EXCELLENCE IN Innovative Product/Service in Healthcare with Highest Societal Impact

(Silver Rolling Trophy – Instituted by
Shantha Biotechnics Pvt. Ltd., Hyderabad)
QUESTIONNAIRE

Part – 1

1. Name and Address of the Industry/ :

organization with Tel./Fax No.

and E-mail

2. Location and addresses of manufacturing :

units/ branches in Telangana/A.P.

where relevant

3. Nature of activity – manufacturing / :

service/export

4. Whether Large/Medium/Small Scale Unit :

5. Nature of the organization :

(Body corporate, partnership,

Proprietorship, NGOs etc.)

Names and Addresses of

Board members, Partners etc.

6. Brief description of goods and services :

produced

7. Particulars of revenue in value (Rupees) :

of the unit (s) for the past 3 years.

(refer Part II (3)

8. Competency and skill level of the :

employees

Skills / Certification/Degrees / Relevant Experience / Remarks
Technical
Social
Academic

9. Enclose Balance sheet & Profit and Loss :

Account for the past 3 years.

10. Give a brief write-up about the nature of :

innovation project/(s)you have

carried out in last three years

11. Analyze objectively (with verifiable) :

data how innovation (products and
services) has contributed to your top line
(Net Revenue) and/or bottom
line growth (EBITDA) over last three years

12. Organizations in the social sector/service :

should provide data to demonstrate how

innovation has positively impacted

society and/or environment at large

(Refer Part II 3)

13. Mention any Awards received earlier :

from any organization/ institution on

innovation explaining the

achievements meriting the Award (s)

including from FTAPCCI

14. Please indicate your willingness or :

Otherwise for the Jury to visit the site,

if so, desired.

PART II

1. Describe (max 100 words) the innovation :

process that your organization follows

on the following parameters:

People :

Process :

Technology :

2. Describe (max 100 words) the nature of :

innovation

Internal (like cost optimization, :

productivity increase)

External :

Commercial :

Social :

Scientific/Educational :

3. Provide data for 3 financial years to :

substantial the impact of innovation

(the measurement parameters are

illustrative only)

Measurement Factors / Rs Lakhs (or other units of measure) / %
Commercial / Increase in Revenue
Increase in EBIT DA
Decrease in input cost
Decrease in Revenue
Decrease in quality rejections
Decrease in Machine downtime
Societal / Increase in literacy rates
Reduction in poverty
Increase in nutrition level
Increase in agricultural yield
Environmental / Reduction in pollution level
Technological (including IT) / Productivity increase

4. Please give a brief write-up to explain :

why you consider yourself suitable for

this Award in terms of the achievement

upto now and prospects of continued

maintenance of the same

Signature & Designation

with Office Seal

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