Form for Maintenance of Records in case of Pre-Natal Diagnostic test/Procedure by Genetic Clinic/Ultrasound Clinic/Imaging Centre - Form F

Service Details are:

 
Service is defined by the - LINE DEPARTMENT - Directorate Of Health Services Family Welfare

The Beneficiary of this service will be Business persons ( G2B )

Types of Service:
Regulatory
(Regulatory Services are those which can be denied by the government)

Do applicant(s) need to register to avail this service?
Yes
The URL at which more information about service are available :
eodb.assam.gov.in
No of Days within which service will be delivered after application submission?
NA          

Note: The time period given is excluding the Government holiday list

Who can apply for this Service?

 
The Application can be submitted by the following:
Institution

How to submit application and Enclosure Details?

  The Application can be submitted by the following:
Online


Following Documents are required along with the application form

Enclosure Type
Type Of Enclosure Original / Photocopy Attestation Required Documents Recommended
Declaration of the person undergoing pre-natal diagnostic test/procedure Original Original Not Required Not Required Declaration of the person undergoing pre-natal diagnostic test/procedure    Declaration of the person undergoing pre-natal diagnostic test/procedure   
Declaration of doctor / person conducting pre-natal diagnostic procedure / test Original Original Not Required Not Required Declaration of doctor / person conducting pre-natal diagnostic procedure / test    Declaration of doctor / person conducting pre-natal diagnostic procedure / test   
UBIN Certificate Original Original Not Required Not Required Copy of UBIN (Unique Business Identification Number) Certificate    Copy of UBIN (Unique Business Identification Number) Certificate   
Common Application Form (Department of Industries and Commerce) Original Original Not Required Not Required Copy of Common Application Form    Copy of Common Application Form   
UBIN Certificate Original Original Not Required Not Required Copy of UBIN (Unique Business Identification Number) Certificate    Copy of UBIN (Unique Business Identification Number) Certificate   
Common Application Form (Department of Industries and Commerce) Original Original Not Required Not Required Copy of Common Application Form    Copy of Common Application Form   
Declaration of the person undergoing pre-natal diagnostic test/procedure Original Original Not Required Not Required Declaration of the person undergoing pre-natal diagnostic test/procedure    Declaration of the person undergoing pre-natal diagnostic test/procedure   
Declaration of doctor / person conducting pre-natal diagnostic procedure / test Original Original Not Required Not Required Declaration of doctor / person conducting pre-natal diagnostic procedure / test    Declaration of doctor / person conducting pre-natal diagnostic procedure / test   

Pre-defined format/template
Document Name Prescribed Format
Application Form (Sign and Upload) view



What will Applicant get as Service Deliverable?

  The applicant will receive Output Certificate/Report as the service deliverable(s).
Certificate/Report