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State of Goa - Section

Section 200 in The Goa Medical Council Rules, 1995

200.

/-Receipt No. .....................Date ....................I have been selected for *Practical .....................................................................................................(State name of approval Institution) training at the Employment in a medical capacity at the .....................................................................(State bane of approval Institution)*Appointment in the Medical Services of the Armed Forces of the Union and I enclose as evidence.
(4)The registration fee of Rs. 200/- (Two hundred only) is sent by Demand Draft.
(5)I am applying for registration for the first time and I was not registered as medical practitioner in India before the date of this application.
(6)I have carefully read the instructions sent with this form and I certify that the particulars furnished above are true to the best of my knowledge and belief.Yours faithfully,................................(Usaual Signature)Date: .....................................Place: ......................................Instructions
(1)All particulars shall be filled in by the applicant only.
(2)All particulars should be in neat legible or type-written.
(3)The registration fee should be sent by Demand Draft only.
(4)The applicants should remember that their names entered in the application must exactly correspond with their names at the University or other Examinations as the case may be.
(5)Evidence under paragraph 3 of the application shall include selection or appointment Order.Hours of Payment:From 9.30 a.m. to 1.00p.m. and from 2.30 p.m. to 5.00 p.m. on all working days from Monday to Friday.Provisional Registration fee .................................. Rs. 200/-Form 15(See Rule 59)Goa Medical CouncilForm of Application for RegistrationToThe Registrar,Goa Medical Council,Panaji.Sir,I request you to register my name and other particulars as stated below, under the Goa Medical Council Act, 1991 and further to give me a certificate of registration:-
NAME IN FULL (beginning with surname and including *father's/husband's name in BLOCK LETTERS) ......................................................................................................................................................................................................
ADDRESS (to be entered in the Register) ......................................................................................................................................................................................................
Maiden name and surname in the case of a married woman(beginning with surname in BLOCK LETTERS) ......................................................................................................................................................................................................
Nationality : ................................... Date of Birth:............................................................................
Description of qualification of which registration is desired.The name of the University or The Licensing Body should Also bestated.   Date of obtaining the qualifications. State also theinstitution from which you appeared fro the said exam, alongwithyour number at examination.  
  (1) Date …............................................(2)Institution: …....................................(3)No. at the Exam. …..........................
I forward herewith original certificates alongwith their xerox copies:-
(1)*Birth Certificate or*Matriculation Certificate or*SSC Exam. Certificate or*School Leaving Certificate.*The degree*Diplomas*Licence*Certificates*Other evidence in support of my having obtained the qualification which I possess, in original.*2 Passport size photographs.*Evidence of Registration in the Dte. of Health Services, Panaji, Goa.*File.
(2)The registration fee of Rs. 500/- (Rupees five hundred only) is sent by Demand Draft in favour of the Registrar, Goa Medical Council, Panaji-Goa.(*3) I am applying for registration for the first time and I was not registered as a medical practitioner under any law in India before this.(*4) I am/was provisionally registered under Section 25 of the Indian Medical Council Act, 1956 and enclose the certificate of provisional registration in original.
(5)I was/have been registered under the .......... (See the Act or Law) in the year ................ and my registration number is/was ....................
(6)I have carefully read the instructions sent with this form and I certify that the particulars furnished above are true to the best of my knowledge and belief.Yours faithfully,...............................(Usual Signature)Instructions
(1)All particulars in the application shall be filled by the applicant only.
(2)All particulars should be in neat legible hand.
(3)The registration fee should be sent by Demand Draft only.
(4)The applicants should remember that names entered in the application must exactly correspond with their names at the University of other examination, as the case may be.
Specimen of Practitioner's Signature as usedon Medical Certificate
Present Address
*Strike off the alternative not applicable.N.B. Please also forward copies of certificates and other evidence, if any, under para 2 of the application.Hours of Payment:
9.30a.m. to 1p.m. & 2 p.m. to 5p.m. on all working days from Monday to Friday.Registration fee-Rs. 500/-.Demand Draft in favour of the Registrar, Goa Medical Council, Panaji, Payable in Panaji.Form 16(See Rule 61)Form of final notice to a registered practitioner for continuance of his name on the RegisterTo,(Here mention the name and address of the Medical Practitioner as entered in the Register)Sir,I am directed to invite your attention to my notice dated the ....... 19 ......., and to give you a final notice as required by Clause (b) of Section 23 of the Goa Medical Council Act, 1991, calling upon you, to return to me the enclosed form of application for the continuance of your name in the Register within forty-five days from the date of this notice together with a fee of Rupees fifty only.If you fail to return the form of application duly filled in and signed alongwith the fee of rupees fifty on or before ......... your name will be removed from the register as a defaulter.Yours faithfully, Registrar, Goa Medical Council. *.............................................. ...............................................Date*Here enter full address of the Registrar.Form 17Form of Notice to a Registered Practitioner for continuance of his name on the Register, under Clause (b) of sub-section (4) Section 16(Here mention the name and address of the medical practitioner as entered in the register).
(1)In pursuance of Clause (b) of sub-section (4) of Section 16 of the Goa Medical Council Act, 1991 notice is hereby given calling upon you to return to me the enclosed form of application for the continuance of your name on the register within forty-five days of this notice.
(2)If you fail to return the application duly filled in and signed on or before ................. it shall not be accepted thereafter unless it is accompanied by a late fee of rupees fifty only.Registrar, Goa Medical Council. *.............................................. ...............................................Date ..............*Here enter full address of the Registrar.