(Signature)
(Name and Designation and full address with official seal.)
Form II
Form II
( See rule 4 (d))
Acknowledgement
* The list of enclosures attached to the application in Form I has been verified with the enclosures submitted and found to be correct.
Or
*On verification it is found that the following documents mentioned in the list of enclosures are not actually enclosed.
i.
ii.
iiii.
iv.
v.
(..............................)
Signature and Designation of Registration Authority, or authorized person in the Office of the Appropriate Authority.
Seal
Form III
Form III
( See Rule 4 (F))
Government of Andhra Pradesh
Health Medical and Family Welfare Department
District Registering Authority
Certificate of Temporary Registration of Allopathic Private Medical Care Establishments
(Valid for 90 days from the date of issue)
i..............................:.........
ii.......................................
Signature of the
(Office seal)
Form IV
Form IV
( See Rule 5 (A))
Government of Andhra Pradesh Health Medical and Family Welfare Department
District Registering Authority
Certificate of Registration of Allopathic Private Medical Care Establishments
i. - - -----------
ii.-------------
Signature and name of the District Registering Authority
.................District
(Office seal)
Form - V
Form - V
( See Rule 5 (C))
Government of Andhra Pradesh
Health Medical and Family Welfare Department
District Registering Authority.........................
................................... Rejection of Application For Grant/renewal of Registration Reference Number and Date:
Rejection of Application For Grant/renewal of Registration
Reference Number and Date:
(1) Name and address of the Allopathic Private Medical Care
Establishment
(2) Reasons for rejection of application for grant / renewal of
registration
Signature, name and designation of the Registration Authority with office seal.
* Strike out whichever is not applicable or necessary
Form - VI
Form - VI
( See Rule-6)
Application for Renewal of Certificate of Registration
Application for Renewal of Certificate of Registration
The Registering Authority
(1) Date of issue of Certificate of Registration to be renewed (enclosed the original Certificate in duplicate)
(2) Date of Expiry of Certificate of Registration to be renewed.
(3) File number of the Registering Authority
(4) Particulars of Renewal fee paid (D.D.No., Name of the Bank, and date) (Original D.D. enclosed)
(5) I hereby declare that the contents mentioned in this application are true and correct to the best of the my knowledge
(Signature)
(Name, Designation and full address with office seal.)
Form VII
Form VII
( See Rale 6)
Government of Andhra Pradesh
Health Medical and Family Welfare Department
District Registering Authority
...........................
Certificate of Renewal of Registration of Allopathic Private Medical Care Establishments
M/s-----------------located at----------------is hereby renewed under the provisions of A.P. Allopathic Private Medical Care Establishments Registration and Regulation) Act, 2002. to provide following medical care services:
i.----------------
ii. --------------
Signature and Name of the District Registering Authority
(Office deal)
Form - VIII
Form - VIII
( See Rule 7(b)
Government of Andhra Pradesh
Health Medical and Family Welfare Department
District Registering Authority
Notice
M/s--------------
Or
Signature and name of the District Registering Authority
(Office seal)
Form IX
Form IX
( See Rule 7 (d))
Government of Andhra Pradesh
Health Medical and Family Welfare Department
District Registering Authority
Order
(1) Reference Number and Date:-------------
(2) Registered notice number and date-------------------
(3) File Number of Registering Authority-------------
(4) Date of hearing---------------------
(5) Whether Establishment has submitted answer in writing................................. Yes/No
(6) If so, what are the contents and documentary evidence produced by the Applicant-Establishment
(7) Are they satisfactory.........................Yes/No
(8) Additional document (s) submitted by the Complaint, if any------------
(9) Are they relevant to case.........................Yes/No
(10) Point(s) for consideration in the case------------
(11) Findings of the District Registering Authority-------
Or
Signature and name of the District Registering Authority
(Office seal)
Form-X
Form-X
( See Rule 8(b))
Application for Filing an Appeal Against the Orders of Registration Authority
Chairman.
Appellate Board and Principal Secretary to Government,
Health, Medical and Family Welfare Department.
A.P. Secretariat Hyderabad-22
Appeal filed under Section 10 (1) of the A.P. Private Medical Care Establishment (R and R) Act, 2002
Section 22 • Andhra Pradesh Allopathic Private Medical Care Establishments (Registration and Regulation) Rules, 2007
22. Particulars of the Registration fee paid (D.D No., Name f the Bank, and Date)
andhra-pradesh-allopathic-private-medical-care-establishments-registration-and-regulation-rules-2007-sec-22.json
•
Section 22
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"section": {
"number": "22",
"title": "22. Particulars of the Registration fee paid (D.D No., Name f the Bank, and Date)",
"chapter": null,
"content": "(Signature)\n(Name and Designation and full address with official seal.)\nForm II\nForm II\n( See rule 4 (d))\nAcknowledgement\n* The list of enclosures attached to the application in Form I has been verified with the enclosures submitted and found to be correct.\nOr\n*On verification it is found that the following documents mentioned in the list of enclosures are not actually enclosed.\ni.\nii.\niiii.\niv.\nv.\n(..............................)\nSignature and Designation of Registration Authority, or authorized person in the Office of the Appropriate Authority.\nSeal\nForm III\nForm III\n( See Rule 4 (F))\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\nCertificate of Temporary Registration of Allopathic Private Medical Care Establishments\n(Valid for 90 days from the date of issue)\ni..............................:.........\nii.......................................\nSignature of the\n(Office seal)\nForm IV\nForm IV\n( See Rule 5 (A))\nGovernment of Andhra Pradesh Health Medical and Family Welfare Department\nDistrict Registering Authority\nCertificate of Registration of Allopathic Private Medical Care Establishments\ni. - - -----------\nii.-------------\nSignature and name of the District Registering Authority\n.................District\n(Office seal)\nForm - V\nForm - V\n( See Rule 5 (C))\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority.........................\n................................... Rejection of Application For Grant/renewal of Registration Reference Number and Date:\nRejection of Application For Grant/renewal of Registration\nReference Number and Date:\n(1) Name and address of the Allopathic Private Medical Care\n\t\t\t\tEstablishment\n(2) Reasons for rejection of application for grant / renewal of\n\t\t\t\tregistration\nSignature, name and designation of the Registration Authority with office seal.\n* Strike out whichever is not applicable or necessary\nForm - VI\nForm - VI\n( See Rule-6)\nApplication for Renewal of Certificate of Registration\nApplication for Renewal of Certificate of Registration\nThe Registering Authority\n(1) Date of issue of Certificate of Registration to be renewed (enclosed the original Certificate in duplicate)\n(2) Date of Expiry of Certificate of Registration to be renewed.\n(3) File number of the Registering Authority\n(4) Particulars of Renewal fee paid (D.D.No., Name of the Bank, and date) (Original D.D. enclosed)\n(5) I hereby declare that the contents mentioned in this application are true and correct to the best of the my knowledge\n(Signature)\n(Name, Designation and full address with office seal.)\nForm VII\nForm VII\n( See Rale 6)\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\n...........................\nCertificate of Renewal of Registration of Allopathic Private Medical Care Establishments\nM/s-----------------located at----------------is hereby renewed under the provisions of A.P. Allopathic Private Medical Care Establishments Registration and Regulation) Act, 2002. to provide following medical care services:\ni.----------------\nii. --------------\nSignature and Name of the District Registering Authority\n(Office deal)\nForm - VIII\nForm - VIII\n( See Rule 7(b)\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\nNotice\nM/s--------------\nOr\nSignature and name of the District Registering Authority\n(Office seal)\nForm IX\nForm IX\n( See Rule 7 (d))\nGovernment of Andhra Pradesh\nHealth Medical and Family Welfare Department\nDistrict Registering Authority\nOrder\n(1) Reference Number and Date:-------------\n(2) Registered notice number and date-------------------\n(3) File Number of Registering Authority-------------\n(4) Date of hearing---------------------\n(5) Whether Establishment has submitted answer in writing................................. Yes/No\n(6) If so, what are the contents and documentary evidence produced by the Applicant-Establishment\n(7) Are they satisfactory.........................Yes/No\n(8) Additional document (s) submitted by the Complaint, if any------------\n(9) Are they relevant to case.........................Yes/No\n(10) Point(s) for consideration in the case------------\n(11) Findings of the District Registering Authority-------\nOr\nSignature and name of the District Registering Authority\n(Office seal)\nForm-X\nForm-X\n( See Rule 8(b))\nApplication for Filing an Appeal Against the Orders of Registration Authority\nChairman.\nAppellate Board and Principal Secretary to Government,\nHealth, Medical and Family Welfare Department.\nA.P. Secretariat Hyderabad-22\nAppeal filed under Section 10 (1) of the A.P. Private Medical Care Establishment (R and R) Act, 2002",
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