

conveniently stop by and complete their records.

MEDICAL GASES:

As oxygen is essential for life, events leading to

hypoxic situation for the patient have to be treated

immediately and carefully. Oxygen is given for

treatment and prevention of a variety of a variety of

cardiac, pulmonary and other diseases.

Oxygen :

This gas is used in general anesthesia in hospital all

over the world. Due to analgesic effects,nitous oxideis also used in amixture with oxygen for analgesia in

painful interventions in hospital environment(obstetric

wards, dental surgery

Nitrous oxide :

Compressed air is required in hospital to operate

surgical instruments such as pneumatic drills,saws,ot

tables,etc.In orthopedics, dental and ent departments.

Air is also used to run ventilators in OT and intensive

care units and may be used as a carrier gas in

amesthesis

Medical Air:

Carbon dioxide is used for varoius medical purpose

such as insfflation gas for minimal invasive

surgery(laparoscopy,endoscopy,arthroscopy)to

enlarge and stabilize body cavities for better visibility

of the surgical field.Carbon dioxide inliquid phase

temperature as low as -76degree and may therefore,

be used for cryotherapy or for local analgesia by

external application into the skin surface.

Carbon Dioxide:

Besides the gases mentiones,it also provide a

cantralized vaccum suction system at all outlet points

which can be used lieu of portable suction machine

and anesthetic gas scavengiring system for the

excess anesthetic gases in ots.

Vaccum Suction:

EMERGENCY EXIT

TOILET

EMPTY

CYCLINDER

C

O

R

R

ID

O

R

ENTRY

ENTRY

LAYOUT FOR MEDICAL GAS PLANT

A GAS SYSTEM VACUUM SUCTION

N0 MANFOLDCOMPRESSOR

FOR MEDICAL

AIR

LIQUID O TANK

O MANFOLD

OFFICE


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AREA TEMPERATURE(DEGREE)

OPERATING THEATRE 21-25

DELIVERY ROOM 21-25

RECOVERY ROOM 24

NURSERY 24-26

INTENSIVE CARE 24-26

HVAC SYSTEM:

There is a need for conditioning air in particular areas

of the hospital to achieve certain level of temperature,

humidity, filtration and circulation.

The areas that require air-conditioning:

Operating rooms, labour-delivery suites, icus,

nurseries, morgues,

Autopsy rooms.

One major difference is that hospital air conditioning ismore attained to patient and patient treatment rather

than comfort.

WATER SUPPLY AND SANITARY SYSTEM:Water requirement of hospital :

The minimum requirement of water supply for an

hospital shall be in accordance with the national

building code(NBC).

Hospital (including laundry )per bed.Number of bed not exceeding 100 = 340

litre per head per day

A) Number OF BEDS EXCEEDING 100 = 450

LITRE PER HEAD PER DAY

B) Nurses/MEDICAL STAFF QUARTERS = 135

LITRE PER HEAD PER DAYC) Minimum HOT WATER REQUIREMENT = 45

LITRE PER HEAD PER DAY

S.NO. FITMENTS I.P.D (M/F) O.P.D .MALE O.P.D FEM. ADMIN (M) ADMIN (F)

1. W.C 1 FOR 6 BED 1 PER 100 2PER 100 1 PER 25 1 PER 15

2. WASH BASIN 1/24PERSON &

1/24 BED

1 PER 100 1 PER 100 1 PER 24 1 PER 25

3. BATH WITH

SHOWER

1 PER EVERY 6

BED

------ ------ 1 PER FLOOR 1 PER FLOOR

4. BED PAN 1PER 6BED

WARD

------- ------- ------ -------

5. CLEANER SINK 1 PER EACH

WARD

1 PER FLOOR 1 PER FLOOR 1 PER FLOOR 1 PER FLOOR

6. KITCHEN SINK 1 PER EACH

WARD

------ ------ ------ -----

7. URINALS 1PER 20 PERSON 1 PER 50

PERSON

------- 1/20PERSON+2.

5%

1/20PERSON+2.

5%

Norms for fitments:

ELECTRICAL SERVICES:

Electricity service should be available 24 hour a day. There should be power back up

system as per requirement.


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BIOMEDICAL WASTE:

Biomedical waste, (bmw), consists of solids, liquids,

sharps, and laboratory waste that are potentially

infectious or dangerous and are considered biowaste..

It must be properly managed to protect the general

public, specifically healthcare and sanitation workers

who are regularly exposed to biomedical waste as an

occupational hazard.

COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIO-MEDICAL WASTES

This bag is used for collecting dry waste material

which is not infectious. Materials like paper, plastics,

cardboard boxes, and other dry waste generated in

hospital office or in the wards are disposed in this bag.

This is not biomedical waste.

Black Bag :

This bag is used for the disposal of plastics collected

from ots, icus and wards.

Red Bag :

This bag is used for highly infectious items like

pathological waste, human anatomical waste such as

body parts, amputated parts/organs, tumors,

placentas, aborted or dead fetuses ,blood soaked

cotton bandages, animal tissues, organs, carcasses

etc.

Yellow Bag :

This bag is used for collecting the segregated metal

sharps such as needles, blades, saws, scalpels and

glass pieces.These bags must be puncture proof.A metal box or a plastic canister should be used

for collecting the metal sharpsIt is strongly recommend that even metal sharps

and broken glass articles should be segregated.Broken glass sharps should be collected in blue/

white bags.

Lead containers:

These containers are used for collecting radioactive

wastes

This waste is to be disposed as per the guidelines

provided by bhabha atomic research centre (barc),

mumbai.

Radioactive wastes, especially cobalt needles usedfor brachy treatment must be returned to barc.

Cytotoxic waste can be stored in sturdy cardboard

boxes and later can be incinerated.

Blue or white opaque Bag :


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Case Study 1: Sahara Apollo Hospital,Lucknow

The 550 bedded hospital spread on an area of 27 acres, is planned to

offer services in more than 52 specialities, super specialties anddiagnostic modalities under one roof complete diagnostic solution.

Distance from railway station is 9km.,Distance from Hazratganj is

7.2km.

Location :Haniman Chauraha ,Gomti Nagar, Lucknow.

Client :Sahara india Parivar

Architect :Architect Hafeez Contract. Archimedes cons. Pvt. Ltd.Site area : 27 acres

Built up area : 74000 Sqmtr

Cost of project : 400 Crores+

No. Of beds : 550

Completion : 2008

Site is located in gomti nagar, a newly developed area in lucknow.

On the west there are institutes.

On the east is the residential belt.On the north is a stretch of commercial land.

On the south runs a railway line and further back is the residential

stretch.

Sahara hospital lucknow :

About hospital :

Approach to hospital :

Project brief :

Site surrounding :

Railway line

24 mtr wide main road

Sahara hospital is situated in gomti nagar ,Lucknow,U.P.


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The main acess is from 24 mtr wide road on two side. Of

which otherside of the road is Gomti Nagar commercial

Plots with no. Of small malls at other vicinity is filled with

residential area.There are two entry from south i.e. one for emergency

and other for OPD and doctors.One entry is from east side for exit for OPD and doctor.

One entry is from north east for service entry .

This hospital is indias first 7 star rating multi speciality

tertiary care hospital of an estimated capacity 550 beds

located in lucknow .It is estimated to care for almost 3 lakh

people with its OPD and 50000 patents through IPD

anually.

To understand the designing of a specialty hospital and to

analyse and understand the issues and technicalities

associated to it and its merits.

The L-shaped 4 storeyed building high, block houses the

diagnostic zone in one arm and OPD in other.

The 16 storey high tower is the patients tower rising

from the center and is fronted by a double height lobby,

which function as the entrance foyer for all the zones.

Two organically shaped double heighted atrium emerge

from the main foyer.The interior are highlighted by the sunny

vistas,closeness to nature and soothing materials.

Acess to block :

Validity of the study:

Objective of the study :

About block organization :

N

Entry for

emergency

Entry for opd

Entry for service

Exit for opd


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Parking :

Basement parking is provide for 350 cars.

Basement parking is underneath the large and open green

space and is accessed by means of 2 ramps on either ends.

Parking is categorized as follows :

1.Ambulatory 5 in nos. At the emergency exit

2.Staff/vip behind the linear block on the surface.

3.Visitor at basement

Circulation :

Entry is provided from the middle of the parking site.

Public is restricted to a certain extent in the building so as to

prevent them from interfering in the privacy of staff, nurse and

doctors.Horizontal circulation is done through corridors.

Vertical circulation by means of lifts and staircase.

Design consideration :

The l shaped storeyed high block houses the diagnostic zone

in one arm and OPD in another.

The 16 storeyed high tower is the patientstower rises from

the center and is fronted by a double height lobby, which

functions as the entrance foyer for all the zones.

Two organically shaped double height atrium emerge from

this main foyer.

The interiors are highlighted by the sunny vistas, closeness to

nature and soothen materials.

The service block is separate and linked by a bridge.

More green area is left for better environment i.e about 75 %

area is green area.

Sales

GREEN AREA


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GREEN AREA

EMERGENCY/

TRAUMA

ATRIUM

ATRIUM

ENTRANCE

LOBBY

DIAGNOSTIC

RECEPTION

O.P.D

SERVICE

APARTMENT

IPD TOWER

SERVICE

BLOCK

WAY TO BASEMENT PARKING

EMERGENCY

ENTRY

OPD

ENTRY

OPD

EXITSERVICE

ENTRY

Site zoning :About function:

Entrance to the site is from north east as

well as from south east.The site is almost of a 1:2 proportion;

diagonally and the portion that makes up the

foreground caters to the adequate landscape

elements with underground parking beneath it.

The main hospital structure is located in thesecond notional portion of the site i.e. on the

back ground stretching towards the south

west.

The service block is located in the south

west corner of the site.Provision for morgue has also been provided

next to service block on the extreme south

west corner.

Provision has been made for patient relative

accommodation on the northwest region of the

site.A connecting bridge connecting the service

and the tower block is also present.

About planning :

Ground floor :

Diagonostic :Two entries ,one main and one from the wing perpendicular to O.P.D.

Multi entries to all the daignostic areas.

Linear block consists of three zones in ground floor that are :

1.Emergency O.T , triage rooms ,plaster rooms ,physiotherapy ,dialysis

and consulting rooms.

2.Diagnostic radiology ,ct scan

3.Pathology labs , administration.

All the above areas have separate entriesconnected via an atrium and are inter connected

by 2.4 m doubly loaded corridor.

All the wings are connected with 2.4 mtr

corridor.

IPD


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All the above areas have separate entries connected via

an atrium and are inter connected by 2.4 m doubly loaded

corridor.

All the wings are connected with 2.4 mtr corridor.

The placing of block in l shaped reducing the 30 %

circulation area.

At every 30 mtr distance in corridor there are fire exit .

Proper waiting area provided in all the facilities.

Lift is provided at the center as well as at the corner.

CIRCULATION AREA, LIFT LOBBY, RECEPTION,

EXAMINATION ROOM

G.FR. PLAN (O.P.D )

1

1

2 3 4 5 6 7 8 9 10

11 12 13 1314 14

GROUND FLOOR PLAN

(DIAGNOSTIC BLOCK)

2.4 M WIDE CORRIDOR

LIFT LOBBY

PATIENT LIFT LOBBY

LIFTLOBBY

RECEPTIONWAITING

ORTHOPAEDICROOM5

NEORO SURGERYCONST.3

NEURO PHYSICIAN3

RECEPTIONBACK SIDE

OPD

IPD

ENTRANCE

LOBBY

N

EMERGENCY ENTRY

MAIN ENTRY

DIAGNOSTIC

OPD

IPD

ENTRANCE

LOBBY

EMERGENCY ENTRY

MAIN ENTRY

GROUND FLOOR PLAN

EMERGENCY:

Emergency is 12 beded in which 6 are for criticalpatient,

6 are for observation, two are triage.

One O.T is there with plaster room and procedure

room.

It has one nurse station and pharmacy store.

It has one counseling room.It has one linen room attached with equipment room.

Front block of 4 tier structure houses O.P.D block.

Simple in both planning and service than I.P.D anddiagnostic block.Main entry is from the parking area.

Directly connected to the atrium and having its own

reception.

Distribution in all four floors are similar in design.

O.P.D :

Area of doctor consultance room is

2950x3700mm

Area of exam. Room is 2950 x 2400 mm.

Area of O.P.D:

N

O.P.D (specialty

facilities per floor):

GROUND FLOOR

INTERNAL MEDICINE

ORTHOCARDIO

BRONCHIOLOGY

PULMONARY

PLASTIC SURGERY

NEURO

PLASTER ROOM

FIRST FLOOR

OPTHAMOLOGY

OBSTETRICS

ENDOCRINEOLOGY

PAEDIATRIC

OPTICAL SHOP

SECOND FLOORGATRO

AYUVEDIC

DERMATOLOGY

UROLOGY

NEPHROLOGY

E.N.T

PHYCHIATRIC

THIRD FLOOR

AROMA THERAPY

PANCH KARMA

OPD

First floor :


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Roll No. - 817


First floor :

Facilities provided in first floor:

Operation Theatre

Pre operative room

Surgical I.C.UStaff area

C.S.S.D

Day Care Unit

H.D.U

Operation Theatre Zone :Placed at the end of first floor with diagnostic

facilities just below it and I.C.Usadjacent to it.

Separate entry for patient, doctors and I.C.U..

Isolated from rest of the hospital hence

minimum traffic flow.

10 O.T present with shared support facilities.Its own sterile area between clinical and ward

zone.

Intensive Care Unit :120 bed C.U is placed adjacent to O.T

complex on first floor placed in doubly corridor.

Comprises of 11 bedded M.I.C.U ,12 beded

surgical I.C.U ,12 bedded neuro I.C.U, 4 beded

transplant I.C.U and coronary I.C.U.I .C.U are attached to the cath lab.

Centrally located nurse station with central

monitoring system.

High Dependency unit:Direct related to nurse station.

8 beded high dependency ward with attachedtoilet is provided.

Artificially lighted and ventilated.

OT

OT

OT

PRE OPERATIVE S.I.C.U C.C.U

CATH LAB

STAFF

AREASTAFF

AREA

CSSD TRANS.

I.C.U

I.C.UWAITING

WAITING

DAY

CARE

HDU

FIRST FLOOR PLAN (O.T ZONE)

GENERAL

WARD

GENERAL

WARD

GENERAL

WARDGENERAL

WARD

GENERAL

WARD

GENERAL

WARD

ISOLA

TION DELUXE DELUXEDELUXE DELUXE

PRIVATE

WARD

PRIVATE

WARD

SEMI

PRIVATE

WARD

SEMI

PRIVATE

WARD

SEMI

PRIVATE

WARD

SEMI

PRIVATE

WARD

5THFLOOR PLAN ( 2 LVL) 6THFLOOR PLAN ( 3 AND 4LVL)

30I.C.U

Area of general ward : 9000x7350mm

Private room : 3500x 3650mm

Semi private room : 4550 x 3675mm

Deluxe room : 3675 x 3650 mm

Semi delux room; 3675x 3500

GENERAL WARDS

SEMI PRIVATE

WARDS

PRIVATE WARDS

SEMI DELUXE

DELUXE

150

70

30

15

5

30I.C.U

P.D and General Wards :

15 storeyed tower houses the I.P.D and

general ward ,placed on the junction of

the blocks.Compact square is adopted

Patient and visitor entry is from the

same corridor of width 2.4m.

Nurse station ,service lifts are placed in

the same corridor.Beds are placed along the periphery to

have maximum ventilation and light.

Piped oxygen and suction is provided in

each ward.

Spacious rooms are separated from the

other rooms.

Two nursing station are provided .Six

bedded general wards placed in tower of

two floors.

Units are inter connected with the toilet

at the end.

For privacy curtains are used.

Semi private wards:Room with two beds and attached toilet.

Balcony and curtain for privacy.Equipped with all facilities and sixth floor.

Private Wards:Consists of a patient room with attached toilet and pantry.

Bed is totally remote control.Deluxe room:Single deluxe ,deluxe and semi deluxe suit are located in

the center with all the services in central core.

Rooms with attached toilet ,balconey and sofa cum bed

is alloted.

Maternity and Neonatal I.C.U :Located on the first floor of the tower.

Consists of two labour rooms.Nurse station and other services are provided

in the central core.Neonatal I.C.U is bedded with all latest

technology technology and mother feeding

room.

No.of O.T , No.Of Beds and No. of Consultant in different specilitation :


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Roll No. - 817


No.of O.T , No.Of Beds and No. of Consultant in different specilitation :

Services:Water supply :

Total water tank 7 that are :

1.25 lakh ltr 5 tank and2 tank of 2 lakh ltr.

Note : 2 tank of 2 lakh ltr capacity are for

fire.

Water treatment plant :

2 for filtration of capacity 15000 ltr.2 for boiler of capacity 15000ltr.

2 for raw water

2 for cosmetic

2 for soft water

Hydro pneumatic system :

3 set of two pump.

Note : 8 pump other to above are for fire.

BED

O.T

CONSULT.

80

2

8

60

2

6

60

2

6

50

2

6

40

2

4

40

1

1

GENERAL MEDICINE GYNAE & OBTETRICS PEDRIATIC & NEONATAL ORTHO & LIMBS E.N.TCARDIO

HOSPITAL

Drainage:14 sump pumps are locatedin the

basement.

Electrical :Total consumption 15 kw for

emergency.

Ups :300 kva (2) 200 kva (2)

Dg set : 1500kva 3 set 2000 kva 2 set

Electicity load:

1300 amp in winter

1700 amp in summer

H.V.A.C ;700 ton chiller of 3 in no.

Note : in summer 2 no. of chiller work

And in winter only one is in working.

Biomedical waste flow chart :

HDU

OT

OT

OT

PRE OPERATIVES.I.C.U C.C.U CATH LAB

STAFF

AREA

CSSD TRANS.

I.C.U

I.C.U DAY

CAREBIO.WASTE

SERVICE ENTRY

Bio gas flow chart :

Laundary & kitchen Service:

Laundary is on the first floor of service block .

Laundary has 5 washing machine, 4 slucing

machine, and 4 hydro extractor.

Kitchen has an veg,non veg zone, patient liquid

food zone,cafeteria preparation zone.

It has a 45 staff dinning attached to it and 55 for

people.

Medical oxygen

Nitrous oxide

Vacum suction

Carbondioxide

MEDICAL GASOT

PRE OPERATIVE S.I.C.U C.C.U CATH LAB

CSSD TRANS.

I.C.U

I.C.U DAY

CAREHDU

LAUNDARY

Gas station is placed at the back of the kitchen.

20-22 commercial cyclinder is the per day

consumption.


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Roll No. - 817


HT PANELBOILER

ROOM

L.T PANEL

HT PANEL

STORE

D G SET

A.C PLANT

OFFICE

GAS PLANT

BIO.WASTE

Sercive ground floor plan

KITCHEN

STAFF DINING

MEDICAL

STORESTAFF LOCKER

Sercive first floor plan


30/45


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Roll No. - 817


INFERENCES :

Adequate waiting area in all departments

Atrium houses a large number of visitors and has different accesses to different departments thereby restricted the flow of visitors to this areas only.

The service block forms the major hub for hospital functions, without the interference of the main stream of the hospital.

Segregation of visitor, staff and service entry.

Separate service lift for food, linen, staff, visitors and patient help to avoid congestion.

Flexibility for the future so that any floor could be converted from wards to rooms and vice versa.Toilets are designed according to the needs of patient.

Emergency evacuation is not catered for since there is no provision of a ramp.

Lack of natural light and ventilation in lower floors.No dirt disposal corridor in the O.T. complex.

Increase in the cost because of introduction of service floors in the building.Service floors create better floors usability as area in services is segregated on floors.

Service floors gives design flexibility as services considerations in design are reduced.

CASE STUDY 2 R M h L hi G ti L k


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Roll No. - 817


CASE STUDY 2 - Ram Manohar Lohia, Gomti nagar, Lucknow

Ram Manohar Lohia HospitalLocation : Vibhuti Khand, Gomti Nagar at Lucknow

Site Area : 25 Acre

Ground Coverage : 20,000 sq m. (30.7%)

Year of Completion : 2007

Introduction

Ram Manohar Lohia combined hospital is located in

Vibhuti Khand, Gomti Nagar.

Access is from 30m wide road which further joins to the

60m wide main road.

In front of its main entry is the Punjab National Bank

Institute, Mandi Parishad and UPRNN head office.

In front of its OPD entry is the rear side of WAVES

multiplex.

The hospital serves as a referral centre for the populationof Lucknow and populations from adjacent districts as well

as belt of Eastern U.P.

The diagnostic services at the institute are state of art in

health care and the Department of Pathology and

Microbiology have been upgraded to State Referral Centre

for Laboratory Investigation.

Department of Radiology has high-end facilities with a

comprehensive 64 slice CT scan, 3 Tesla MRI, BMD,

mammography etc.The hospital is networked by a all- inclusive web-based

HIS system which provides electronic records from

registration to discharge.The administrative wing comprises of the Director,

Finance controller and Engineers in Engineering divisions

and Joint Director Material Management.

Main Display Board

About Planning :


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Roll No. - 817


About Planning :

The basic planning of Ram Manohar Lohia Hospital is

the concept of placement of various functions space

along the two corridor.

Along one corridor OPD , Diagnostic facilities,

Pathology Services, Emergency, ICUs, OTs are

placed whereas along second IPD blocks are placed.These two corridors are separated by open spaces

between them .

Ramps are projected out in these open spaces.

There is separate entrance for individual blocks but

interconnected through straight running corridors.All services are clubbed together and placed at rear

end.

Patient relatives blocks are also provided to

accommodate the relatives of patients and also

manage the crowd of hospital.Ample space is left for landscaping but not fully

developed by the authority.

Building is north-south oriented according to thecomposite climate of Lucknow.

OPD BLOCK

Double height waiting area in centre and

consultant examination room at side

Every OPD have its individual space.

Registration counter in front of the entrance

hence clearly visible.

Space for making queue is provided in front of

the counter.Separate entrance for OPD provided from side

road.

Skylight in the central waiting space for light andventilation.

DIAGNOSTIC BLOCK


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Roll No. - 817


Rooms are placed at the periphery so that itcan have natural light and ventilation.

Pay ward had separate entry at the ground floor.

The rooms are located at the periphery and the

toilets at the one end in between the wardsNurses station, DU, CU, treatment room, nurse rest

room, toilet, doctor room provided in the middle.Separate staircase is for services and one lift too is

proposed for that.

Pay ward have contain single bedded room with

attach toilet.

MAIN BLOCKMain entrance to the hospital is through

central wing.

It has administration the first, second floor

and entrance at the ground floor through spiral

staircase the left side of the entrance lobby.

Entrance lobby is of double height.Left side of the central wing is the radiology at

the ground floor and pathology at the first floor.

This not been constructed yet.

At the right side is the maternity deptt. On

ground floor and ICCU, ICU at the first floor.

DIAGNOSTIC BLOCK

Physiotherapy deptt. is places at the ground

floor and dialysis at the first floor.

Ample waiting space in front of the deptt.

The deptt. is equipped with latest

equipments.

Has corr idor running on its two sides, one

leads to the ward and the other leads to the

main entry.

Three hospital lifts are present, no passenger

lift, as it is only storey.

Toilets ventilated in open court and placed

along the long straight corridor running across

the whole hospital.

There are 3 IPD blocks, one contains pay

wards and other two are general wards.

Emergency / Casuality


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Roll No. - 817


Emergency / Casuality

Adjacent to ICCU, ICU unit is emergency block.

it has separate entrance and at the rear end of

the hospital beside service block.

As Pathology and Radiology department is not

constructed, temporary pathology is in emergency

block.

Two CTs are in emergency block at groundfloor.

OT ComplexSeparate entrance for doctors and patient.

Visitorsentry is prohibited in OT complex.

There are 6 OTs with dirty corridor running

along its periphery.

This dirty corridor then join to the staircase

which leads to the ground floor directly without

creating any cumbersome within the hospital area.

The dirty contain disposable bay which is shared

by two OTs.it has post operative room outside the OT

complex and pre operative inside of it.

Nurses station is located as such , that nurses

can look after all patients.

Doctors and nurses enter into OT through their

changing room.Doctors and nurses lockers are also present.

Emergency Block

O.T. View

Supply of gases

Automatic system for washing hand

Digital machine for

temp, , time &

emergency callingTo open the door ,to enter in O.T.touch pad.


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Roll No. - 817


Circulation spaces

Horizontal circulation is prominent and main feature

of the hospital.

The corridor of 3 mt. width run across the various

departments.

Vertical circulation is through staircase, lifts and

ramps.2 hospital and 3 passenger lifts are provided.

Service staircase is separately provided.2 ramps of 1:10 slope is provided.

Services

Electric supply from power corporation limited, UP. As a stand by there is one DG set of 125kv

capacity.

Water stored in underground tanks by using 2 bore

wells.

There are 3 hand pumps to supply drinking water to

the patient relativesand other visitors.

All services are placed at rear end and connected tohospital through corridors.

Structural analysis

Column grid of 6.4m x 6.4m in all blocks.

Floor to floor height is 3.6m at each floor.

Beam depth is 600 mm.

SPIRAL STAIR CASE LARGE AND WIDE CORRIDORS

STERLIZING OF EQUIPMENTSELECTRICAL SUPPY

PARKING


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Roll No. - 817


Parking in front of every block entry.Separate parking for staff and patient and visitors provided.

All parking is on surface.

MATERIAL

Washed grit finish in white cement and marble chip in exterior.

The exterior finish is maintenance free.

Floor finishes by Kota stone in the circulation spaces and mosaic

tile in the remaining spaces.

Wall finishes is provided by plain plaster with white wash.

INFERENCE

All the spaces should be connected to each other.Every deptt. should have natural light and ventilation.

Sufficient waiting spaces should be provided in OPD block.

Emergency entrance should be close to the main entrance and

free from any hindrance.Emergency, OT, ICU, Diagnostic facilities should be closed to

each other.Diagnostic facilities should also be closed to the OPD.

SUPPLY OF OXYGEN AT EMERGENCY TIME

TO DISINFECT THE EQUIPMENT

CONCEPT


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Roll No. - 817


A hospital is a building which once starts working

difficult to make alteration. Therefore require great

focus while designing. Architects must have good idea

of advancements of the medical and hospital needs.

The major focus while designing should be on the

inter relationship of the spaces and volumes.

Connectivity and segregation of spaces. Differentiate

the movement of patient ,doctor, staff and visitors etc.

Functioning of the hospital is also very importantissue to be considered from very beginning while

designing. Services are the heart of hospital.

SEGREGATION OF MOVEMENTS

There are 4 entries provided in hospital

1. Main entry also as O.P.D entry which is given

from 30.0 mt. wide road on south west side.

2. Emergency entry is given at north which is

assessed by 45.0 mt. wide service road andclearly visible from Amar shaheed path.

3. Staff and doctors entry is given from south east

side, as there residences are also provided in

same direction.

4. Services entry is provided at east corner of

hospital block.

9.0mt. wd road

30.0mt.Wdroad

Commercialland

EMERGENCY

ENTRY

O.P.D ENTRY

SERVICES

ENTRY

STAFF &

DOCTORS

ENTRY

SEPERATING NOIST & QUITE ZONE

Noist area like service zone and quite area like O.T.

& wards should be placed at distance.

O.TSERVICES

WARDS WARDS

O.T

SERVICES SERVICES

EMEREGCY

MATERNITY

O.T.

WARDS

ZONING OF THE BLOCKS

Hospital is designed as two blocks of O.P.D & I.P.D.

O.T.

I.C.U

SECOND FLOOR

WARDS

TYPICAL FLOOR

W

ARDS

O.P.D

EMERGENCY

O.P.D

DIA

GONOSTIC

GROUND FLOOR

KITCHEN

O.P.D

MATERNITY

O.P.D

LABORATORY

FIRST FLOOR

N.I.C.U

SERVICES

BASEMENT

SERVICES

PHISIOTHERAPY


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Roll No. - 817


A hospital is a function oriented building.

Its function decides its form.

Form follows function.

CREATING A BUFFER ZONE AT ENTRACE

Buffer zone from the road will help to reduce the

noise of traffic.Huge trees at entry side will help to reduce noise

and pollution.

9.0mt. wd road

30.0

mt.Wdroad

Commercialland

GREEN PARK

ORIENTATION

The chief aim of orientation of building is to provide

physically & psychologically comfortable living inside

the building by creating the condition which suitably

and successfully ward of the undesirable effects of

severe weather to considerable extent .

The prevailing flow towards the south east directionthrough major part of the year.

The building is oriented in such a way that a

maximum no. of opening should get the natural north

light max. number of opening should be north side.

KITCHEN

O.P.D

EMERGENCY

O.P.D

DIAGONOSTIC

GROUND FLOORNW

SE

MATERNITY

O.T.

WARDS

LABORATORY

N.I.C.U

I.C.U

WARDS

PARKING

Separate parking space for the doctors and

staff.

Separate parking for ambulance is made in

emergency.

Basement parking and surface parking is

also provided for visitors.

BLOCK CONNECTIVITY

Diagnostic is placed as it is closer to both

O.P.D & Emergency.

Emergency, maternity, O.T, complex and

wards are placed one above another in

sequence so that to make better vertical

connectivity through lifts.

Services are placed in basement and

separate lifts are provided so that a quickservices can be provided without any

hindrance.

PLANNING CONCEPT


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Roll No. - 817


GROUND FLOOR

A huge entrance hall is provided at entry with double height lobby.At entry in front there is a may I help you counter where a unknown person

can find a suitable path. Behind the counter wall a beautiful mural is provided

which gives pleasant look to the lobby.

Further there is reception on left side and pharmacy counter on right side.

O.P.D BLOCK

OPD block is provided on both side of entrance hall.

In OPD block each consult room room is provides as below layout pattern.

TYPICAL CONSULT ROOM LAYOUT FOR O.P.D

EMERGENCY BLOCK

Proceeding further from entrance hall towards front with 7.0 mt. wide

corridor.

This corridor also act as main corridor which connect each block with

one another.

Moving further on this corridor at left side emergency block is placed.

Emergency block is provided with separate entry on north side of siteplan.So, that a minimum time is loss.

At entry to emergency a reception, nurses station and doctorson duty

is placed in front so that a quick service can be provided.Further a triage followed by x ray, emergency lab, and plaster room.

If patient is in very critical condition then can be directly taken to

emergency O.T. which is provided in emergency block.

DIAGNOSTIC BLOCK

It is provided in front of emergency block.Diagnostic block is placed in such a way so that it remain in direct

connected with emergency and OPD block.

KITCHEN & CAFETERIA

Kitchen at south east side of building block.

Hospital kitchen for inpatient wards is kept separate from kitchen &

cafeteria for staff.. A dietician is also provided in ward patient kitchen, so that a proper

guidance can be provided.

FIRST FLOOR

O P D block is provided as below in ground floor


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Roll No. - 817


LABORATORY BLOCK

Laboratory is provided just above diagnostic block.It is provided with sample collection , blood bank, and other labs like,

microbiology, biochemistry, hematology, immunology.

A media preparation and washing area is also provided.

MATERNITY WARD, NICU, PICU

Maternity ward, NICU & PICU is provided in first floor and is internally

connected with maternity complex.

SECOND FLOOR

O.T. BLOCK

O.T. block is provided above maternity block.

There are 4 O.T.s are provided with shared services at mid.

Dirty corridor is connected with each O.T. block which further leads to

dumb waiter.Planning is based on double corridor system in which sterile corridor is

kept separate from non sterile corridor.

WAITING AREARECEPTIONSERVICE LIFT

PRE LABOUR ROOM

POST LABOUR

& NURSERY

DELIVERY

ROOM

LABOUR O.T.

DOCTORS, NURSES

& STAFF CHANGE

ROOMS PATIENT LIFT

NURSES STATION

& DOCTORS ON

DUTY

DIRTYCORRIDOR

O.P.D. block is provided as below in ground floor.

MATERNITY COMPLEX

Above emergency block Maternity block is provided so that a emergency

labour case can be deal with minimum time loss.

Planning is based on double corridor system in which sterile corridor is

kept separate from non sterile corridor.Dirty corridor is provided with O.T. and delivery room which further lead to

dumb waiter.

MATERNITY BLOCK LAYOUT


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Roll No. - 817


WAITING AREARECEPTIONSERVICE LIFT

PRE

OPERATIVE

O.T. BLOCK POST

OPERATIVE

DOCTORS,

NURSES & STAFF

CHANGE ROOMSCONFERENCE

ROOM

SERVICES

NURSES

STATION &

DOCTORS ON

DUTY

PATIENT LIFT

DIRTYCORRIDOR

O.T. BLOCK LAYOUT

I.C.U BLOCK

I.C.U. block is provided with o.t. complex.I.C.U is connected internally through O.T. block.

A proper seperation of visitors are made, so that a visitors can meet

patient in time limit only.A reception and gown change area is provided between patientsrelative

waiting area and ICU.ICU is provided with nurses station, equipment store, clean utility, dirty

utility, treatment room, ICU lab, ICU pharmacy, and a doctor on duty with

his rest room.

All patient beds are provided in glass cubicle , so that a clear visibility can

be made.Distance between each bed is kept 3.0 mt. which is more than required.

TYPICAL FLOOR

WARD BLOCK

Al above floors are provided with wards.

RAMP


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Roll No. - 817


FLOOR HEIGHTS

There is one ramp is provided in hospital at centre place with slope 1:15 and width of

3.0 mt.

LIFT

Separate lift are provided for doctors, ward patients, visitors, services and O.P.D.

O.P.D LIFTS

DOCTORS LIFTS

SERVICE LIFTS

INPATIENT

WARD LIFT

VISITORS

LIFT

STAIRCASE

Staircase is provided with 2.0 mt. width.All staircase are provided at periphery and open outside at ground

floor with 2.0 mt. wd. FHC, fire proof door.

FHC is also provided with each staircase.

BIBLIOGRAPHY


44/45



Roll No. - 817


BOOK REFERED:

1. I.P.H.S2. N.B.C

3. NEUFERT

4. HOSPITALS, facilities planning and

managementG. D. KUNDERS

5. MODERN TRENDS in planning and

designing of hospitalsS.K GUPTA.


45/45



Roll No. - 817


THE END

THANK YOU

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