Section 1994 in The Transplantation of Human Organs Rules, 1995

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Union of India - Section

Section 1994 in The Transplantation of Human Organs Rules, 1995

1994. have been explained to me and I confirm that: -

I understand the nature of criminal offences referred to in the sections.No payment of money or money's worth as referred to in the sections of the Act has been made to me or will be made to me or any other person.I am giving the consent and authorisation to remove my .. (organ)of my own free will without any undue pressure, inducement, influence or allurement.I have been given a full explanation of the nature of the medical procedure involved and the risks involved for me in the removal of my .

(organ). That explanation was given by .. (name of registered medical practitioner).

I understand the nature of that medical procedure and of the risks to me as explained by that practitioner.I understand that I may withdraw my consent to the removal of that organ at any time before the operation takes place.I state that particulars filled by me in the form are true and correct to my knowledge and nothing material has been concealed by me..Signature of the prospective donorDate.Note : To be sworn before Notary Public, who while attesting shallensure that the person / persons swearing the affidavit(s) signs (s) on the Notary Register, as well.·(√)Wherever applicable.[Form 1(B)] [Substituted by G.S.R. 571(E), dated 31.7.2008 (w.e.f. 4.8.2008).][To be completed by theprospective related donor][See rule 3]My full name is and this is my photograph

Photograph of the Donor(Attested by Notary Public)	{\|
To be affixed and attested by Notary Public after it is affixed.

|}My permanent home address is. Tel:My present home address is Tel:...Date of birth .. (day/month/year)I authrise to remove for therapeutic purposes/consent to donate my.(statewhich organ) to may husband/wife..whose full name is..andwho was born on(day/month/year) and whose particulars areas follows:-

Photograph of the Donor(Attested by Notary Public)	{\|
To be affixed and attested by Notary Public after it is affixed.

|}Ration/consumer Card number and Date of issue & place(Photocopyattached)and/orVoter's I-Card number, date of issue, Assembly Constituency .(Photocopyattached)and/orPassport number and country of issue ...(Photocopyattached)and/orDriving Licence number, Date of issue, licensing authority .and/orPAN...and/orOther proof of identity and address ...I submit the following asevidence of being married to the recipient:

(a)A certified

copy of a marriage certificateOR

(b)An

affidavit of a "near relative" confirming the status of marriage to be swornbefore Class I Magistrate/Notary Public.

(c)Family

photographs.

(d)Letter

from member of Gram Panchayat/Tehsildar/Block Development Officer/MLA/MPcertifying factum and status of marriage.OR

(e)Other

credible evidence.I solemnly affirm and declarethat sections 2, 9, and 19 of the transplantation of Human Organs Act, 1994have been explained to me and I confirm that: -I understand the nature of criminal offences referred to in the sections.No payment of money or money's worth as referred to in the sections of the Act has been made to me or will be made to me or any other person.I am giving the consent and authorisation to remove my .. (organ)of my own free will without any undue pressure, inducement, influence or allurement.I have been given a full explanation of the nature of the medical procedure involved and the risks involved for me in the removal of my .

(organ). That explanation was given by .. (name of registered medical practitioner).

I understand the nature of that medical procedure and of the risks to me as explained by that practitioner.I understand that I may withdraw my consent to the removal of that organ at any time before the operation takes place.I state that particulars filled by me in the form are true and correct to my knowledge and nothing material has been concealed by me..Signature of the prospective donorDate.Note : To be sworn before Notary Public, who while attesting shallensure that the person / persons swearing the affidavit(s) signs (s) on the Notary Register, as well.··(√)Wherever applicable.[Form 1(C)] [Substituted by G.S.R. 571(E), dated 31.7.2008 (w.e.f. 4.8.2008).][To be completed by theprospective un related donor][See rule 3]My full name is and this is my photograph

Photograph of the Donor(Attested by Notary Public)	{\|
To be affixed and attested by Notary Public after it is affixed.

|}My permanent home address is. Tel:My present home address is Tel:...Date of birth .. (day/month/year)Ration/consumer Card number and Date of issue & place(Photocopy attached)and/orVoter's I-Card number, date of issue, Assembly Constituency .(Photocopy attached)and/orPassport number and country of issue ...(Photocopy attached)and/orDriving Licence number, Date of issue, licensing authority .and/orPAN...and/orOther proof of identity and address ...Details of last three years income and vocation of donor..I hereby authorize removal for therapeutic purposes/consent todonate my . (state which organ) to my relative (specify son /daughter / father / mother./brother./ sister), whose name is .. and who was born on .(day / month / year) and whose particulars areas follows:

Photograph of the Donor(Attested by Notary Public)	{\|
To be affixed and attested by Notary Public after it is affixed.

|}Ration/ Consumer Card number and Date of issue & place(Photocopy attached)and/orVoter's I-Card number, date of issue, Assembly Constituency .(Photocopy attached)and/orPassport number and country of issue ...(Photocopy attached)and/orDriving Licence number, Date of issue, licensing authority .(Photocopy.attached)and/orPAN...and/orOther proof of identity and address ...I solemnly affirm and declarethat:-Sections 2, 9, and 19 of the transplantation of Human Organs Act,

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Union of India - Section

Section 1994 in The Transplantation of Human Organs Rules, 1995

1994. have been explained to me and I confirm that: -