Divyajyoti trust presentation (Mandvi,Dist-Surat)07.10.2015

DIVYAJYOTI TRUSTDR. UDAY GAJIWALADIVYAJYOTI TRUST, MANDVI

OUR INSPIRATION

May I be born again and again, and suffer thousands of miseries, so

that I may worship the only God that exists, the only God I believe in, the sum total of all souls and above all,

my God the wicked, my God the miserable, my God the poor of all races, of all species, is the special

object of my worship. Swami Vivekanda – (V.137)

VisionTo become a centre of excellence so that no one remains needlessly blind

for want of eye care services. Mission

Provide quality comprehensive eye care services accessible and affordable to all including free services to poor in

the rural tribal area around Mandvi

ESTABLISHMENT

• TRUST ESTABLISHED IN 2010.• HOSPITAL STARTED ON 22ND MAY 2011• ACTIVITIES DONE BEFORE START OF THE HOSPITAL

– SURVEY OF THE AREA – NEED OF EYE CARE IN THE AREA– OTHER EYE CARE SERVICE PROVIDERS IN THE AREA– SELECTION OF TOWN / PLACE

LOCATION• Since the trust wanted to work for poor

people, a search of poor and needy area was made

• As the founders belong to Surat district, Tribal area of Surat district was selected

• The tribal belt of Gujarat extends from Dharampur to Panchmahal – passing through Valsad, navsari, Tapi, Surat, Bharuch, Narmada, Vadodara and Dahod districts

LOCATION• The tribal area of Surat district is located in the

eastern corner of the district• Mandvi is located at the beginning of the tribal

area of Surat district• Mandvi is the centrepoint – well connected with

the interior villages • Educational facilities are also available• 65kms from Surat• No railway connectivity – nearest railway

station are Bardoli and Vyara about 25-30 kms away

• Population of Mandvi is about 25,000

LOCATION ON THE MAP

MANDVI IS LOCATEDNEAR SURAT IN

GUJARAT

LOCATION ON THE MAP

MANDVI IS LOCATEDIN THE EASTERN CORNER OF THE SURAT DISTRICTTOWARDS THE BORDER WITH MAHARASHTRA

LOCATION ON THE MAP

MANDVI IS LOCATED ON THE BANKS OF RIVER TAPI.65 KMs AWAY FROM SURAT.ROADS ARE GOOD.

SURAT

MANDVI

TEJAS EYE HOSPITAL run by

DIVYAJYOTI TRUST

• TRIBAL AREA OF SURAT DISTRICT• NO OTHER EYE CARE SERVICE PROVIDER EVEN IN

PRIVATE SET UP• COMMUNITY DEPENDENT UPON EYE CAMPS

CONDUCTED BY VARIOUS PLAYERS• POOR COMMUNITY – MAJORITY LANDLESS

LABOURERS• NEAREST FREE EYE CARE AVAILABLE - 60 KMS AWAY• FURTHER EAST – NO EYE CARE PROVIDER UPTO 100

KMS DISTANCE

BENEFICIARIES• Poor tribal population of the area• Particularly the community in the interior

villages of the tribal forest area• Very little income generation potential• Majority are daily wage earners• They live an old fashioned orthodox life – full of

wrong beliefs and taboos• They go to traditional healers for their health

problems• No other eye care – for that matter no

charitable health care services are available in the area apart from Govt. infra structure


DIVYAJYOTI TRUST

• WE WANTED TO HAVE A CAMPUS• STARTED LOOKING FOR PIECE OF LAND• PROHIBITIVE COST IN THE TOWN• NEED FOR BIG FINANCE• NON AVAILABILITY OF FUNDS• WE DECIDED TO SETTLE WITH A SMALL HOSIPTAL


DIVYAJYOTI TRUST

• READYMADE BUILDING WAS TAKEN OVER – A DIAMOND FACTORY BUILDING LYING IDLE FOR LAST 4-5 YEARS

• STANDING ON 10,000 SQ. FT. AREA• 8000 SQ. FT. CONSTRUCTION AVAILABLE ON GROUND

FLOOR AND 2000 SQ. FT. ON FIRST FLOOR• WE COVERED THE OTHER 6000 SQ. FT. OPEN TERRACE • BUILDING RENOVATED INTO A 40 BEDDED EYE HOSPITAL

WITH 16000 SQ. FT. AREA• RENOVATION STARTED IN SEPT. 2010 AND COMPLETED

IN MAY 2011

ENTRANCE OF THE BUILDING – BEFORE RENOVATION

TRUSTEES & GUESTS VISITING THE SITE DURING RENOVATION

OLD SET UP – 10 SUCH CUBICLES WERE THERE

• FOUR AT THE FAR END – TO BE USED FOR OPERATION THEATRE• THE MIDDLE FOUR TO BE USED AS WARDS


DIVYAJYOTI TRUST

• TWO OPHTHALMOLOGISTS DECIDED TO JOIN US– ONE WAS SENT TO ICEH LONDON FOR ONE YEAR M.Sc.

COMMUNITY OPHTHALMOLOGY– ONE WAS SENT TO ARAVIND EYE HOSPITAL, MADURAI

FOR CORNEA FELLOWSHIP• PARA MEDICAL STAFF SELECTED AND SENT TO

SEWA RURAL, JHAGADIA FOR TRAINING INCLUDING OPHTHALMIC ASSISTANTS AND NURSES


DIVYAJYOTI TRUST

• FACILITIES AVAILABLE AT THE BEGINNING– 40 beds indoor unit– Semi special room with two beds and air conditioned special room– Separate isolation ward for infective patients– Round the clock emergency services– Dormitory facility for the relatives– Comfortable waiting area– Availability of full time counseling services to patients about their

disease and treatment options– 3 well equipped operation theatres– Well equipped speciality clinics for retina, cornea, glaucoma,

sonography, laser etc


DIVYAJYOTI TRUST

• FACILITIES AVAILABLE AT THE BEGINNING– Facility for general anaesthesia– Laboratory facility– Janseva Medical and optical store where drugs and spectacles are

provided at subsidized rates– Lift for patients– Kitchen and dining facility (Kasturi bhojanshala) – free to patient and

one relative– TVs with cable connection in both wards and in waiting areas in OPD

and in special clinic for entertainment.– Library with spiritual and other books– Mineral water plant and cooler for drinking water facility– 35 KVA and 15 KVA Diesel Generator units


DIVYAJYOTI TRUST

• EQUIPMENTS AVAILABLE– Topcon 3D OCT 3000 with anterior & posterior segment software– Geuder posterior vitrectomy machine with phaco machine– Clinical specular microscope from Topcon– Eye bank specular microscope from H.A.I.– HFA 740i visual field analyser from Carl Zeiss– YAG III laser from Carl Zeiss– Frequency doubled Green laser from Carl Zeiss with all three delivery

systems – slit lamp, LIO and endo laser– Digital fundus camera from Carl Zeiss for fluorescein angiography– A-B combined scan from OTI– Autorefractor from Biomedix– IOL Master from Zeiss for IOL power calculation– A scan from Biomedix


DIVYAJYOTI TRUST

• EQUIPMENTS AVAILABLE• Topcon Non contact Tonometer• Automated lensometer CL 90 from Topcon• Photo slit lamp SL 7D from Topcon for documentation and training and also

education of the family members• Topcon OMS 710 operating microscope with assistant scope and CC TV

attachment• Topcon OMS 90, Zeiss 1 FR & Moller Wedel operating microscope • Non mydriatic fundus cameras• Pachymeter from Sonomed• Corneal topographer from Topcon• AMO Sovereign Compact Whitestar phaco machine• Vision screener for screening paediatric patients• Horizontal high speed autoclave machine, ETO steriliser• Auto analyser and cell counter for laboratory

PRESENT ACTIVITIES – BASE HOSPITAL• 12 FULL TIME OPHTHALMOLOGISTS• 90 TOTAL STAFF STRENGTH• DAILY OPD – AVERAGE 150 • ALL TYPES OF EYE SURGERIES – AVERAGE 30 / day• REGULAR SPECIALITY CLINICS – RETINA, CORNEA,

PAEDIATRIC, GLAUCOMA AND LOW VISION DAILY. OCULOPLASTY, NEURO OPHTH. TWICE A MONTH

• TRAINING ACTIVITIES – O’LOGISTS, OPHTH. ASSTT., OT NURSES, SPECTACLE FITTING ETC.

• EYE BANK• RESEARCH ACTIVITIES• HEALTH EDUCATION – PAMPHLETS, VIDEO, FGDs

ISO CERTIFIED HOSPITAL

FOCUS ON QUALITY

• ISO CERTIFICATION• AVAILABILITY OF WRITTEN PROTOCOL• OBSESRVANCE OF STRICT PROTOCOL• REGULAR INFECTION CONTROL

COMMITTEE MEETING• EXTERNAL EVALUATION• CONTINUOUS MONITORING• IHMS FROM ARAVIND• OPERATED OUR PRESIDENT

TRAINING ACTIVITIES• VISION TECHNICIAN – ONE YEAR CERTIFICATE COURSE• OPHTHALMIC NURSING – ONE YEAR CERTIFICATE COURSE• COMPREHENSIVE OPHTHALMOLOGY FELLOWSHIP - ONE YEAR• CORNEA FELLOWSHIP - ONE YEAR• SICS FELLOWSHIP – TWO MONTHS• PHACO FELLOWSHIP – ONE MONTH• MEDICAL RETINA FELLOWSHIP – TWO MONTHS• GLAUCOMA OBSERVERSHIP – TWO MONTHS• OPTICAL FITTING TRAINING – THREE MONTHS• SHORT TERM CUSTOMISED TRAINING OF OT STAFF AND

OPHTHALMIC ASSISTANTS – ONE / TWO WEEKS

RESEARCH ACTIVITIES• RAAB STUDY

– TO KNOW EXISTING STATUS IN THE AREA– ALREADY PRESENTED IN VARIOUS CONFERENCES– WON FIRST PRIZE IN STATE LEVEL CONFERENCE

• RAVI STUDY– TO KNOW THE STATUS OF VISUAL IMPAIRMENT IN THE AREA– SUPPORTED BY SIR DORABJEE TATA TRUST

• COMPREHENSIVE BLINDNESS SURVEY IN MANDVI BLOCK

• DOOR TO DOOR DIABETES SCREENING IN MANDVI– 25000 BLOOD SUGAR TESTS DONE– 800 POSITIVE

• DR AWARENESS SURVEY IN MANDVI• RAAB STUDY IN JHABUA DISTRICT, MADHYA PRADESH

FOR SIGHTSAVERS

RESEARCH ACTIVITIES• COMPREHENSIVE BLINDNESS SURVEY –

UMARPADA AND MANGROL BLOCKS• BLOOD SUGAR, BLOOD PRESSURE AND INTRA

OCULAR PRESSURE TESTS OF 40+ INDIVIDUALS IN UMARPADA AND MANGROL BLOCKS – UNIQUE ACTIVITY FOR THE FIRST TIME IN INDIA

• CLINICAL STUDIES – – EFFICACY OF AVASTIN vs. LASERS– GLAUCOMA DEMOGRAPHY AMONG OUR PATIENTS– COMPARISION OF VERIOUS TECHNIQUES OF INTRA

OCULAR PRESSURE MEASUREMENTS– PROSPECTIVE STUDY OF CORNEAL ULCER PATIENTS

COMING TO OUR CLINIC

PRESENT ACTIVITIES – OUTREACH• THRICE A WEEK DIAGNOSTIC EYE CAMPS

– CATERING TO 2.5 MILLION POPULATION– UPTO 125 kms FROM MANDVI– COMPREHENSIVE SCREENING

• TWO SURGICAL SATELLITE CENTRES– UNDER PPP MODE– DAILY OPD BY OPHTH. ASSTT.– TWICE A WEEK SURGERIES BY O’LOGIST FROM HQ– TRYINT TO SET UP TELEMEDICINE FACILITY

• SUPPORTING LIONS EYE HOSPITAL, CHORWAD– ONE OPHTH. ASSTT. POSTED THERE– TRAINED THEIR TEAM– DOOR TO DOOR SCREENING GOING ON– HOSPITAL IS ALREADY FUNCTIONAL

• DIABETIC RETINOPATHY SCREENING• AWARENESS GENERATION• PLANNING TO START TWO VISION CENTRES – UMARPADA AND

DEDIAPADA SOON

PRESENT ACTIVITIES – REHABILITATION

• COMMUNITY EYE SERVICES PROGRAMME STARTED FROM 1ST APRIL 2012

• 2 LACS POPULATION OF MANDVI BLOCK COVERED• 133 VILLAGES – 10 WORKERS• 115 BLINDS • INCLUSIVE EDUCATION FOR BLIND CHILDREN• DOOR TO DOOR SURVEY CONDUCTED –

ADDITIONALLY SOCIO ECONOMIC STATUS STUDIED• RBS OF ALL ABOVE THE AGE OF 40 YEARS DONE• COMPLETED IN DEC. 2014• MOVED ON TO UMARPADA AND MANGROL BLOCKS

PRESENT ACTIVITIES – REHABILITATION

• COMMUNITY EYE SERVICES PROGRAMME STARTED FROM 1ST JANUARY 2015

• 3 LACS POPULATION OF UMARPADA AND MANGROL BLOCKS COVERED

• 250+ VILLAGES – 15 WORKERS• TRAINING OF WORKERS COMPLETED• DOOR TO DOOR SURVEY CONDUCTED –

ADDITIONALLY SOCIO ECONOMIC STATUS STUDIED• RBS OF ALL ABOVE THE AGE OF 40 YEARS DONE• ACTUAL REHABILITATION SERVICES WILL START

NOW.

PRESENT ACTIVITIES – HOSTEL FOR BLIND STUDENTS

• STARTED FROM JUNE 2013• 20 STUDENTS• ATTEND REGULAR SCHOOL IN MANDVI• TAUGHT BRAILLE IN THE EVENING• STARTED LEARNING MUSIC• STARTED LEARNING COMPUTERS• WON PRIZES IN VIBRANT GUJARAT AT DISTRICT

LEVEL• APPEARED IN FIRST EXAM OF MUSIC – WILL SOON

APPEAR FOR SECOND EXAM• WILL INCREASE THE NO. TO 25 NEXT YEAR

OUR TEAM

OPD - DRINKING WATER FACILITY

OPD WITH PHOTO SLIT LAMP

OPERATION THEATRE

MEDICAL STORE & LIBRARY

OPTICAL STORE

KITCHEN

DINING AREA

GROUP WORK DURING VISION MISSION WORKSHOP

STAFF MAKING PRESENTATION

STAFF GET TO GATHER

TRUSTEE MEETING

TECHNICAL ADVISORY COMMITTEE


DIVYAJYOTI TRUST

• CHALLENGES FACED:– WAITING AREA FALLING SHORT– NO. OF STAFF FALLING SHORT– OT SPACE APPEARS LESS– PARAMEDICS ADDED BUT WE WERE UNABLE TO TRAIN

THEM– COMPETENCE LEVELS OF STAFF NOT UPTO THE MARK

OPD STATISTICS

REPORT OF THE OPD OF THREE YEARS

Year T NT Total

2012 - 2013 32788 12176 44964

2013 - 2014 33883 18696 52579

2014 - 2015 40856 21222 62078

TOTAL 107527 52094 159621

PROCEDURESInvestigation 2012 - 2013 2013 - 2014 2014 - 2015

Total Total TotalA SCAN 3279 3767 5011AUTOMATED PERIMETRY 178 300 275B SCAN 988 1349 1298CHALAZION 37 34 42FLUORESCEIN ANGIOGRAPHY 232 184 44FOCAL LASER 21 3 33FUNDUS PHOTO 7 39 227FOREIGN BODY REMOVAL 184 450 478GREEN LASER 304 279 795OCT 877 1258 1150PACHYMETRY 199 494 507SPECULAR MICROSCOPY 1 147 51TOPOGRAPHY 6 56 24YAG LASER CAPSULOTOMY 374 478 660YAG LASER IRIDECTOMY 45 114 231

Total 6732 8952 10826

SURGERIESName of Surgery

Total2012 - 2013 2013 - 2014 2014 - 2015

CATARACT PHACO + IOL 596 625 1153CATARACT SICS + IOL 3121 3471 3710CATARACT SIMPLE WITHOUT IOL 15 16 19SICS+AGS WITH IOL 6 23 42SICS+PTERIGYUM+IOL 43 99 95ANTI GLAUCOMA SURGERY 9 10 29KERATOPLASTY 62 91 113AVASTIN INJ 506 422 311PTERIGYUM 112 143 226SIMPLE RETINAL DETACHMENT 21 13 32VITRECTOMY 111 138 181DCR 29 65 65RETINAL DETACHMENT + VITRECTOMY 34 67 44SICS + IOL + VITRECTOMY 48 82 159OTHER RETINA SURGERY 28 31 94OCULOPLASTY SURGERY 43 65 68SQUINT SURGERY 16 18 29OTHER SURGERY 90 135 161FOREIGN BODY REMOVAL 189 457 481YAG LASER - CAPSULOTOMY - IRIDECTOMY 419 602 891GREEN LASER 323 281 528

Total 5821 6854 8431

CLINICS PERFORMANCESUB SPECIALITY WORK COMPARISION

SpecialityOPD Surgery

2012-2013 2013-2014 2014-2015 2012-2013 2013-2014 2014-2015

RETINA 1281 3605 5297 917 848 965

GLAUCOMA 150 1229 2414 9 15 33

CORNEA 552 1534 1796 68 98 113

OCULOPLASTY 125 295 207 94 202 165

PAEDIATRIC SURGERY 152 188 190 68 93 126

NEURO OPHTHALMOLOGY 0 194 160 0 0 0

LOW VISION 1 284 123 0 0 0

TOTAL 2261 7329 17516 1156 1256 1402

DIAGNOSTIC EYE CAMPS

YEAR NO. OF CAMPS OPD REFER

CATARACTREFER

SPECIALISTOPTICAL

SALEMEDICIN

EOPERATIO

NS

2012 - 2013 110 16787 2708 694 7862 809 2180

2013 - 2014 121 19764 3346 974 8401 1648 2417

2014 - 2015 152 25790 4430 1406 10442 2341 3310

2014-2015 Diabetic retinopathy camps

10 1096 211 81 369 115 144

Total 393 63437 10695 1487 27074 4913 8051

SATELLITE SURGERIESNETRANG PHC STATISTICS - LAST THREE YEARS

YearOPD IOL OPERATIONS OPTICAL

ORDERNew Old Total M F M F Total

2012 - 2013 2635 1069 3704 140 160 144 146 290 0

2013 - 2014 3390 1080 4470 137 167 138 177 315 258

2014 - 2015 3679 973 4652 25 31 25 33 58 299

Total 9704 3122 12826 302 358 307 356 663 557

JHANKHVAV CHC STATISTICS - LAST TWO YEARS

YearOPD IOL OPERATIONS OPTICAL

ORDERNew Old Total M F M F Total

2012 - 2013 1172 400 1572 73 95 74 97 171 0

2013 - 2014 1765 858 2623 61 64 62 67 129 62

2014 - 2015 1590 642 2232 89 85 89 85 174 77

Total 4527 1900 6427 223 244 225 249 474 139

SUB SPECIALITY WORK – CURRENT YEAR

Speciality OPD Surgery

Up to 30th Sep.15 Up to 30th Sep.15

Retina 3134 704

Glaucoma 1246 33

Cornea 1319 61

Oculoplasty 138 123

Paed. Ophthalmology 63 107

Neuro-Ophthalmology 79 0

Low Vision 24 0

Total 6003 1028

RETINA SURGICAL WORK – CURRENT YEAR

Name of SurgeryPaid Subsidized Free + Camp free Total

30th Sep.15 30th Sep.15 30th Sep.15 30th Sep.15

AVASTIN INJ 216 16 50 282SIMPLE RETINAL DETACHMENT/

Complicated5 7 8 20

VITRECTOMY 33 24 47 104

RETINAL DETACHMENT + Vitrectomy 0 3 2 5

SICS + IOL + VITRECTOMY 4 12 79 95

Other Retina Surgery 27 10 28 65

Green Laser 194 15 45 254

Total 479 87 259 825

DR WORK TILL DATE

Year Laser Avastin Surgery Total

2012 – 2013 323 506 1156 1985

2013 – 2014 281 422 1256 1959

2014 – 2015 528 311 1402 2241

Total 1132 1239 3814 6185

CORNEAL GRAFTING WORK TILL DATE

Year OKP TKP Total

2012 – 2013 13 49 62

2013 – 2014 59 33 92

2014 – 2015 50 65 115

Total 122 147 269

SUBHASH PRAJAPATI – PITUITARY GLAND TUMOUR – NOW WORKING AS COMPUTER

OPERATOR WITH US

KERATOPLASTY WORK

BILATERAL PAEDIATRIC CATARACT

BEFORE SURGERY

AFTER SURGERY

SQUINT SURGERY

BEFORE SURGERY AFTER SURGERY

62

TREATMENT OF DIABETIC RETINOPATHY

OCULOPLASTY

BEFORE SURGERY AFTER SURGERY

SUB CONJUNCTIVAL THREAD WORM

AWARENESS SESSION IN SCHOOLS AND VILLAGES

INNOVATIVE APPROACHES ADAPTED

• DOOR TO DOOR SCREENING OF 40+ FOR DIABETES FOLLOWED BY SCREENING FOR DR

• SCREENING OF ALL 40+ PATIENTS FOR DM & HT AT HQ

• STARTED SCREENING FOR DM AND GLAUCOMA IN CAMPS

• DISTRIBUTING GOGGLES WITH SIDE COVER FOR AGRICULTURAL WORKERS AT TOKEN RATES


DIVYAJYOTI TRUST

• FUTURE PLANS– PROCURE 2 – 3 ACRES OF LAND – DONOR HAS ALREADY DECLARED –

PROCEDURES TO BE COMPLETED– START UNIVERSITY AFFILIATED TRAINING PROGRAMMES

( PREPARING TRAINERS) • ALREADY APPLIED FOR B. Sc. OPTOMETRY• WILL APPLY FOR DNB OPHTHALMOLOGY IN JANUARY 2016.

– STRENGTHEN STAFF – INCREASE THEIR COMPETENCE • WORKING WITH H. V. DESAI EYE HOSPITAL, PUNE. SUPPORTED BY SEVA FOUNDATION,

USA– TARGET 10000 SURGERIES IN THIS FIFTH YEAR OF OPERATIONS– PLAN MORE RESEARCH ACTVITIES– ADD FEW EQUIPMENTS LIKE ERG, UBM, HRT ETC.

• PROJECT ALREADY APPROVED BY KAPS AND LCIF– EMPHASIS ON STAFF DEVELOPMENT & TOTAL QUALITY MANAGEMENT

HOW CAN YOU CONTRIBUTE?

• DONATE EYES OF YOUR FAMILY MEMBERS• CALL NEAREST EYE BANK WHEN DEATH OF A

FAMILY MEMBER OCCURS• JOIN US IN SPREADING AWARENESS ABOUT

EYE DISEASES– DIABETES– GLAUCOMA– REFRACTIVE ERROR– LOW VISION DEVICES

DONATION SCHEMES FOR HOSPITAL• Scheme Amount in Rs.• Organising one diagnostic eye camp & operations 51,000/-• Organising one diagnostic eye camp

11,000/-• Sponsoring one cataract operation

1,000/-• Treatment of all poor patients for one day (tithidan) 5,000/-• Free food to the patients and relatives for one meal 2,500/- • (Both lunch and dinner) Free food to the patients and relatives for 1,500/- • one meal (Either lunch and dinner) Tea for all the patients and 500/- • relatives for one day – both morning and evening • Distribution of free dark glasses to all the operated patients on one day 251/-• Distribution of free medicines to poor patients for a day 500/-

• Sponsor one corneal transplant operation 2,000/-• Rehabilitation of one blind person 10,000/-• Sponsoring one blind child for education 15,000/-

(Support needed in terms of salary of our braille teacher and other miscellaneous expenses)

DONATION SCHEMES FOR HOSTELSr. no. Details Total (In INR)

1. Hostel for blind children Light bill per month 2000×12 = 24000

24000

2. Uniform for 15 children Rs. 800 for two pair×20 16000 3. Books/ Notebooks/ Stationary Rs. 500×20 100004. Milk for one time in morning

10Rs.×20=200×300 days = 60000Breakfast 10Rs.×20=200×300 days = 60000Food twice a day 50Rs.×20=1000×300 days = 300000

420000

5. Sweater for children 300×20 = 6000Raincoat for children 200×20 = 4000

10000

6. Tour – travelling – picnic 50007. Shibir for blind children twice in a year 200008. Festival celebration (Diwali, holi) 50009. Daily wear clothes – 2 pair @ 800Rs. ×20 16000

10. Salary of a rector 8000×12 9600011. Salary of braile teacher 96000

Total 718000

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Divyajyoti trust presentation (Mandvi,Dist-Surat)07.10.2015

Healthcare

Transcript of Divyajyoti trust presentation (Mandvi,Dist-Surat)07.10.2015