Website: www.apmconline.in, apmedicalcouncil.

com
Email: apmedicalcouncil@sify.com
Phone Nos: 040-24657639 / 65577343

ANDHRA PRADESH MEDICAL COUNCIL

SULTAN BAZAR :: HYDERABAD

Application for Renewal of Medical Registration

See Section-15C of A.P Medical Practitioners Registration
(Amendment) Act, 2013
To Affix recent
The Registrar, Passport size
A.P.Medical Council, Photograph duly
Hyderabad-500095. attested by any
Civil Surgeon /
Prl.of anyMedical
College/Supdt. of
any Hospital

Sir,

I, undersigned Dr.___________________________________ registered with

A.P.Medical Council under Registration No_______________ dated_________ . I have
complied with the requirements of Section-15C of A.P.Medical Practitioners Registration
Act, 1968 (Amendment Act No.10 of 2013) and the rules made thereunder. Necessary Fee
is paid herewith in the shape of Demand Draft drawn in favour of Andhra Pradesh Medical
Council, and request that my Medical Registration may be renewed and a certificate be
issued. The details are as under.

NAME OF THE DOCTOR:_________________________________________________

(With Surname in full and in block letters)

FATHER’S NAME :__________________________________________________

MOTHER’S NAME :__________________________________________________

BLOOD GROUP :__________________________________________________

DATE OF BIRTH :___________________________SEX:___________________

REGN. NO.& DATE :__________________________________________________

QUALIFICATION /
COLLEGE & UNIVERSITY:_________________________________________________

PERMANENT ADDRESS :__________________________________________________

______________________________________________

E-mail______________________ Pin code No: _____________Phone No. _____________

Medical Qualifications for Name of the Medical College Details of Registration No. and
which Registration was / University Date
granted where the Degree was
obtained

P.T.O
 :: 2 ::

The originals and the attested copies of the required documents are submitted
herewith. The originals may kindly be returned when no longer required.

The above facts are true to the best of my knowledge.

Yours faithfully,

( Signature of the Doctor)

REQUIREMENTS FOR RENEWAL OF MEDICAL REGISTRATION:

1. D.D. For Rs.1000/- drawn in favour of “ANDHRA PRADESH MEDICAL COUNCIL” ,

HYDERABAD from ANDHRA BANK.
2. Final Medical Registration Certificate issued by A.P.Medical Council in original
and its copy and certificates of Registration of Additional Qualifications if any.
3. Proof of Date of Birth (SSC, Passport or any relevant certificate).
4. One Recent Passport size photograph.
5. Attendance Certificates of C.M.E programmes having not less than30 credit hours
during the preceding five years.
6. Late Fee of Rs. 100/- per month after 09-09-2014 for a further period of one year.

D.D.No……………………………………………...,Date……………………………….,Rs.……………………………………….
Bank Name:……………………………..…………..Branch Name…………………….…,Branch Code……………….

REGISTRAR

Note:-

i). Every Registered Medical Practitioner shall renew his Registration after expiry of the
period of five years from the date of his original Registration.

ii). Renewal of Registration shall be done before 09-09-2014.

iii). The Registered Medical Practitioner who fails to renew his registration within the
stipulated period, can renew his registration upto a further period of one year
on payment of late fee. No application for grant of renewal of
Registration will be accepted on or after the date specified in this regard even on
payment of late fee.

iv). The name of the Registered Medical Practitioner will be removed from the
Register, if he fails to renew his Registration as specified above.

v). Fresh Registration will be granted in case of the removal of names of Registered
Medical Practitioners from the Medical Register as per the procedure laid down in
Rules.

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