Professional Documents
Culture Documents
(Reaffirmed 2010)
UDC 362.111-725.51
(Reaffirmed 2009)
(Reaffirmed 2008)
(Reaffirmed 2007)
(Reaffirmed 2006)
(Reaffirmed 2005)
© Copyright 1988
BUREAU OF INDIAN STANDARDS
MANAK BHAVAN, 9 BAHADUR SHAH ZAFAR MARG
NEW DELHI 110002
Gr 8 November 1988
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Indian Standard
BASIC REQUIREMENTS FOR
HOSPITAL PLANNING
PART 1 UP TO 30 BEDDED HOSPITAL
0. FOREWORD
0.1 This Indian Standard ( Part 1 ) was adopted degree of specialization and larger bed
by the Bureau of Indian Standards on 20 July complements
1988, after the draft finalized by the Hospital
Planning Sectional Committee had been approved 0.6 While preparing this standard, assistance has
by the Consumer Products and Medical Instru- been derived from the following
ments Division Council Report of the hospital equipment standardi-
zation committee, issued by the Directorate
0.2 T h e Government of India is the signatory to General of Health Services, Government of
the Alma Ata declaration to achieve the objective India ( popularly known as 'Bajaj Commi-
of health lor all by the year 2 000 A D T h e ttee Report' 1980 )
country at present has nearly 7 000 hospitals with
over 500 000 beds with a bed population ratio Guide to Staffing Pattern for Hospitals,
of 0 7 bed per 1 000 population This bed com- issued by the N a n nal Institute of Health &
plement is inadequate and inequitably distributed Family Welfare, Government of India
and even inefficient National Health Policy
(1983) has laid guidelines towards comprehensive Delhi Nursing H o m e Registration ( 1953 )
and integrated approach to development and Act and Amendment to Rules (1965), issued
strengthening of national health care infrastruc- by the Delhi Administration
ture Primary health care has been adopted as the
principal instrument of action 0.6.1 Assistance has also been derived from
Project report on hospital planning prepared by
0.3 In order to accomplish the above objective, Dr A K Nagpal, Managing Partner of Hospital
therefore, it will be necessary to strengthen the Designs and Svstems, New Delhi
existing health care infrastructure and make it 0.7 This standard covers requirements mainly for
more efficient and responsive to the health needs 30 bedded hospital meant for community health
and priorities of our country centres However, a suitable scope has been
provided for further expansion
0.4 This standard comprises the following sections
describing five fundamental aspects ot hospital 0.8 The other paris of this Indian Standard
planning, namely which will be published in due course are as
follows
Section 1 Functional programme
Basic Requirements for Hospital Planning
Section 2 Functional and space requirements
Part 2 Up to 100 bedded hospital
Section 3 Manpower requirements
Part 3 Up to 250 bedded hospital
Section 4 Instruments and equipment
Part 4 Up to 500 bedded teaching hospital
Section 5 Building requirements
Part 5 Up to 500 bedded non-teaching
0.5 It is envisaged that the above requirements hospital
will not only serve as guidelines for planning of Part 6 Up to 750 bedded teaching hospital
30 bedded hospitals but also will form the basis of
further development in the field to structure speci- Part 7 Up to 750 bedded non-teaching
fic building standards for hospitals with higher hospital
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( Continued ) ( Continued )
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Min Win
8.1.6 Administrative and Ancillary Staff General attendants 2
Stenographer 1 Security attendants 4
Storekeeper 1 Sanitary attendants 5
Adminstration assistant 1
Trlephone operator/Telex operator 1
Driver 1 Grand Total 63
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IS : 12433 ( P a r t 1) - 1988
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IS : 112433 ( P a r t 1 ) - 1988
11.11 Supporting Facilities — Various clinics 12.2.3 Radiology and Fluoroscopy Room — The
under O P D required supporting facilities which size of the room shall depend upon the type of
include waiting spaces, medical records and injec- equipment installed. T h e room should have a
tion room. A social worker room to render service sub-waiting area with toilet facility and a change
to patients may also be provided. room facility, if required Fluoroscopy room shall
be completely cut off irom the direct light
through provisions of air-locks. T h e radiography
11.11.1 Waiting Spaces — General waiting per units should be operated from separate control
clinic and subsidiary waiting spaces are required room or behind a lead mobile protection screen
adjacent to each consultation and treatment room of 1 5 mm lead equivalent wherever necessary.
in all the clinics.
12.2.4 Film Developing and Processing Room —
Film developing and dark rooms shall be provi-
11.11.2 Medical Records — It is desirable to ded in the department for loading, unloading,
maintain the medical records of the out patients developing and processing of X-ray films. The
in continuation of registration area. room should be provided between a pair of
radiography rooms so that new and exposed
11.11.3 Injection Room — For administering X-ray films may be easily passed through the
injection to partients a central injection room cassette pan with 2 0 mm lead backing installed
in the wall in between. The room should be
shall be provided in conjunction with the dispen-
completely cut off from direct light through pro-
sary.
vision of airlock For ventilations, exhaust fans
shall be provided. The room shall have a loading
12. DIAGNOSTIC ZONE bench ( with acid and alkali resistant t o p ) ,
processing tank, washing tank and a sink Floor-
ing for the room shall be acid and alkali proof
12.1 Clinical Laboratory — T h e clinical labo-
ratory should be provided with 600 mm wide 12.2.5 Film Drying and Storing — There shall
a n d 800 mm high bench of length about 2 m be some space available for flim drying and
per technician and to full width of room for storting near the room of film developing.
pathologist incharge of the laboratory. Each
laboratory bench shall have laboratory sink with 12.2.6 Treatment Room — Treatment room ot
swan neck fittings, reagent shelving, gas and the department shall include space for the intra
power point and under-counter cabinet. T o p of X-ray and contact therapy apparatus which is ot
t h e laboratory bench shall be of acid alkali proof simple character, occupies little space and may
material. not need elaborate structural requirements.
15
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IS : 12433 ( P a r t 1) - 1988
12.2.7 Ultra Sound — Ultra sound, a scanning 13.4.1 Nursing Station — It should be position-
device of imaging department, also requires a ed in such a way that the nurse can keep a
small room for use mainly by gynaecology a n d continuous watch over the patients T h e room
obstetric clinic shall contain a cupboard to hold materials which
might otherwise be placed in clean utility room,
13. INTERMEDIATE ZONE ( Inpatient a drug cupboard, sink, chair, small table a n d
nursing units ) space for call system points and records Separate
toilet facilities for nurses shall be provided.
13.1 General — Inpatients Nursing Units, that
is, ward concept is fast changing due to policy of 13.4.2 Treatment Room — Major dressing a n d
early ambulation and infact only a few patients complicated treatments should be carried out in
really need to be in the bed T h e basic considera- the treatment room to avoid the risk of cross-
tions in placement wards is to ensure sufficient infection
nursing care locating them according to the
needs of treatment in respective medical disci- 13.4.3 Ward Pantry— For collection and distri-
pline and checking cross infection In this case bution of meals and preparation of beverages, a
there should be two ward units, one for male and ward pantry shall be provided It should be
one for female fitted with a hot-water supply geyser, refrigerator
and a hot case and should have the facilities for
13.2 W a r d U n i t — In planning a ward, the
storing cudery, etc
aim should be to minimize the work of the nurs-
ing staff and provide basic amenities to the 13.4.4 Ward Store — A store shall be provided
patients within the Unit T h e distances to be for storing the weekly requirements of clothes,
travelled by a nurse from bed areas to treatment bed sheets, and other ward equipment
room, pantry, etc should be kept to be minimum
T h e ward unit may be made of desired number 13.4.5 Sluice Room — A room shall be provided
of beds at the rate of 7 m 2 per bed and should for emptying and cleaning bed pans, urine
be arranged with a minimum distance of 2 25 m bottles, and sputum mugs, disposing ot used dress-
between centre of two beds and a clearance of ing and similar material, storage of stool a n d
200 mm between the bed a n d wall In wards the urine specimen, etc
width of doors shall not be less than 1 2 m and
all wards should have dado to a height of 1 2 m 13.4.6 Day Space — For those patients who
Isolation unit in the form of one single bedded are allowed to sit and relax, a room shall be
rooms per ward unit may be provided to cater provided in the ward unit itself It should afford
for certain case requiring isolation from other an easy access to patients and supervision by the
patients An area of 14 m 2 for such room to nursing staff and should be provided with easy
contain a bed, bedside locker, easy chair for chairs, book shelves and small tables It may
patient, a chair for the visitor and a built in also serve as dining space
cupboard for storing clothes is recommended
This isolation unit should have separate toilet
facilities 13.4.7 The sanitary requirements of an Inter-
mediate Zone' are given below
13.3 T y p e of Ward — Wards may be either
nightingale or rigs type In the former, beds are Item Number Requited
arranged at right angle to the wall with the feet
towards the central corridor, and in the latter Water closets 2 ( for male ward )
4 to 6 beds are arranged parallel to the longitudi- 3 ( for female ward )
nal walls and each pair of beds facing each other
A rig type ward is recommended from socio- Ablution taps 1 for each water closet
environments stand point plus 1 watt r tap with
drainage arrange-
13.4 General Ward Facilities — Each ward ment in the vicinity
unit should have a set ot ward ancillaries as of water closets
given below
Urinals 2 ( for male ward )
a) Nursing station,
Wash Basins 2 ( each ward )
b) Treatment room,
c) W a i d pantry, Baths 2 ( for each ward )
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14. CRITICAL ZONE ( OPERATION closing devices. Natural lighting shall be provided
THEATRE/LABOUR ROOM with large windows and general illumination by
DEPARTMENT ) means ol fluorescent tubes. The operating room/
labour room should be normally arranged in
14.1 General — Operating suite/labour room is pairs with scrub-up and instrument sub-sterilizing
technically a therapeutic aid in which a team of room.
surgeons, anaesthtsists, nurses and sometime
pathologist and radiologist operate upon or care 14.7 Scrub-up — In this room the operating
for the patients. For optimum utilization of the team washes and scrub-up their hands and arms,
operation/labour room units, this department, put on their sterile gown, gloves and other covers
as a rule, should not be reserved rigidly for use before entering the operation theatre/labour room.
by a particular department. It should have a single leaf door with self-closing
device and viewing window to communicate with
14.2 C i r c u l a t i o n — Normally there are three the operation theatre/labour room. A pair of
types of traffic flow, namely (a) patients, (b) staff, surgeons sinks with elbow or knee operated taps
and (c) supplies. All these should be properly are required.
channelized.
14.8 I n s t r u m e n t Sterilization — It is a sub-
14.3 P a t i e n t s — Patients are brought from the sterilizing unit attached to the operation theatre/
ward and should not cross the transfer area in labour room limiting its role to operating instru-
their ward clothing which is a great source of ments on an emergency basis only. This room
infection Change-over of trolleys should be should be equipped with high pressure, quick
effected at a place which will link up both pre- sterilization apparatus. Instrument cupboard and
operative and post-operative rooms. a work bench with sinks are required.
14.3.1 Preparation Room ( Theatre Pack ) — It 14.9 D i s p o s a l — Theatre refuse, such as dirty
should be a work room for arranging for stret- linen, used instruments and other disposable/non-
chers, dressing and all other surgical items. disposable item should be removed to a room
14.3.2 Pre-operative Room — Patients are trans- after each operation. Non-disposable instruments
ferred from respective ward to this room for after initial wash is given back to instrument
premedication before operation. Segregation of sterilization unit and rest of the disposable items
male and female patients is to be taken care of. are disposed and destroyed. Dirty linen is sent to
T h e room should have toilet facility separately laundry through a separate exit. T h e room should
be provided with sink, slop sink, work bench and
for men and women.
draining boards.
14.3.3 Post Operative Resting — Immediately
after the operation, the patients are kept in a 15. SERVICES ZONE
room situated close to the operation theatre/ 15.1 Dietary Service ( Optional ) — T h e dietary
labour room until such time they arc found fit to service of a hospital is an important therapeutic
be taken to their parent ward. tool. Properly rendered, it shall be a clinical and
14.4 Staff — T h e doctors, nurses, technicians administrative means of stimulating rapid recovery
a n d assisting staff should enter from a separate of patients thereby shortening patients stay in the
route and through a set of change rooms and an hospital. T h e aim in hospital catering, therefore,
air lock. They should communicate through the should be to produce well cooked, appetizing and
nutritious food as economically as possible. T h e
sterile corridor. A shoe change and gowning
achievement of this objective shall depend on
space near the air lock shall also be provided.
administrative efficiencies of the staff, planning
Separate change rooms for doctors, nurses and
department, layout and equipment. T h e hospital
technicians shall be provided, with arrangement kitchen alone could be responsible for spreading
for lockers, bathing and toilet facilities. diseases if hygienic conditions are not maintained.
14.5 Supplies — All sterile goods should have a Use of cooking gas and electricity will definitely
separate entry point reaching the clean corridor improve the hygienic conditions of a hospital
independently; soiled material should be taken kitchen. Good natural light and ventilation is of
out by the exit only. Store rooms shall be provi- great importance.
ded for storing theatre supplies, such as stretcher,
trolley, sterile material, medical gas cylinders, 15.2 Central Sterilization and Supply De-
instruments and linen. p a r t m e n t ( CSSD ) — Sterilization, being one of
the most essential services in a hospital, requires
14.6 O p e r a t i o n Theatre/Labour R o o m — the utmost consideration in planning. Centraliza-
Operating room/labour room should be made tion increases efficiency, results in economy in
dust-proof, moisture proof, corners and junctions the use of equipment and ensures better supervi-
of walls, floor a n d ceiling should be rounded to sion and control. T h e materials and equipments
prevent accumulation of dust and to facilitate dealt in CSSD should fall under three categories:
cleaning. All doors should be two leaf type with a) those related to the operation theatre depart-
a minimum 1-5 m width and shall have self ment, b) common to operating and other
17
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departments, and c) pertaining to other depart- 15.5.2 Illumination — For requirements and
ments alone. method for daylighting in hospital building refe-
rence may be made to IS : 2440-1975*. The
15.3 Laundry Services — Laundering of hospi- level of illumination for various visual tasks shall
tal linen shall satisfy two basic considerations, be provided in accordance with IS : 4347-1967†.
namely, cleanliness and disinfection. The hospital General lighting of all hospital areas except stores
could be provided with necessary facilities for and lavatory block shall be fluorescent. In other
drying, pressing and storage of soiled and clean- areas it is recommended to be of incandescent
ed linens. lamps. Electrical installation except for artificial
illumination, shall be in accordance with IS :
15.4 Civil Engineering 732 ( Part 2 )-1983‡ IS : 732 ( Part 3 )-1982‡
IS : 8030-1976§ and SP:30-1985||.
15.4.1 Budding Maintenance — An office-cum-
store should be provided to handle day to day
maintenance works of the hospital building
15.5.2.1 Shadowless light — Shadowless light
15.4.2 Horticulture — To maintain the hospital ( mountable type ) shall be provided in operation
landscaping, a room to store garden implements, theatres and operating delivery rooms whereas in
seeds, etc, should be provided. other areas, where operation of minor nature are
carried out shadowless ( portable type ) shall be
15.4.3 Water Supply — Arrangements shall be provided.
made to supply 10 000 litres of potable water per
day to meet all the requirements ( including
laundry ) except fire fighting Storage capacity 15.5.2.2 Emergency lighting — Emergency
for 2 da\ s requirements should be on the basis of portable light units should also be provided in the
the above consumption Round the clock water wards and departments to serve as alternative
supply shall be made available to all wards and source of light in case of power failure.
departments of the hospital. Separate reserve
emergency overhead tank shall be provided for
operation theatre. Necessary water storage over- 15.5.2.3 Lighting protection — The lighting
head tanks with pumping/boosting arrangement protective system of hospital buildings shall be in
shall be made. The laying and distribution of accordance with IS : 2309-1969¶.
the water supply system shall be according to the
provisions of IS : 2065-1983*. Gold and hot
water supply piping should be run in concealed 15.5.2.4 Call bells — Gall bell switches ( see
form embedded into wall with full precautions IS : 2268-1966** should be provided for all beds
to avoid any seepage in all types of wards with indicator lights and
location indicator situated in the nurses duty
15.4.4 Drainage and Sanitation — The design, room of the wards.
construction and maintenance of drains for waste
water, surface water, sub-soiled water and sewer- 15.5.3 Ventilation — Ventilation of hospital
age shall be in accordance with IS : 1742-1983†. buildings may be achieved by either natural
15.4.4.1 The selection, installation and supply and natural exhaust of air, or natural
maintenance of sanitary appliances shall be in followingandstandards
supply mechanical exhaust of air. The
of general ventilation are
accordance with IS : 2064-1973‡ The design and recommended for various areas of the hospital
installation of soil, waste and ventilating pipes building based on maintenance of required
shall be as given in IS : 5329-1983§. oxygen, carbon-doixide and other air quality
15.5 Electrical Engineering levels and for the control of body odours when
no products of combustion or other contaminants
15.5.1 Sub-Station and Generation — Electric sub- are present in the air or anaesthesia gases which
station and generating set to accommodate trans- are highly explosive are present:
former, HT/LT panel and generating set to meet
the electrical requirement of the hospital shall be *Guide for daylighting of buildings (second revision ).
provided Standby generators should be provided †Code of practice for hospital lighting
to generate power requirement for essential and ‡Code of practice for electrical wiring installations:
critical areas of the hospital such as OT/LR and Part 2 Design and Construction ( second revision )
Part 3 Inspection and testing of installations ( second
radiology department revision )
§Specification for luminaires for hospitals
*Code of practice for water supply in building ( second ||INational electrical code: Part 3 Electrical installation
recision ) in non-industrial buildings, Section 4 Medical establish-
†Code of practice for building drainage (second revision). ment
‡Code of practice for selection, installation and main- ¶Code of practice for the protection of building and
tenance of sanitary appliances ( first revision ) allied structure against lighting (first revision )
§Code of practice for sanitary pipe work above ground **Specification for electric call bells and buzzers for
for buildings (first revision ) indcor use ( revised ).
18
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IS : 12433 ( P a r t 1) - 1988
Space to be Ventilated Air changes per hour duties for patient care and all employees of the
hospital who are within the building in the event
Bathrooms/toilets 6 - 12 of emergency.
Wards 8 - 12
Kitchens 6-9 T h e alerting system shall be capable of being
operated from intercoms, telephones and the
Operation theatres 15 - 20 administrative office.
Other air-conditioned 8 - 10
spaces 15.7.3 Fire Protection
15.7.3.1 First-aid fire-fighting equipment —
15.5.3.1 T h e general principles of nautral ven- Adequate first-aid, fire-fighting equipment shall be
tilation shall be in accordance with I S : 3362-1977*. provided and installed in accordance with IS :
W h e r e adequate air changes cannot be obtained 2190-1979*.
by natural ventilation, mechanical ventilation
either by exhaust of air or by positive ventilation 15.7.3.2 Fire alarm — Manually-operated fire
( like fans and other equipment) or combination alarm facilities shall be provided in hospital build-
of two shall be provided. Fans and other equip- ings which sound an audible alarm in adminis-
ments for mechanical ventilation may be located trative department, engineering service, offices,
in convenient positions having regard to the fire office and such other locations where gongs,
intake of fresh air, accessibility for maintenance sirens, whistles or bells do not disturb the patients.
and noise control. Exhaust fans shall be provided Distinctive visual or audible alarm shall be insta-
in walls on one side or in the attic or roof. T h e lled at each nurses duty room, duty station and
exhausted air shall not find entry back into used for fire alarm purpose only. Hospitals may
hospital. also be equipped with Automatic fire alarm system
conforming to IS : 2189-1976†.
15.6 M e c h a n i c a l E n g i n e e r i n g
15.7.4 Waste Disposal System — T h e hospital
15.6.1 Air-conditioning and Room Heating — Air- shall be provided with one incinarator consisting
conditioning units shall be provided only for the of a burning chamber and chimney.
operation theatre and neonatal unit. However,
air-coolers or hot air convectors may be provided 15.7.5 Mortuary — Mortuary shall provide faci-
for the comforts of the patients and the staff lities for keeping of dead bodies and conducting
depending upon the local needs. autopsy. It should be so located that the dead
bodies can be transported unnoticed by the general
15.6.2 Refrigeration — Hospital shall be pro- public and patients. Relatives and mourners should
vided with water coolers and refrigerators ( see have direct access to the mortuary. T h e mortuary
IS : 1474-1959† ) in wards and departments, shall have facilities for walk in cooler, post
depending upon the local needs. mortem area, etc.
15.7 O t h e r Services 16. ADMINISTRATIVE ZONE
15.7.1 Gas Supply 16.1 G e n e r a l A d m i n i s t r a t i o n — T h e adminis-
tration department of hospital shall essentially
15.7.1.1 Medical gas — Medical gases com-
look after organised group of people, patients and
prise mainly of oxygen and nitrous oxide. T h e
resources in order to accomplish the task of provid-
cylinder supply should be made available. ing best patient care. It shall have two main sec-
15. 7.1.2 Cooking gas — For better hygienic tions, namely, general and medical records.
conditions use of LPG cooking gas ( liquefied General section shall deal with all matters relating
petroleum gas ) cylinders are recommended. to overall upkeep of the hospital as well as welfare
of its staff and patients. Medical records section
15.7.1.3 Laboratory gas — LPG ( liquefied shall function for professional work in diagnosis,
petroleum gas ) cylinders should be made avail- treatment and care of patients.
able for pathological lab. Alternatively, kerosine
stove may be made available where gas supply is 16.2 General S t o r e s — Hospital stores comprises
not available. stores needed for various hospital functioning and
should be grouped centrally in the service complex.
15.7.2 Telephone and Intercom — Wiring in con- T h e area for each type of stores should be utilized
duits shall be provided to give telephone outlet to the optimum by providing built in shelves at
points in room, wards and departments as desired different heights according to the type of stores.
by the authority. An intercom system may also be Adequate ventilations and security arrangement
provided in addition to the telephones. T h e com- shall be provided. Stores should also be provided
munication system should be adequately designed in with fire fighting arrangement.
hospitals for alerting all persons charged with
*Code of practice for selection, installation and main-
tenance of portable first-aid fire extinguishers ( second revi-
*Code of practice for natural ventilation of residential sion ).
buildings (first revision ). †Code of practice for installation of automatic fire alarm
†Specification for commercial refrigerators. system using heat sensitive type fire detectors (first revision).
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IS : 112433 ( P a r t 1 ) - 1988
APPENDIX A
(Clauses 9.1 and B-3 )
LIST OF INDIAN STANDARDS ON E X T R A C T I O N FORCEPS
IS : 4976-1987 Forceps, extraction, dental, upper anteriors, No. 1 and 2 (first revision )
IS : 4977-1968 Forceps, extraction, dental, lower molar, Hawk's Bill N o . 1
IS : 6824-1972 Forceps, extraction, dental, lower wisdom tooth
IS : 6825-1972 Forceps, extraction, dental, upper cuspids and bicuspids
IS : 6826-1972 Forceps, extraction, dental, lower incisors, cuspids and bicuspids, left
IS : 6827-1972 Forceps, extraction, dental, upper molars, left
IS : 6828-1972 Forceps, extraction, dental, upper molars, right
IS : 6856-1972 Forceps, extraction, dental, upper root, narrow beak
IS : 6858-1972 Forceps, extraction, dental, lower incisors, cuspids a n d bicuspids
IS : 6859-1972 Forceps, extraction, dental, upper root, wide beak
IS : 6866-1986 Forceps, extraction, dental, upper wisdom tooth (first revision )
IS : 6867-1972 Forceps, extraction, dental, upper root, medium peak
IS : 6868-1972 General requirements for forceps, extraction, dental
IS : 8044-1976 Forceps, extraction, dental, lower molar, children
IS : 8045-1976 Forceps, extraction, dental, lower incisors and canines, children
IS : 8046-1976 Forceps, extraction, dental, upper incisors
IS : 8047-1976 Forceps, extraction, dental, upper molar, children
APPENDIX B
[ Clause 9.1 (C-4) ]
BLACKSMITH AND CARPENTRY T O O L S
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