<?xml version="1.0" encoding="UTF-8"?>
<!--REG30PARAB V1.0 (01-06-2026)-->
<xbrli:xbrl xmlns:in-capmkt="http://www.sebi.gov.in/xbrl/2026-04-30/in-capmkt" xmlns:in-capmkt-ent="http://www.sebi.gov.in/xbrl/Regulation_30_Para_B_Of_Part_A_Of_Schedule_III/2026-04-30/in-capmkt/in-capmkt-ent" xmlns:xbrldt="http://xbrl.org/2005/xbrldt" xmlns:nonnum="http://www.xbrl.org/dtr/type/non-numeric" xmlns:in-capmkt-types="http://www.sebi.gov.in/xbrl/2026-04-30/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.w3.org/1999/xlink"><link:schemaRef xlink:type="simple" xlink:href="in-capmkt-ent-2026-04-30.xsd"/><xbrli:context id="MainI"><xbrli:entity><xbrli:identifier scheme="http://www.sebi.gov.in/in-capmkt/ScripCode">540975</xbrli:identifier></xbrli:entity><xbrli:period><xbrli:instant>2026-09-07</xbrli:instant></xbrli:period></xbrli:context><xbrli:context id="I_CapacityAddition"><xbrli:entity><xbrli:identifier scheme="http://www.sebi.gov.in/in-capmkt/ScripCode">540975</xbrli:identifier></xbrli:entity><xbrli:period><xbrli:instant>2026-09-07</xbrli:instant></xbrli:period><xbrli:scenario><xbrldi:explicitMember dimension="in-capmkt:SubTypeOfEventAsPerRegulation30ParaBOfPartAOfScheduleIIIAxis">in-capmkt:CapacityAdditionMember</xbrldi:explicitMember></xbrli:scenario></xbrli:context><xbrli:unit id="INR"><xbrli:measure>iso4217:INR</xbrli:measure></xbrli:unit><in-capmkt:NSESymbol contextRef="MainI">ASTERDM</in-capmkt:NSESymbol><in-capmkt:NameOfTheCompany contextRef="MainI">ASTER DM QUALITY CARE LIMMITED</in-capmkt:NameOfTheCompany><in-capmkt:ScripCode contextRef="MainI">540975</in-capmkt:ScripCode><in-capmkt:MSEISymbol contextRef="MainI">NOTLISTED</in-capmkt:MSEISymbol><in-capmkt:ISIN contextRef="MainI">INE914M01019</in-capmkt:ISIN><in-capmkt:TypeOfEventAsPerRegulation30ParaBOfPartAOfScheduleIII contextRef="MainI">Capacity addition/Product launch (Sub-para 3-Para B)</in-capmkt:TypeOfEventAsPerRegulation30ParaBOfPartAOfScheduleIII><in-capmkt:SubTypeOfEventAsPerRegulation30ParaBOfPartAOfScheduleIII contextRef="I_CapacityAddition">Capacity addition</in-capmkt:SubTypeOfEventAsPerRegulation30ParaBOfPartAOfScheduleIII><in-capmkt:TypeOfAnnouncementAsPerRegulation30ParaBOfPartAOfScheduleIII contextRef="MainI">New</in-capmkt:TypeOfAnnouncementAsPerRegulation30ParaBOfPartAOfScheduleIII><in-capmkt:WhetherEventOrInformationDisclosedIsAnOutcomeOfTheBoardMeeting contextRef="MainI">false</in-capmkt:WhetherEventOrInformationDisclosedIsAnOutcomeOfTheBoardMeeting><in-capmkt:DateOfOccurrenceOfEventOrInformation contextRef="MainI">2026-08-31</in-capmkt:DateOfOccurrenceOfEventOrInformation><in-capmkt:TimeOfOccurrenceOfEventOrInformation contextRef="MainI">22:07:00</in-capmkt:TimeOfOccurrenceOfEventOrInformation><in-capmkt:DateOfReport contextRef="MainI">2026-09-07</in-capmkt:DateOfReport><in-capmkt:ExistingCapacityOfProjectOrPlant contextRef="MainI">~795 beds</in-capmkt:ExistingCapacityOfProjectOrPlant><in-capmkt:ExistingCapacityUtilizationByProjectOrPlant contextRef="MainI">~596 beds (FY26 occupancy of ~75%)</in-capmkt:ExistingCapacityUtilizationByProjectOrPlant><in-capmkt:ProposedCapacityAdditionInProjectOrPlant contextRef="MainI">~184 beds</in-capmkt:ProposedCapacityAdditionInProjectOrPlant><in-capmkt:PeriodWithinWhichCapacityIsToBeAdded contextRef="MainI">on or before May 2028</in-capmkt:PeriodWithinWhichCapacityIsToBeAdded><in-capmkt:InvestmentRequiredForProposedCapacityAddition contextRef="MainI" unitRef="INR" decimals="0">1344000000</in-capmkt:InvestmentRequiredForProposedCapacityAddition><in-capmkt:ModeOfFinancingForCapacityAddition contextRef="MainI">Others</in-capmkt:ModeOfFinancingForCapacityAddition><in-capmkt:DetailsOfOtherModeOfFinancingForCapacityAddition contextRef="MainI">Debt 70% and Equity 30%</in-capmkt:DetailsOfOtherModeOfFinancingForCapacityAddition><in-capmkt:RationaleForCapacityAddition contextRef="MainI">To expand the healthcare capacity through the construction of KIMSHEALTH New Block, address space constraints in the existing hospital complex, facilitate expansion of key specialties, enhance patient experience, strengthen healthcare infrastructure in Trivandrum and support future growth.</in-capmkt:RationaleForCapacityAddition></xbrli:xbrl>
