FORM B - CERTIFICATE OF REGISTRATION
[See Rules 6(2), 6(5) and 8(2)]
(To be issued in duplicate)
1. In exercise of the powers conferred under Section 19 (1) of the Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1994 (57 of 1994), the Appropriate Authority ………………….. hereby grants registration to the Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic* named below for purposes of carrying out Genetic Counselling/Pre-natal Diagnostic Procedures*/Pre-natal Diagnostic Tests as defined in the aforesaid Act for a period of five years ending on …………….
2. This registration is granted subject to the aforesaid Act and Rules thereunder and any contravention thereof shall result in suspension or cancellation of this Certificate of Registration before the expiry of the said period of five years.
A. Name and address of the Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*.
B. Name of Applicant for registration.
C. Pre-natal diagnostic procedures approved for (Genetic Clinic).
(iii) Chorionic villi biopsy
(v) Foetal skin or organ biopsy
(vii) Any other (specify)
D. Pre-natal diagnostic tests* approved (for Genetic Laboratory)
(i) Chromosomal studies
(ii) Biochemical studies
(iii) Molecular studies
3. Registration No. allotted
4. For renewed Certificate of Registration only
Period of validity of earlier Certificate From ……. To ……. Or Registration.
Signature, name and designation of The Appropriate Authority
DISPLAY ONE COPY OF THIS CERTIFICATE AT A CONSPICUOUS PLACE AT THE PLACE OF BUSINESS