24. Repeal and Saving.

(a) the previous operation of any law so repealed or anything duly done or suffered thereunder, or
(b) any right, privilege, obligation or liability acquired, accrued or incurred under any law so repealed in so far as it is consistent with the provisions of these rules; or
(c) any penalty, forfeiture or punishment incurred in respect of any offence committed against any law so repealed;
(d) any investigation, proceeding, legal proceeding, or remedy in respect of any such right privilege, obligation, liability, penalty, forfeiture or punishment as aforesaid; and any such investigation, proceeding, legal proceeding or remedy may be instituted, continued or enforced, and any such penalty, forfeiture or punishment may be imposed as these rules had not been framed.
[Form I]
[Form I]
(See rule 15B)
Application For Establishing Massage Parlour/spa
Application For Establishing Massage Parlour/spa
(1)
Name of the Massage Parlour/SPA, if any:
Latest passport size photo of the applicant Self Attested
(2)
Name of promoters with full postal address:
(3)
Status of owners/promoters, whether company (copy of
memorandum and Articles of Association may be furnished):
(a)
Partnership firm (if yes, copy of Partnership Deed and
certificate of registration under Partnership Act may be
furnished):
(b)
Proprietary concern (if yes, give name and address of the
promoters):
(4)
Location of the centers alongwith full address:
(5)
Details of Location-
(a)
Area:
(b)
Title (whether outright purchased) if yes, copy of the
registered lease deed should be furnished:
Yes/No
(c)
Survey number:
(d)
Village, Taluka and District:
(e)
Distance from nearest town:
(f)
Distance from nearest railway station:
(g)
Distance from nearest airport:
(6)
If center is attached to a hotel/resort/hospital:
(7)
Details of the building-
(a)
Plinth area (floor-wise):
(b)
Building number:
(c)
Details of building license from local body (attach blueprint
of the building and copy of building license):
(8)
Details of facilities-
(9)
Details of equipment-
(a)
Massage table (number and size):
Yes
No
(b)
Gas or electric stove:
(c)
Medicated water facility:
Yes
No
(d)
Facilities for sterilization:
Yes
No
(e)
Facility for steam bath:
Yes
No
(f)
Others, if any (please specify):
(10)
Details of personnel-
(a)
Number of male masseurs:
(b)
Number of female masseurs:
(11)
Quantity of medicine and health programmes-
(a)
The firm that supplies medicine (with full address):
(b)
The health programmes offered (specify length of each
treatment programme):
(12)
Acceptance of the regularity conditions:
(13)
Application fees (details of DD) (a demand draft for Rs.
1,000/- drawn in favour of–
The Director, Directorate of Health Services, Government
of Goa, Campal, Panaji – Goa 403 001), is to be
enclosed with the application:
(14)
I am aware of the conditions prescribed by the Directorate of
Health Services for the Massage Parlour/SPA and wish to confirm
that I shall abide by the same and such other conditions as may
be laid down from time to time by the Directorate of Health
Services for the Massage Parlours/SPA.
(Name)
Address
_______________________ _______________________ _______________________ _______________________
Form II
Form II
( See rule 15C)
Grant of Permit to Operate an Ambulance Van
Grant of Permit to Operate an Ambulance Van
(1)
Name of the owner or operator of an Ambulance:
Latest passport size photo of the applicant Self
Attested
(2)
Name of promoters with full postal address:
(3)
Social Security Number:
(4)
Telephone Number:
(5)
Mobile Number:
(6)
Details of Ambulance:
(a)
Ambulance Number:
(b)
Type of Ambulance:
(7)
Status of owner/promoters, whether company is registered:
(8)
Type of service
Full Time Part Time Full or Part Time
Full Time
Part Time
Full or Part Time
(9)
Location of the ambulance centers alongwith full address
(where the ambulance will be stationed):
(10)
Details of Location-
(a)
Distance from nearest Primary Health Centre:
(b)
Distance from nearest District Hospital:
(c)
Distance from Goa Medical College:
(11)
If ambulance is attached to the Hospital/ Nursing home/ NGO/
Panchayat (Give details):
(12)
Type of Ambulance:
Grade A Grade B
Grade A
Grade B
(13)
Details of personnel-
I.
(a)
Name of the Attendant:
(b)
Qualification of the Attendant:
(c)
Trained in First Aid:
(d)
Phone Number:
II.
(a)
Name of the Driver:
(b)
Driver License Number:
(c)
Expiration Date:
(d)
Phone Number:
(14)
Application fees (details of DD) (a demand draft for Rs.
3,000/- drawn in favour of-
The Director, Directorate of Health Services, Government
of Goa, Campal, Panaji–Goa 403 001), is to be
enclosed with the application:
(15)
I am aware of the conditions prescribed by the Government for
the Ambulance Service, and wish to confirm that I shall abide by
the same and such other conditions as may be laid down from time
to time by the Directorate of Health Services for the Ambulance
Service.
Full name and designation of the applicant
Place:
Date: