FORM H

[See rule 9(5)]

    PERMANENT RECORD OF APPLICATION FOR REGISTRATION, GRANT OF REGISTRATION REJECTION OF APPLICATION FOR REGISTRATION AND RENEWALS OF REGISTRATION

   1.    Sl. No.

    2.    File number of Appropriate Authority.

    3.    Date of receipt of application for grant of registration.

    4.    Name, Address, Phone/Fax etc. of Applicant.

    5.    Name and address(es) of Genetic Counselling Centre*/Genetic Laboratory*/Genetic Clinic*.

    6.     Date on which case considered by Advisory Committee and recommendation of Advisory committee, in  summary.

    7.    Outcome of application (state granted/rejected and date of issue of orders).

    8.    Registration number allotted and date of expiry of registration.

    9.    Renewals (date of renewal and renewed upto).

    10.  File number in which renewals dealt.

    11.    Additional information, if any.

                                                                              Name, Designation and Signature of appropriate Authority

Guidance for Appropriate Authority

  (a)     Form H is a permanent record to be maintained as a register, in the custody of 
            the Appropriate Authority.

           (b)     *Means strike out which ever is not applicable.

            (c)     Against item 7, record date of issue of order in Form B or Form C.

            (d)     On renewal, the Registration Number of the Genetic Conselling Centre/Genetic
                      Laboratory/Genetic Clinic will not change. A fresh registration Number will be allotted   
                      in the event of change of  ownership or management.

            (e)    No registration number shall be allotted twice.

            (f)     Each Genetic Counselling Centre/Genetic Laboratory/Genetic Clinic may be allotted a
                     folio consisting of two facing pages of the Register for recording Form H. 
                   

            (g)    The space provided for   'additional information'   may  be  used  for  recording
                      suspension,  cancellations, rejection of application for renewal, change of ownership/
                      management, outcome of   any legal proceeding, etc.

            (h)     Every folio (i.e. 2 pages) of the Register shall be authenticated by signature of the
                      Appropriate Authority with date, and every subsequent entry shall also be similarly
                      authenticated.