(i)No building for the accommodation of dispensary shall be constructed and no extension of such building involving an alteration of the structural design shall be made, until the plan of such building or extension has been approved by the Director of Health, Orissa. An extension on or alteration involving no change of design shall be approved by the [Chief District Medical Officer] [Substituted and inserted vide S.R.O. 510/12.9.1983.].