FORM C

[See rules 6(3), 6(5) and 8(3)]

REJECTION OF APPLICATION FOR REGISTRATION OR
RENEWAL OF REGISTRATION

    In exercise of the powers conferred under section 19(2) of the pre-natal Diagnostic Techniques(Regulation and prevention of Misuse) Act, 1994 the Appropriate Authority ------------------------------------------------- hereby rejects the application for grant */ renewal* of  registration of the Genetic Counselling Centre* / Genetic Laboratory /Genetic Clinic* named below for the resons stated.

    Name and address of the Genetic Counselling Centre* / Genetic

    Laboratory* / Genetic Clinic*

    Name of Applicant who has applied for registration

                                    Reasons for rejection of application for registration

                                                                                                                     Signature, name and designation of

Date:                                                                                                             Appropriate Authority -------------------

                                                                                                                        SEAL

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* Strike out whichever is not applicable or necessary.