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<!--ANNAgreement V1.0 (10-04-2026)-->
<xbrli:xbrl xmlns:in-capmkt="https://www.sebi.gov.in/xbrl/2024-04-30/in-capmkt" xmlns:in-capmkt-ent="https://www.sebi.gov.in/xbrl/Announcement_For_Agreements/2024-04-30/in-capmkt/in-capmkt-ent" xmlns:in-capmkt-roles="https://www.sebi.gov.in/xbrl/Announcement_For_Agreements/2024-04-30/in-capmkt-roles" xmlns:xbrldt="http://xbrl.org/2005/xbrldt" xmlns:nonnum="http://www.xbrl.org/dtr/type/non-numeric" xmlns:in-capmkt-type="https://www.sebi.gov.in/xbrl/2024-04-30/in-capmkt-types" xmlns:link="http://www.xbrl.org/2003/linkbase" xmlns:net="http://www.xbrl.org/2009/role/net" xmlns:num="http://www.xbrl.org/dtr/type/numeric" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:iso4217="http://www.xbrl.org/2003/iso4217" xmlns:negated="http://www.xbrl.org/2009/role/negated" xmlns:xbrldi="http://xbrl.org/2006/xbrldi" xmlns:xbrli="http://www.xbrl.org/2003/instance" xmlns:xl="http://www.xbrl.org/2003/XLink"><link:schemaRef xlink:type="simple" xlink:href="in-capmkt-ent-2024-04-30.xsd"/><xbrli:context 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scheme="https://www.sebi.gov.in/in-capmkt/ScripCode">539551</xbrli:identifier></xbrli:entity><xbrli:period><xbrli:startDate>2026-10-06</xbrli:startDate><xbrli:endDate>2026-10-06</xbrli:endDate></xbrli:period><xbrli:scenario><xbrldi:typedMember dimension="in-capmkt:PartiesOfTheAgreementAxis"><in-capmkt:PartiesOfTheAgreementDomain>PartiesOfTheAgreementDomain2</in-capmkt:PartiesOfTheAgreementDomain></xbrldi:typedMember></xbrli:scenario></xbrli:context><xbrli:context id="I_PartiesOfTheAgreement2"><xbrli:entity><xbrli:identifier scheme="https://www.sebi.gov.in/in-capmkt/ScripCode">539551</xbrli:identifier></xbrli:entity><xbrli:period><xbrli:instant>2026-10-06</xbrli:instant></xbrli:period><xbrli:scenario><xbrldi:typedMember dimension="in-capmkt:PartiesOfTheAgreementAxis"><in-capmkt:PartiesOfTheAgreementDomain>PartiesOfTheAgreementDomain2</in-capmkt:PartiesOfTheAgreementDomain></xbrldi:typedMember></xbrli:scenario></xbrli:context><xbrli:context id="D_PartiesOfTheAgreement3"><xbrli:entity><xbrli:identifier scheme="https://www.sebi.gov.in/in-capmkt/ScripCode">539551</xbrli:identifier></xbrli:entity><xbrli:period><xbrli:startDate>2026-10-06</xbrli:startDate><xbrli:endDate>2026-10-06</xbrli:endDate></xbrli:period><xbrli:scenario><xbrldi:typedMember dimension="in-capmkt:PartiesOfTheAgreementAxis"><in-capmkt:PartiesOfTheAgreementDomain>PartiesOfTheAgreementDomain3</in-capmkt:PartiesOfTheAgreementDomain></xbrldi:typedMember></xbrli:scenario></xbrli:context><xbrli:context id="I_PartiesOfTheAgreement3"><xbrli:entity><xbrli:identifier scheme="https://www.sebi.gov.in/in-capmkt/ScripCode">539551</xbrli:identifier></xbrli:entity><xbrli:period><xbrli:instant>2026-10-06</xbrli:instant></xbrli:period><xbrli:scenario><xbrldi:typedMember dimension="in-capmkt:PartiesOfTheAgreementAxis"><in-capmkt:PartiesOfTheAgreementDomain>PartiesOfTheAgreementDomain3</in-capmkt:PartiesOfTheAgreementDomain></xbrldi:typedMember></xbrli:scenario></xbrli:context><xbrli:unit id="pure"><xbrli:measure>xbrli:pure</xbrli:measure></xbrli:unit><xbrli:unit id="shares"><xbrli:measure>xbrli:shares</xbrli:measure></xbrli:unit><in-capmkt:NameOfTheCompany contextRef="MainI">Narayana Hrudayalaya Ltd.</in-capmkt:NameOfTheCompany><in-capmkt:NSESymbol contextRef="MainI">NH</in-capmkt:NSESymbol><in-capmkt:TypeOfAnnouncement contextRef="MainI">New</in-capmkt:TypeOfAnnouncement><in-capmkt:TypeOfAgreement contextRef="MainI">Others</in-capmkt:TypeOfAgreement><in-capmkt:DetailsOfOtherTypeOfAnnouncement contextRef="MainI">Operations and Management Agreement</in-capmkt:DetailsOfOtherTypeOfAnnouncement><in-capmkt:StageOfAgreement contextRef="MainI">Execution of agreement</in-capmkt:StageOfAgreement><in-capmkt:AgreementsEnteredIntoBy contextRef="MainD">Listed Entity</in-capmkt:AgreementsEnteredIntoBy><in-capmkt:WhetherEventOrInformationDisclosedIsAnOutcomeOfBoardMeeting contextRef="MainD">false</in-capmkt:WhetherEventOrInformationDisclosedIsAnOutcomeOfBoardMeeting><in-capmkt:DateOfOccurrenceOfEvent contextRef="MainI">2026-10-05</in-capmkt:DateOfOccurrenceOfEvent><in-capmkt:TimeOfOccurrenceOfEvent contextRef="MainD">15:00:00</in-capmkt:TimeOfOccurrenceOfEvent><in-capmkt:WhetherTheListedEntityIsPartyToTheAgreement contextRef="MainD">true</in-capmkt:WhetherTheListedEntityIsPartyToTheAgreement><in-capmkt:DateOfReport contextRef="MainI">2026-10-06</in-capmkt:DateOfReport><in-capmkt:DetailsOfExecutionOfAgreement contextRef="MainI">Company has entered into an Operation and Management Agreement with the Mission of Mercy Hospital and Research Centre, a Society registered under the West Bengal Societies Registration Act, 1961 having its registered office at No. 125/1, Park Street, Kolkata – 700017 and The Assemblies of God of North India, a Society registered under the West Bengal Societies Registration Act, 1961 having its registered office at 18, Royd Street, Kolkata - 700015 to operate, manage, direct and control the Mission of Mercy Hospital &amp; Research Centre situated at No. 125/1, Park Street, Kolkata – 700017 (the “Hospital”) and provide healthcare services, leveraging the Company’s expertise in healthcare and hospital management.</in-capmkt:DetailsOfExecutionOfAgreement><in-capmkt:WhetherProposedOrExecutedAgreementIsInNormalCourseOfBusiness contextRef="MainI">true</in-capmkt:WhetherProposedOrExecutedAgreementIsInNormalCourseOfBusiness><in-capmkt:ImpactOfAgreementOnManagementAndControlOfTheListedEntity contextRef="MainI">There is no material impact on management and control of Narayana Hrudayalaya Ltd.</in-capmkt:ImpactOfAgreementOnManagementAndControlOfTheListedEntity><in-capmkt:NumberOfPartiesToTheAgreement contextRef="MainI" unitRef="pure" decimals="0">3</in-capmkt:NumberOfPartiesToTheAgreement><in-capmkt:NameOfPartiesOrCounterPartiesOfTheAgreement contextRef="D_PartiesOfTheAgreement1">Narayana Hrudayalaya Ltd.</in-capmkt:NameOfPartiesOrCounterPartiesOfTheAgreement><in-capmkt:NatureOfThePartiesOfTheAgreement contextRef="I_PartiesOfTheAgreement1">Party entering into the agreement</in-capmkt:NatureOfThePartiesOfTheAgreement><in-capmkt:DetailsOfShareholdingInTheEntityWithWhomTheAgreementIsExecuted contextRef="I_PartiesOfTheAgreement1">NIL</in-capmkt:DetailsOfShareholdingInTheEntityWithWhomTheAgreementIsExecuted><in-capmkt:NumberOfSharesOfPartyOfTheAgreement contextRef="I_PartiesOfTheAgreement1" unitRef="shares" decimals="INF">0</in-capmkt:NumberOfSharesOfPartyOfTheAgreement><in-capmkt:PercentageOfShareholdingOfPartyOfTheAgreement contextRef="I_PartiesOfTheAgreement1" unitRef="pure" decimals="INF">0</in-capmkt:PercentageOfShareholdingOfPartyOfTheAgreement><in-capmkt:WhetherThePartiesToTheAgreementAreRelatedToPromoterOrPromoterGroupOrAssociateOrHoldingOrSubsidiaryOrGroupCompaniesOrDirectorOrKMPAndItsRelativesInAnyManner contextRef="I_PartiesOfTheAgreement1">false</in-capmkt:WhetherThePartiesToTheAgreementAreRelatedToPromoterOrPromoterGroupOrAssociateOrHoldingOrSubsidiaryOrGroupCompaniesOrDirectorOrKMPAndItsRelativesInAnyManner><in-capmkt:NameOfPartiesOrCounterPartiesOfTheAgreement contextRef="D_PartiesOfTheAgreement2">Mission of Mercy Hospital and Research Centre</in-capmkt:NameOfPartiesOrCounterPartiesOfTheAgreement><in-capmkt:NatureOfThePartiesOfTheAgreement contextRef="I_PartiesOfTheAgreement2">Party entering into the agreement</in-capmkt:NatureOfThePartiesOfTheAgreement><in-capmkt:DetailsOfShareholdingInTheEntityWithWhomTheAgreementIsExecuted contextRef="I_PartiesOfTheAgreement2">NIL</in-capmkt:DetailsOfShareholdingInTheEntityWithWhomTheAgreementIsExecuted><in-capmkt:NumberOfSharesOfPartyOfTheAgreement contextRef="I_PartiesOfTheAgreement2" unitRef="shares" decimals="INF">0</in-capmkt:NumberOfSharesOfPartyOfTheAgreement><in-capmkt:PercentageOfShareholdingOfPartyOfTheAgreement contextRef="I_PartiesOfTheAgreement2" unitRef="pure" decimals="INF">0</in-capmkt:PercentageOfShareholdingOfPartyOfTheAgreement><in-capmkt:WhetherThePartiesToTheAgreementAreRelatedToPromoterOrPromoterGroupOrAssociateOrHoldingOrSubsidiaryOrGroupCompaniesOrDirectorOrKMPAndItsRelativesInAnyManner contextRef="I_PartiesOfTheAgreement2">false</in-capmkt:WhetherThePartiesToTheAgreementAreRelatedToPromoterOrPromoterGroupOrAssociateOrHoldingOrSubsidiaryOrGroupCompaniesOrDirectorOrKMPAndItsRelativesInAnyManner><in-capmkt:NameOfPartiesOrCounterPartiesOfTheAgreement contextRef="D_PartiesOfTheAgreement3">The Assemblies of God of North India</in-capmkt:NameOfPartiesOrCounterPartiesOfTheAgreement><in-capmkt:NatureOfThePartiesOfTheAgreement contextRef="I_PartiesOfTheAgreement3">Party entering into the agreement</in-capmkt:NatureOfThePartiesOfTheAgreement><in-capmkt:DetailsOfShareholdingInTheEntityWithWhomTheAgreementIsExecuted contextRef="I_PartiesOfTheAgreement3">NIL</in-capmkt:DetailsOfShareholdingInTheEntityWithWhomTheAgreementIsExecuted><in-capmkt:NumberOfSharesOfPartyOfTheAgreement contextRef="I_PartiesOfTheAgreement3" unitRef="shares" decimals="INF">0</in-capmkt:NumberOfSharesOfPartyOfTheAgreement><in-capmkt:PercentageOfShareholdingOfPartyOfTheAgreement contextRef="I_PartiesOfTheAgreement3" unitRef="pure" decimals="INF">0</in-capmkt:PercentageOfShareholdingOfPartyOfTheAgreement><in-capmkt:WhetherThePartiesToTheAgreementAreRelatedToPromoterOrPromoterGroupOrAssociateOrHoldingOrSubsidiaryOrGroupCompaniesOrDirectorOrKMPAndItsRelativesInAnyManner contextRef="I_PartiesOfTheAgreement3">false</in-capmkt:WhetherThePartiesToTheAgreementAreRelatedToPromoterOrPromoterGroupOrAssociateOrHoldingOrSubsidiaryOrGroupCompaniesOrDirectorOrKMPAndItsRelativesInAnyManner><in-capmkt:DateOnWhichAgreementWasEntered contextRef="MainI">2026-10-05</in-capmkt:DateOnWhichAgreementWasEntered><in-capmkt:PurposeOfEnteringIntoTheAgreement contextRef="MainI">The Agreement has been entered into for the exclusive appointment of the Company to operate, manage, direct and control the Hospital during the term of the Agreement, leveraging the Company’s experience and expertise in operating and managing healthcare facilities and to support the long-term sustainability, service capacity and effective operation of the Hospital. The Agreement relates to the operation and management of the Hospital and does not confer any ownership or lease rights or other interest in the underlying Land upon the Company.</in-capmkt:PurposeOfEnteringIntoTheAgreement><in-capmkt:SignificantTermsOfTheAgreementInBriefSpecialRightsLikeRightToAppointDirectorsOrFirstRightToShareSubscriptionInCaseOfIssuanceOfSharesOrRightToRestrictAnyChangeInCapitalStructure contextRef="MainI">Under the binding Operation and Management Agreement, the Company has agreed to be engaged and appointed, on an exclusive basis, to run, manage, operate, direct and control the Hospital on a long-term basis, subject to the terms of the said Agreement with customary payment terms, representations and warranties and obligations under such nature of understanding. The commencement of commercial operations of the Hospital by the Company is subject to satisfaction of certain conditions precedent by the respective parties, which may take up to 12 months from the date of execution of the Agreement.</in-capmkt:SignificantTermsOfTheAgreementInBriefSpecialRightsLikeRightToAppointDirectorsOrFirstRightToShareSubscriptionInCaseOfIssuanceOfSharesOrRightToRestrictAnyChangeInCapitalStructure><in-capmkt:WhetherThereIsAnyIssuanceOrTransferOfSharesToTheParties contextRef="MainI">false</in-capmkt:WhetherThereIsAnyIssuanceOrTransferOfSharesToTheParties><in-capmkt:DetailsAndQuantificationOfTheRestrictionOrLiabilityImposedUponTheListedEntity contextRef="MainD">No such restriction or liability imposed upon the listed entity.</in-capmkt:DetailsAndQuantificationOfTheRestrictionOrLiabilityImposedUponTheListedEntity></xbrli:xbrl>
