Award Nomination

Award Profile

Select Sector:*
Private Hospitals
Health & Wellness
Medical Equipment
Medical Tourism
Corporate
Health Insurance
Diagnostics Laboratories
Corporate Social Responsibility
Start-Up
Banking and Financing Institutions
Pharma

Project Category :*
Product/Project Title:*

Details of Applicant

Name:*

Designation:*

Name of Organisation:*

Address:*

City:*

State:*

Country:*

Postal Code:

Telephone No:*
(with area code)

Mobile No:*
(with country code)

E-Mail:*

Website:*

Facebook page of the Organisation:

LinkedIn page of the Organisation:

Twitter Handle of the Organisation:

Details of Project Implementing Agency

Name of Organisation:*

Address:*

City:*

State:*

Country:*

Postal Code:
Head of Organization:*

Telephone No:*
(with area code)

Mobile No:*
(with country code)

E-mail:*

Alternate E-mail:

Website:

Social Media profile of the Project:

Details of Project Initiative

Brief Description:*
(Maximum word limit of 2000 Characters)

Objective:*

Target Group:*

Geographical Reach
Please specify reach within India:
Please specify reach outside India:
When did it become operational:
 
Is it still operational:*
Yes        No

 
Five points that make the Project innovative:
    1*  

    2*  

    3*  

    4  
    5  
Five key achievements of the Project:
    1*    

    2*    

    3*    

    4     
    5     
Five key challenges faced while implementing the Project and how they were overcome:
    1*    

    2*    

    3*    

    4     
    5     
Five points that make the Project replicable:
    1*    

    2*    

    3*    

    4     
    5     
Five points to elaborate on the scalability of the Project:
    1*    

    2*    

    3*    

    4     
    5     
Documents publishing URL:
            
Facebook page of the Project:
LinkedIn page of the Project:
Twitter handle of the Project:
 
Upload Organisation Logo:*
(Maximum file size 1 MB in jpeg, jpg or png format)

Upload supporting documents:
(Maximum file size 1 MB in pdf or doc format)

Upload scanned copy of Authorisation Certificate:*
(Maximum file size 1 MB in pdf or doc format)