Office Address : Shop No. UGF-7, The Palm Arcade, Ismailganj, Indira Nagar, Lucknow 8130781031Mon - Fri: 9:00AM - 8:00PM

Forms Download

Download Forms (Under Transplantation of Human Organs and Tissues Rules, 2014)

Forms

S. No Form No. Description Download
1 Form 1 For organ or tissue donation from identified living near related donor Click Here
2 Form 2 For organ or tissue donation by living spousal donor Click Here
3 Form 3 For organ or tissue donation by other than near relative living donor Click Here
4 Form 4 For certification of medical fitness of living donor Click Here
5 Form 5 For certification of genetic relationship of living donor with recipient Click Here
6 Form 6 For spousal living donor Click Here
7 Form 7 For organ or tissue pledging Click Here
8 Form 8 For Declaration cum consent Click Here
9 Form 9 For unclaimed body in a hospital or prison Click Here
10 Form 10 For certification of brain stem death Click Here
11 Form 11 APPLICATION FOR APPROVAL OF TRANSPLANTATION FROM LIVING DONOR Click Here
12 Form 12 APPLICATION FOR REGISTRATION OF HOSPITAL TO CARRY OUT ORGAN OR TISSUE TRANSPLANTATION OTHER THAN CORNEA Click Here
13 Form 13 APPLICATION FOR REGISTRATION OF HOSPITAL TO CARRY OUT ORGAN/TISSUE RETRIEVAL OTHER THAN EYE/CORNEA RETRIEVAL Click Here
14 Form 14 APPLICATION FOR REGISTRATION OF TISSUE BANKS OTHER THAN EYE BANKS Click Here
15 Form 15 APPLICATION FOR REGISTRATION OF EYE BANK, CORNEAL TRANSPLANTATION CENTRE, EYE RETRIEVAL CENTRE UNDER TRANSPLANTATION OF HUMAN ORGANS ACT Click Here
16 Form 16 CERTIFICATE OF REGISTRATION FOR PERFORMING ORGAN/TISSUE TRANSPLANTATION/RETRIEVAL AND/OR TISSUE BANKING Click Here
17 Form 17 Certificate of Renewal of Registration Click Here
18 Form 18 CERTIFICATE BY THE AUTHORISATION COMMITTEE OF HOSPITAL (If hospital authorisation committee is not available then the Authorisation Committee of the district/state) where the transplantation has to take place (To be issued on the letter head). Click Here
19 Form 19 Certificate by competent authority [as defined at rule 2(c)] For Indian near relative,other than spouse, cases (In case of spousal donor, Form 6 will be applicable) Click Here
20 Form 20 Verification certificate in respect of domicile status of recipient or donor [To be issued by tehsildar or any other authorised officer for the purpose (required only for the donor - other than near relative or recipient if they do not belong to the state where transplant hospital identified for operation is located)] Click Here
21 Form 21 Certificate of relationship between donor and recipient in case of foreigners (To be issued by the Embassy concerned) Click Here