HOSPITAL INFECTION CONTROL COMMITTEE

Netaji Subhas Medical College and Hospital, Amhara, Bihta, Bihar
(Established by Sitwanto Devi Mahila Kalyan Sansthan)

1. PREAMBLE

This Constitution is framed in accordance with the National Guidelines for Infection Prevention and Control in Healthcare Facilities issued by the National Centre for Disease Control (NCDC), Ministry of Health and Family Welfare, Government of India (January 2020), the WHO Guidelines on Core Components of Infection Control Programmes, standards prescribed by the National Accreditation Board for Hospitals and Healthcare Providers (NABH), and directives issued by the National Medical Commission from time to time.

The institution is committed to providing safe, quality healthcare services through effective prevention and control of healthcare-associated infections (HAIs), protection of patients, healthcare workers, and visitors from infection risks, and containment of antimicrobial resistance through evidence-based infection prevention and control practices.

The Hospital Infection Control Committee shall function as the apex body responsible for planning, implementing, monitoring, and evaluating the infection prevention and control Programme at the institution.

2. NOMENCLATURE

The Committee constituted under this Constitution shall be known as the "Hospital Infection Control Committee" (hereinafter referred to as "HICC" or "the Committee") for the purpose of establishing, implementing, and monitoring the infection prevention and control Programme at the institution.

3. DEFINITIONS

For the purposes of this Constitution:

• Healthcare-Associated Infection (HAI) means an infection occurring in a patient during the process of care in a hospital or other healthcare facility which was not present or incubating at the time of admission, including occupational infections among healthcare workers.
• Infection Prevention and Control (IPC) means measures aimed at preventing and controlling infections and transmission of infections in healthcare settings.
• Standard Precautions means the basic level of infection control precautions to be used in the care of all patients at all times to prevent and control infections.
• Transmission-Based Precautions means additional precautions beyond standard precautions for patients known or suspected to be infected with pathogens spread by airborne, droplet, or contact routes.
• Hospital Infection Control Team (HICT) means the operational team constituted by HICC comprising the Infection Control Officer and Infection Control Nurses responsible for day-to-day implementation of IPC activities.
• Infection Control Officer (ICO) means the clinician or microbiologist designated as the head of the Hospital Infection Control Team responsible for overall IPC programme implementation.
• Infection Control Nurse (ICN) means trained nursing personnel dedicated to implementing infection control practices, surveillance, and training at the facility level.
• Link Nurse means a designated nurse from each clinical unit responsible for coordinating IPC activities in that unit and serving as liaison with the HICT.
• Antimicrobial Stewardship Programme (AMSP) means a coordinated programme to optimize antimicrobial use, improve patient outcomes, reduce antimicrobial resistance, and decrease healthcare costs.
• Biomedical Waste (BMW) means any waste generated during diagnosis, treatment, or immunization of human beings or animals, or in research activities, or in production or testing of biological materials.
• Multidrug-Resistant Organisms (MDRO) means bacteria and other microorganisms that are resistant to multiple antimicrobial agents.
• Healthcare Worker (HCW) includes all doctors, nurses, resident doctors, interns, paramedical staff, technicians, support staff, and all persons working in the healthcare facility.

4. COMPOSITION OF THE HOSPITAL INFECTION CONTROL COMMITTEE

4.1 The Hospital Infection Control Committee shall consist of the following members nominated by the Management of Netaji Subhas Medical College and Hospital:

Table 1: Composition of Hospital Infection Control Committee

4.2 Mandatory Requirements

• The Principal/Dean of the institution shall be the Chairperson of HICC.
• The Infection Control Officer shall preferably be a Professor/HOD from the Department of Microbiology, Clinical Epidemiology, or Infectious Diseases.
• The Committee shall have multidisciplinary representation from clinical departments, support services, and administration.
• At least one Senior Infection Control Nurse shall be appointed as Member Secretary.
• The Committee shall ensure representation from major clinical specialties, CSSD, pharmacy, housekeeping, laundry, engineering, and biomedical waste management.
• All members should be trained in infection prevention and control principles and practices.

4.3 Hospital Infection Control Team (HICT)

The HICC shall constitute a Hospital Infection Control Team for day-to-day implementation of IPC activities:

• Infection Control Officer (ICO): Head of HICT (Professor/HOD Microbiology or designated clinician)
• Infection Control Nurses (ICN): Minimum one full-time ICN per 250 beds
• Link Nurses: One designated nurse from each clinical unit/ward

The HICT shall work under the guidance of HICC and report to the Chairperson through the ICO.

5. TENURE OF MEMBERS

• The Hospital Infection Control Committee shall function for a tenure of three years from the date of constitution.
• The Committee shall be reconstituted every three years with fresh nominations.
• Members may be re-nominated for subsequent terms.
• Any vacancy arising due to transfer, retirement, resignation, or otherwise shall be filled by fresh nomination within 30 days with intimation to NMC.
• The Infection Control Officer and Senior ICN shall continue in their roles for the entire tenure to ensure continuity.

6. OBJECTIVES AND FUNCTIONS

• To establish and maintain an effective infection prevention and control programme at the institution
• To minimize the risk of healthcare-associated infections among patients, healthcare workers, and visitors
• To prevent and control the transmission of infections in all areas of the healthcare facility
• To contain antimicrobial resistance through effective IPC measures and antimicrobial stewardship
• To ensure compliance with national guidelines, standards, and regulations regarding infection prevention and control
• To develop, review, and update institutional IPC policies, standard operating procedures, and infection control manual
• To conduct surveillance of healthcare-associated infections and monitor infection rates
• To investigate outbreaks of infections and implement control measures
• To provide education and training on IPC to all categories of healthcare workers
• To monitor compliance with IPC practices through regular audits and feedback
• To ensure availability of adequate infrastructure, equipment, and supplies for IPC
• To coordinate with other hospital committees for integrated patient safety and quality improvement
• To maintain documentation and prepare periodic reports on IPC activities
• To promote a culture of patient safety and infection prevention across the institution
• To ensure safe handling and disposal of biomedical waste as per regulatory requirements

7. ROLES AND RESPONSIBILITIES OF COMMITTEE MEMBERS

7.1 Chairperson (Principal/Dean)

• Provide leadership and administrative support for the IPC programme
• Chair HICC meetings and approve major policy decisions
• Ensure allocation of adequate resources including budget, manpower, infrastructure, and equipment
• Review HAI surveillance data and approve recommendations for corrective measures
• Ensure compliance with national guidelines and accreditation standards
• Facilitate coordination between HICC and institutional management
• Monitor overall performance of the IPC programme
• Promote a culture of safety and accountability among all staff

7.2 Infection Control Officer (ICO)

• Serve as head of the Hospital Infection Control Team
• Develop and update IPC policies, SOPs, and infection control manual
• Plan and coordinate HAI surveillance activities and data analysis
• Investigate outbreaks and recommend control measures
• Monitor antimicrobial use and support antimicrobial stewardship programme
• Advise on infection control aspects of new procedures, equipment, and construction
• Coordinate IPC training programmes for healthcare workers
• Conduct regular audits of IPC practices including hand hygiene, sterilization, and cleaning
• Monitor occupational health aspects including post-exposure prophylaxis and immunizations
• Prepare agenda for HICC meetings and present surveillance reports
• Maintain liaison with public health authorities and report notifiable diseases
• Coordinate research activities related to infection control
• Provide expert guidance on IPC matters to all departments

7.3 Senior Infection Control Nurse (Member Secretary)

• Coordinate day-to-day activities of the Hospital Infection Control Team
• Conduct daily rounds in wards and ICUs for HAI surveillance
• Monitor implementation of standard precautions and transmission-based precautions
• Track laboratory reports and identify potential infections
• Maintain HAI surveillance data and records
• Train and supervise Link Nurses across all units
• Conduct training programmes on IPC for nursing staff and other healthcare workers
• Monitor hand hygiene compliance and bundles (VAP, CLABSI, CAUTI, SSI prevention)
• Ensure availability and proper use of personal protective equipment
• Monitor biomedical waste segregation and disposal practices
• Document sharps injuries and coordinate post-exposure prophylaxis
• Maintain records of healthcare worker immunizations
• Prepare minutes of HICC meetings and follow up on action points
• Assist ICO in outbreak investigations and audits

7.4 Clinical Department Representatives

• Implement IPC policies and SOPs in their respective departments
• Ensure adherence to standard precautions by all staff in the department
• Report suspected HAIs and outbreaks to the HICT promptly
• Participate in HAI surveillance and provide clinical data
• Support antimicrobial stewardship by following antibiotic policy
• Facilitate IPC training for departmental staff
• Implement recommendations of HICC in the department
• Participate in root cause analysis of infections and adverse events
• Ensure proper maintenance and sterilization of department-specific equipment

7.5 Chief Nursing Officer

• Ensure implementation of IPC practices by nursing staff across all units
• Facilitate appointment and deployment of Infection Control Nurses
• Support training of nursing staff on IPC principles and practices
• Monitor nursing compliance with hand hygiene and aseptic techniques
• Ensure availability of IPC supplies in all nursing units
• Coordinate with ICO and Senior ICN for IPC activities
• Address nursing-related IPC issues and challenges

7.6 CSSD In-charge

• Ensure effective sterilization and disinfection of reusable medical devices
• Maintain SOPs for cleaning, disinfection, and sterilization processes
• Monitor functioning of sterilization equipment and maintain logs
• Ensure proper segregation of clean and dirty areas in CSSD
• Train CSSD staff on sterilization protocols and quality control
• Coordinate with departments for timely supply of sterile instruments
• Maintain documentation of sterilization processes and biological indicators
• Report equipment malfunctions and IPC concerns to HICC

7.7 Pharmacy In-charge

• Support antimicrobial stewardship programme through proper drug dispensing
• Maintain records of antimicrobial consumption
• Ensure availability of antimicrobials as per hospital formulary
• Provide data on antimicrobial usage patterns to HICC
• Implement restrictions on antimicrobial dispensing as per hospital policy
• Educate healthcare providers on rational antimicrobial use

7.8 Housekeeping and Sanitation In-charge

• Implement SOPs for environmental cleaning and disinfection
• Ensure proper cleaning of patient care areas, OTs, ICUs, and other critical areas
• Train housekeeping staff on cleaning protocols and use of disinfectants
• Maintain cleaning schedules and checklists for all areas
• Ensure proper segregation and handling of linen and waste
• Coordinate with HICT for special cleaning during outbreaks
• Maintain adequate stock of cleaning materials and disinfectants

7.9 Laundry Services In-charge

• Implement SOPs for safe handling, transportation, and processing of linen
• Ensure segregation of soiled and clean linen
• Maintain proper washing, drying, and sterilization protocols
• Train laundry staff on infection control practices
• Coordinate with departments for timely supply of clean linen
• Report linen-related IPC concerns to HICC

7.10 Engineering and Maintenance In-charge

• Ensure proper functioning of HVAC systems, water supply, and sanitation
• Maintain air quality in operation theaters, ICUs, and isolation rooms
• Ensure availability of clean water and proper drainage systems
• Coordinate repairs and maintenance affecting infection control
• Implement IPC considerations in construction and renovation projects
• Monitor waste disposal systems and sewage treatment

7.11 Biomedical Waste Management In-charge

• Implement Biomedical Waste Management Rules, 2016 (as amended)
• Ensure proper segregation, collection, storage, and disposal of biomedical waste
• Train healthcare workers on BMW categories and color-coding system
• Maintain BMW records and submit reports to regulatory authorities
• Coordinate with authorized BMW treatment facilities
• Monitor compliance with BMW protocols across all departments

7.12 Hospital Administrator

• Provide administrative support for HICC activities
• Facilitate procurement of IPC supplies and equipment
• Ensure timely implementation of HICC recommendations
• Coordinate with various departments for resource allocation
• Monitor budgetary aspects of the IPC programme

8. MEETING PROCEDURES

• The Hospital Infection Control Committee shall meet at least once every quarter (minimum four meetings per year).
• Additional emergency meetings may be convened by the Chairperson or ICO when required, especially during outbreaks or critical situations.
• The Member Secretary shall prepare the agenda in consultation with the ICO and circulate it to all members at least seven days before the meeting.
• Agenda shall include HAI surveillance reports, audit findings, outbreak investigations, policy reviews, and action taken on previous recommendations.
• Quorum for the meeting shall be at least half of the total members including either the Chairperson or Medical Superintendent.
• Minutes of meetings shall be recorded by the Member Secretary and circulated within seven days of the meeting.
• Action points shall be assigned with timelines and responsible persons.
• Decisions shall be taken by consensus or, if required, by majority vote.
• Guest experts, consultants, or representatives from specific departments may be invited as special invitees when necessary.
• Follow-up on previous action points shall be reviewed in each meeting.

9. INFECTION PREVENTION AND CONTROL PROGRAMME

The HICC shall establish and maintain a comprehensive IPC programme including the following components:

9.1 IPC Policies and Procedures

Develop and maintain an Infection Control Manual containing:

• Standard precautions (hand hygiene, PPE, respiratory hygiene, sharps safety)
• Transmission-based precautions (airborne, droplet, contact)
• Procedures for cleaning, disinfection, and sterilization
• Device-associated infection prevention bundles (VAP, CLABSI, CAUTI, SSI)
• Isolation protocols and barrier nursing
• Antimicrobial stewardship policy
• Outbreak investigation and management protocols
• Biomedical waste management procedures
• Occupational health and post-exposure prophylaxis protocols
• Special area protocols (OT, ICU, NICU, dialysis, endoscopy)

• Review and update all IPC policies annually or as needed
• Ensure policies are evidence-based and aligned with national guidelines
• Disseminate policies to all departments and ensure accessibility

9.2 Healthcare-Associated Infection Surveillance

• Conduct targeted surveillance of device-associated infections:
  • Central Line-Associated Bloodstream Infections (CLABSI)
  • Ventilator-Associated Pneumonia (VAP)
  • Catheter-Associated Urinary Tract Infections (CAUTI)
  • Surgical Site Infections (SSI)
• Monitor antimicrobial resistance patterns through collaboration with microbiology laboratory
• Calculate infection rates per 1000 device-days or per 100 procedures
• Analyze trends and compare with benchmark data
• Identify high-risk areas and implement targeted interventions
• Maintain confidentiality of patient data during surveillance
• Prepare monthly and annual surveillance reports for HICC review

9.3 Standard Precautions

• Hand Hygiene: Implement WHO Five Moments of Hand Hygiene:
  • Before patient contact
  • Before aseptic procedures
  • After body fluid exposure risk
  • After patient contact
  • After contact with patient surroundings
• Ensure availability of handwashing facilities, soap, alcohol-based hand rub, and paper towels
• Conduct regular hand hygiene compliance audits
• Personal Protective Equipment (PPE): Ensure availability and proper use of gloves, gowns, masks, face shields, and eye protection
• Respiratory Hygiene and Cough Etiquette: Display signage and provide tissues, masks, and hand hygiene facilities
• Sharps Safety: Use safety-engineered devices, provide sharps containers, and ensure proper disposal
• Aseptic Techniques: Ensure sterile procedures for invasive interventions

9.4 Device-Associated Infection Prevention Bundles

Implement evidence-based bundles for prevention of:

• Central Line-Associated Bloodstream Infections (CLABSI):
  • Hand hygiene before insertion
  • Maximal sterile barrier precautions
  • Chlorhexidine skin antisepsis
  • Optimal catheter site selection (avoid femoral vein)
  • Daily review of line necessity
• Ventilator-Associated Pneumonia (VAP):
  • Elevation of head of bed (30-45 degrees)
  • Daily sedation vacation and assessment of readiness to extubate
  • Peptic ulcer disease prophylaxis
  • Deep vein thrombosis prophylaxis
  • Oral care with chlorhexidine
• Catheter-Associated Urinary Tract Infections (CAUTI):
  • Insert only when necessary
  • Aseptic insertion technique
  • Maintain closed drainage system
  • Daily review of catheter necessity
  • Remove as soon as possible
• Surgical Site Infections (SSI):
  • Appropriate surgical antimicrobial prophylaxis (timing, selection, duration)
  • Preoperative skin preparation with appropriate antiseptic
  • Glycemic control
  • Normothermia maintenance
  • Appropriate wound care and surveillance

9.5 Antimicrobial Stewardship Programme

• Develop and implement hospital antibiotic policy with formulary restrictions
• Establish antibiogram based on institutional resistance patterns
• Implement standard treatment guidelines for common infections
• Monitor antimicrobial consumption and resistance trends
• Conduct prospective audits and provide feedback to prescribers
• Implement antimicrobial approval and review systems for restricted antibiotics
• Educate healthcare providers on rational antimicrobial use
• Coordinate with Pharmacy and Therapeutics Committee

9.6 Outbreak Investigation and Management

• Establish protocols for early detection of potential outbreaks
• Constitute outbreak investigation team with ICO as coordinator
• Conduct epidemiological investigation to identify source and mode of transmission
• Implement immediate control measures (isolation, cohorting, enhanced cleaning)
• Collect specimens for microbiological confirmation
• Conduct contact tracing and surveillance of exposed persons
• Communicate with stakeholders and report to public health authorities
• Document outbreak investigation and implement preventive measures
• Prepare outbreak investigation report with lessons learned

9.7 Occupational Health and Safety

• Maintain healthcare worker immunization records (Hepatitis B, Tetanus, Influenza, etc.)
• Implement protocols for post-exposure prophylaxis (needle stick, splash injuries)
• Maintain sharps injury register and analyze patterns
• Provide hepatitis B vaccination to all healthcare workers
• Conduct pre-placement and periodic health screening
• Ensure availability of PEP kits for HIV, Hepatitis B, and Hepatitis C exposures
• Train healthcare workers on safe practices and use of PPE

10. EDUCATION AND TRAINING

• Conduct orientation programmes on IPC for all new healthcare workers during induction
• Organize at least four training sessions per year on various IPC topics for different categories of staff
• Training topics shall include:
  • Hand hygiene techniques and compliance
  • Standard and transmission-based precautions
  • Device-associated infection prevention bundles
  • Biomedical waste management
  • Outbreak management
  • Antimicrobial stewardship
  • Occupational health and post-exposure prophylaxis
• Use multimodal training methods (lectures, demonstrations, videos, simulations)
• Conduct practical training on hand hygiene, donning/doffing PPE, and aseptic techniques
• Provide training to support staff (housekeeping, laundry, waste handlers)
• Maintain records of training programmes including attendance and feedback
• Evaluate effectiveness of training through pre- and post-tests and compliance audits

11. MONITORING, AUDIT, AND FEEDBACK

Conduct regular audits of IPC practices including:

• Hand hygiene compliance (monthly)
• Bundle compliance for device-associated infection prevention (weekly in ICUs)
• Environmental cleaning and disinfection (monthly)
• Sterilization processes and biological indicators (as per schedule)
• Biomedical waste segregation and disposal (weekly)
• PPE availability and proper use (monthly)
• Isolation precautions compliance (as needed)

• Use standardized audit tools and checklists
• Provide immediate feedback to departments and individuals
• Share audit results in HICC meetings with trend analysis
• Implement corrective and preventive actions based on audit findings
• Re-audit after interventions to assess improvement
• Recognize and reward departments with high compliance

12. INFRASTRUCTURE AND RESOURCE REQUIREMENTS

The institution shall provide the following infrastructure and resources for effective IPC programme:

• Dedicated office space for Hospital Infection Control Team
• Computers with internet connectivity for surveillance and data management
• Communication equipment (phones, mobile devices)
• Access to VigiFlow or other surveillance software
• Adequate handwashing facilities with running water in all patient care areas
• Alcohol-based hand rub dispensers at point of care
• Adequate supply of personal protective equipment (gloves, gowns, masks, face shields)
• Isolation rooms with negative pressure for airborne infections
• Functional Central Sterile Supply Department with autoclaves and monitoring systems
• Microbiology laboratory with capacity for culture, sensitivity, and antimicrobial resistance testing
• Adequate housekeeping staff and cleaning equipment
• Biomedical waste management infrastructure as per regulatory requirements
• Budget allocation for IPC activities, training, and supplies
• Access to national and international IPC guidelines and literature

13. COORDINATION WITH OTHER COMMITTEES

The Hospital Infection Control Committee shall coordinate with:

• Pharmacy and Therapeutics Committee: For antimicrobial stewardship, formulary management, and antibiotic policy
• Quality Assurance Committee: For patient safety initiatives and quality improvement projects
• Blood Transfusion Committee: For transfusion-associated infection prevention
• Biomedical Waste Management Committee: For safe waste handling and disposal
• Hospital Building Committee: For IPC considerations in construction and renovation
• Ethics Committee: For ethical considerations in IPC research and outbreak investigations
• Internal Complaints Committee: For workplace safety and occupational health concerns
• Disaster Management Committee: For infection control during emergencies and pandemics

14. DUTIES OF THE INSTITUTION

The Management of Netaji Subhas Medical College and Hospital shall:

• Provide leadership and commitment to the IPC programme
• Allocate adequate budget for IPC activities, infrastructure, and manpower
• Appoint qualified and trained personnel as Infection Control Officer and Infection Control Nurses (minimum 1 ICN per 250 beds)
• Ensure availability of functional microbiology laboratory services
• Provide infrastructure for hand hygiene (sinks, soap, ABHR) in all patient care areas
• Ensure adequate supply of personal protective equipment at all times
• Support training and continuing education for healthcare workers on IPC
• Facilitate implementation of HICC recommendations
• Ensure compliance with national guidelines, regulations, and accreditation standards
• Monitor performance of IPC programme through review of surveillance data and audit results
• Promote a culture of patient safety and zero tolerance for non-compliance with IPC practices
• Provide support for research and quality improvement activities related to IPC
• Ensure timely reporting of outbreaks and notifiable diseases to public health authorities

15. PERFORMANCE EVALUATION

The effectiveness of the IPC programme shall be evaluated through:

15.1 Process Indicators

• Hand hygiene compliance rate (target: >80%)
• Bundle compliance rates for device-associated infection prevention (target: >90%)
• Environmental cleaning audit scores (target: >85%)
• Proportion of healthcare workers immunized against Hepatitis B (target: 100%)
• Biomedical waste segregation compliance (target: 100%)
• Proportion of healthcare workers trained on IPC annually (target: 100%)

15.2 Outcome Indicators

• Central Line-Associated Bloodstream Infection (CLABSI) rate per 1000 central line-days
• Ventilator-Associated Pneumonia (VAP) rate per 1000 ventilator-days
• Catheter-Associated Urinary Tract Infection (CAUTI) rate per 1000 catheter-days
• Surgical Site Infection (SSI) rate per 100 procedures
• Antimicrobial resistance patterns and trends
• Number and duration of HAI outbreaks
• Sharps injury incidence rate per 100 healthcare workers

15.3 Benchmarking

• Compare institutional infection rates with national and international benchmarks
• Participate in national HAI surveillance networks
• Share data with accreditation bodies (NABH) and regulatory authorities
• Set internal targets for continuous improvement

16. ANNUAL REPORT

The Hospital Infection Control Committee shall prepare an annual report containing:

• Summary of HICC meetings and major decisions
• HAI surveillance data with trend analysis
• Device-associated infection rates and benchmarking
• Antimicrobial resistance patterns
• Outbreak investigations and control measures
• Hand hygiene and bundle compliance audit results
• Training programmes conducted and healthcare workers trained
• IPC policy updates and new initiatives
• Infrastructure and resource improvements
• Challenges faced and recommendations for improvement
• Action plan for next year with priorities and targets

The annual report shall be submitted to:

• Management of the institution
• National Medical Commission
• State health authorities
• Accreditation bodies (NABH)

The report shall be presented to the Governing Body and Academic Council.

17. DISPLAY AND DISSEMINATION

• This Constitution and details of HICC shall be displayed on the institution's notice boards and website
• Information about committee composition, ICO and ICN contact details shall be made easily accessible
• IPC policies and SOPs shall be available in all departments and on the institutional intranet
• Hand hygiene posters and guidelines shall be displayed at all handwashing stations and patient care areas
• Biomedical waste color-coding charts shall be displayed in all clinical areas
• Isolation precautions signage shall be displayed on isolation room doors
• Regular IPC updates and alerts shall be communicated through circulars, emails, and newsletters

18. AMENDMENTS

This Constitution may be amended from time to time in accordance with changes in the National Guidelines for Infection Prevention and Control, WHO guidelines, NABH standards, or regulations issued by the Government of India or National Medical Commission.

Any amendments shall require approval from the Management and intimation to NMC and accreditation bodies.

19. EFFECTIVE DATE

This Constitution shall come into effect from the date of approval by the Management of Netaji Subhas Medical College and Hospital and notification to the National Medical Commission.

Adopted by:

FOR AND ON BEHALF OF THE INSTITUTION:

Dr. __________________ [Name & Signature]
Principal/Director
Netaji Subhas Medical College & Hospital
Date: _______________
Seal:

Prof. _________________ [Name & Signature]
Chairperson, Governing Body
Date: _______________

APPROVED AND NOTIFIED BY:

Sitwanto Devi Mahila Kalyan Sansthan
Secretary: _________________ [Name & Signature]
Date: _______________