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    Declaration Urule 62

    Uploaded by

    Mohammed Patel
    The document is a declaration form for filing a complaint against a doctor with the Maharashtra Medical Council. It includes fields for the complainant's name and contact information as well as the doctor's name, registration number, qualifications, and address. The complainant declares that the information provided in the complaint is true to the best of their knowledge and that they are willing to appear before the Council with witnesses and evidence. The declaration is signed and dated by the complainant before a notary public or gazetted officer.

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    Declaration Urule 62

    Uploaded by

    Mohammed Patel
    10 views1 page
    The document is a declaration form for filing a complaint against a doctor with the Maharashtra Medical Council. It includes fields for the complainant's name and contact information as well as the doctor's name, registration number, qualifications, and address. The complainant declares that the information provided in the complaint is true to the best of their knowledge and that they are willing to appear before the Council with witnesses and evidence. The declaration is signed and dated by the complainant before a notary public or gazetted officer.

    Original Description:

    Declaration U/62

    Original Title

    DECLARATION URULE 62

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    The document is a declaration form for filing a complaint against a doctor with the Maharashtra Medical Council. It includes fields for the complainant's name and contact information as well as the doctor's name, registration number, qualifications, and address. The complainant declares that the information provided in the complaint is true to the best of their knowledge and that they are willing to appear before the Council with witnesses and evidence. The declaration is signed and dated by the complainant before a notary public or gazetted officer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    10 views1 page

    Declaration Urule 62

    Uploaded by

    Mohammed Patel
    The document is a declaration form for filing a complaint against a doctor with the Maharashtra Medical Council. It includes fields for the complainant's name and contact information as well as the doctor's name, registration number, qualifications, and address. The complainant declares that the information provided in the complaint is true to the best of their knowledge and that they are willing to appear before the Council with witnesses and evidence. The declaration is signed and dated by the complainant before a notary public or gazetted officer.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Affix Court Fee

    Stamp of Rs 10/-

    DECLARATION

    Date:

    (Under Rule 62 of the Maharashtra Medical Council, Rule 1967)

    I the undersigned Shri / Smt ..................................................................................................

    Hereby declare that whatever I have stated in my complaint against

    Dr. (Full Name) .............................................................................................................

    His / Her M. M. C. Registration No...................................................................................

    Qualification ...........................................

    Address..............................................................................................................................

    Telephone No .......................................... Mobile No. ..............................................

    Is true to the best of my knowledge and belief

    I am ready to appear before the Maharashtra Medical Council along with my witnesses
    and documentary evidence etc.

    I am signing this declaration on oath and on my willingness

    Signature

    Full Name of Complainant

    Address

    Pin code

    Telephone Number

    Mobile Number

    DATED SIGNATURE

    Before me
    (Notary Public/Gazette Officer)
    With Seal/Stamp

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