AGREEMENT

We company name manufacturer of ____ Medical Devices (hereinafter called as

manufacturer) at Office address: ___________ & Manufacturing unit address:
___________ contracts with ________________-a registered Medical Practitioner,
(hereinafter called as Doctor) as Consulting Physician (reg. No. _________) who is
practicing at ____________ for Medical Checkup of employees at defined time period
usually 1 year.

Doctor has disclosed all material information regarding registration as a medical

professional, competence and field of practice.
This agreement is valid for 2 years. This agreement can be cancelled by either of the parties,
with prior intimation of 1 month.

Authorized Signatory,
MANUFACTURER DOCTOR

Date: Date:
Place: Place:
Stamp: Stamp: