MEDICO
LEGAL

 

 

 

      

 

 

What is Law     Right of
Doctors
     Responsibilities
Negligence     Consents
Records     Cases

Legislations    Medical
Ethics
    FAQ’s

 

-:
Importance of Record Keeping :-

 

 

|
Investigations
| Referal
to Specialist
| Anticipating
Complications
|

| Insurance | Procedure
before Consumer forum
| Doctor
as Consumer
|

| Model
information sheet
|

 


If
any legal problem arises than properly
maintained records are of utmost
importance. They are proof of what one has
done actually for his patient. Record
includes
.

a.)
Informed consent.

 

b.)
Chronological order of progress of disease
and treatment, investigations, opinions,
X-rays etc.

 

c.)
 Details
of procedure or surgery or anesthesia
given
.

 

d.)
Record of investigations be it
radiological, pathological or reports of
CAT or MRI or any other opinion of specialist or consultant.

e.) Record
includes record of refusal of treatment or
investigation or surgery.

f.) 
Records of adult patients are
maintained for 3 years and children for 21
years. (3+18 years).

 

 

 

 

 

 

 

 

 

IMPORTANCE
OF
INVESTIGATIONS
/ X-rays/ MRI/ CAT SCAN/
SONOGRAPY

 

 

 

Importance
of investigations:
In
modern time a proof of establishing
diagnosis is most essential.
A documentation of such diagnosis
can be done by well-planned out
investigations. One must avoid unnecessary
investigations. One must prefer
non-invasive investigation or invasive
one. Routine investigation to get basic
knowledge about patient’s condition is
essential.
Legally
speaking investigations speaks and vouches
for correct diagnosis and indication for
treatment and surgery performed by doctor.Few rules for asking investigations
are in following fruitful and beneficial manner:

 

1.

Define the diagnostic dilemma or
differential diagnosis properly.

 

2.

Ask yourself that after getting the
results of investigation you will narrow
down in your diagnostic dilemma or

differential diagnosis. 

 

3.

Avoid asking special investigations
routinely. Only Basic investigations like:
Blood count. Stool, urine, etc. could be
under taken routinely. Diseases caused by
bacteria should be cultured
 

 

4.

Is precise diagnosis must before
proceeding for management and treatment or
gross diagnosis will be sufficient.

 

5.

What difference it will make if
particular investigation is not done will
it harm patient?

 

6.

What possible harms can be done to
patient while undertaking particular
investigation. Can it cause death?

 

7.

Will cost of investigation burden
patient more than it will benefit him ?

 

8.

Is investigation required urgently
or can it be postponed ?

 

9.

Is there any way to reach to
diagnosis e.g. follow-up
etc. which could avoid
investigation.

 

10.
All the circumstances related to in terms
of its need, urgency, cost, benefit should
be told to patient.

 


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IMPORTANCE
OF
REFERAL
TO SPECIALIST

 

 

 

If
time and condition of patient permits one
should obtain expert opinion in ” out
of the routine” cases and all serious
patients. Importance of seeking medical
history and information from relatives and
patients as described and annexed to
consent from.
Why
reference to specialist is needed and
when?

 

 

 

1.

For confirmation of the diagnosis
and management plan of a particular
patient.

 

2.

All serious patient should get
benefit of specialist so as to avoid
“missed chance” situation later
on when

patient becomes worse.

 

3.

All unusual cases must be referred
to specialist.

 

 

 

4.

More than one persons opinion, if
opinion concurs, has better value in the
law courts in case of any legal

problem,
if any, arises later on.

 

 

 

5.

References are made to specialist
if any procedure can not done with out his
help. Special skill is needed for

the
procedure which only specialist can offer.
eg. Venesection, Lumber puncture

 


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ANTICIPATING
COMPLICATIONS

 

 

 

KNOWN
AND UNKNOWN COMPLICATIONS OF DISEASE,
INVESTIGATIONS AND PROCEDURE:
One is expected to take reasonable
standard care for known complication and
must explain patient and relatives in
detail and to their satisfaction all these
complications.
Unknown
complication arise out of a situation must
be tackled in goodfaith, sometimes with
adventure to save life. One should do
utmost to save life and let it be known
and felt by patient and relatives.
Few
rules to remember while tackling
complications:

 

    • Calculate drug does properly as per
      kilo of body weight particularly for drug,
      which have depressant action on
      respiration and heart. Give these drugs
      after proper dilutions. Give drugs very
      slowly if needed to be given intravenously
      so as to avoid any unknown complications.

 

    • Anticipate known complications and
      be prepared to tackle them in time and
      effectively.

      Keep ready life
      support system.

       

 

    • Life threatening unknown
      complication should be tackled with out
      fear of ” what people will think
      ” Patients life is of supreme
      importance and one can not even wait for
      consent in unusual life threatening
      situations.

      (Unforseen
      complication teaches a lesson to each
      doctor and may help in advancing medical
      treatment).

       

 

    • Law courts are not going to hold
      you responsible for any untoward incident
      or even death as a sequel of  any unknown
      complication or any error of judgement or
      misadventure. What is required of a doctor
      is standard, reasonable medical care of an
      average medical professional.

 

 


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INSURANCE

 

 

 

Insurance
and Doctors:

 

Insurance is a
special contract where payment by insurer
is contingent on liability arising out of
contingent loss. Insured pays
consideration in terms of premium to
insurer. On same principles of insurance
doctor’s indemnity policy is based.

 

    • Doctors indemnity
      policy:

       

      Any liability
      arises out of civil litigation insurance
      company will pay for the insured amount
      (indemnity covered for). Limit of insured
      amount per case during the year or all
      cases during the year should be same.
      Minimum premium is for physician and is double for surgeon, triple for plastic
      surgeon. There are number of exclusion
      clauses which must be studied before
      taking indemnity cover from insurance
      companies. Generally it is RS 1000/= for
      RS. 10,00,000/+ of insurance for
      physicians.

 

    • Doctors composite package
      insurance:
      It
      covers building, contents of dispensary or
      hospital and consulting room including
      furniture, fixture, fittings, stocks of
      medicines, medical instruments and kits
      and electronics items, neon sign board and
      doctors professional indemnity etc. Same
      contents can be covered for burglary,
      housebreaking and theft, finality
      guarantee for cashier, compounder or other
      authorized employees. Limit for fidelity
      is 20,000/= also covers money lost in
      transit.

 

    • Other insurances:

       


      a.) Mediclaim: Covers disease, which needs
      hospitalization, all expenses during
      hospital stay
      .


      b.)
      Personal accident policy: covers any type
      of accidental injuries or death anywhere
      in world and provides
      for weekly
      compensation for the loss of income
      incurred due to accident.

      c.)
       Motor
      car insurance policy

      .

       

 

 


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PROCEDURE
BEFORE CONSUMER FORUM

 

    • Any patient having claims less than/equal
      to five lakh rupees can approach district
      consumer forum for

      redressal which is situated in each
      district.

 

    • A patient with claim more then RS.
      5 lakh but less then /equal to RS. 20 lakh
      approaches state commission or prefers
      an appeal against in 30 days of district
      forum’s order.

      A doctor can also
      appeal to state forum
      against forum’s order with in 30 days.

       

 

    • Patient having claims of more than
      20 lakh may approach national commission
      are appeal with in 30 days from the order
      state forum.

       

       

 

    • Doctors receive copy of complaint
      filed by patient from consumer forum and
      have to file written statement return reply with in
      30 days
      of receipt to commission.

      This may be
      extended upto 15 more days.

       

 

    • Complainant is asked to adduce
      evidence on affidavit so also the opposite
      party.

 

    • Most of the time simple clean cut
      deficiency of services is tried before
      consumer forum and complaints involving
      complicated issue of law and evidence are
      referred to civil court.

       

       

 

 


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DOCTORS
AS CONSUMERS

 

 

 

1.

A Doctor is a consumer if he buys
goods and services for his own consumption
or use.

 

2.

A Doctor is consumer as far as
following services are concerned:

 


a]
Insurance claims including
doctor’s indemnity and doctor’s
composite policy and mediclaim
.

b]  Banking
services.

c]  Postal
and telecommunication services.

d]  Electricity
services.

e]  A
Doctor is a consumer for the purpose of
the equipment he buys for use for his
patients. He can also

approach
Monopolistic and restrictive trade
practices commission, MRTP House,
Shahjahan Road, New

Dehli-110029.


f]

So
in conclusion whatever doctor buys for the
benefit of his patients he can now claim
to be consumer

if any defect in goods or deficiency in
service  is found.

 


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INFORMATION
FROM
PATIENT
AND
MEDICAL
HISTORY

ONE
CAN CHOOSE INFORMATION FROM FOLLOWING
MODEL INFORMATION SHEET OR MODIFY
I_______________________________________________________________
Born
on________________________________ female,
Married/single/divorced.

R/o________________________________________________________
____________________________________________________________
Occupation
_________________________________________________________

CANCEL “NO”
IF “YES” THEN GIVE DETAILS:

WRITE N.A. FOR NOT
APPLICABLE

1.

Do you have diabetes?
NO/___________
 

 

2.

Do you have blood pressure
(Hypertension) No/_____________
 

 

3.

Do you have heart trouble?
NO?_______________
 

 

4.

Do you have lung trouble. (asthma
etc.)? NO/_________________
 

 

5.

Did you have abnormal bleeding
after extraction/surgery/injury?
NO/____________

 


6.
Did you have allergy/reaction to
any medicine /injection (e.g. penicillin,
sulfa etc.)NO/_________
 

 

7.

Are you taking any drug or
medicine? NO/_______________
 

 

8.

Did you have serious illnesses or
operation? No/_______________
 

 

9.

Did you have fits/fainting
attacks/giddiness? No/_____________
 

 

10.
Did you have jaundice? NO/______________
 

 

11.
Are you HIV positive? No/_______________
 

 

12.
Are you Australia Antigen positive?
No/______________
 

 

13.
Do you have rheumatic disease?
NO/____________
 

 

14.
Do you suffer from hay fever, eczema or any
other Allergy? NO/___________
 

 

15.
Are you an expectant mother/breast
feeding? NO/____________
 

 

16.
Is there any matter you wish to discuss?
NO/__________
 

 

17.
Number of deliveries_____________
 

 

18.
Nature of deliveries
Normal/forceps/caesarean/premature/stillbirth/miscarriage/abortion-__________

Date of last Menstrual period:
/
/  

 

19.
Menstrual period:
Regular/irregular/painful/scanty/too
much_____________ 

 

20.
History of birth defects in any children:
No/____________
 

 

21.
Did you have swelling of feet/swelling
eyelid : NO/______________
 

 

22.
Did you have Eclampsia/vesicular
mole/placenta praevia/twins/triples/multiple
pregnancy:

NO/________________  

 

23.
Are you suffering from anaemia :
No/_____________
 

 

24.
Do you have ulcer/acidity : NO/__________
 

 

25.
_____________________________________________

I hereby declare that I
have not concealed and

fully disclosed all
material facts regarding the status of my
health relevant to medical
/SURGICAL/MEDICAL

treatment.

SAMPLE OF IDEAL CONSENT FORM:
ONE CAN CHANGE TO SUIT
INDIVIDUAL DOCTORS REQUIRMENT

Date ../../  

I
hereby employ
Dr.____________________________ for the
personal services for my
MEDICAL/SURGICAL
treatment. I____________________________________________________
R/o
_________________________________________________


_________________________________________________

I hereby declare that I
am more than 18 years of age.
I
hereby consent to the performance of
SURGICAL /MEDICAL
treatment upon myself or
my____________________________________________________

Daughter/wife/ward/niece/neighbour
or any other _________________________

Such treatment to
consist
of______________________________________
______________________________________________

I further consent to
such other or additional treatment,
whether or not described above as may be
indicated by reasonably standard and
prudent SURGICAL/MEDICAL practices if
during the course
of treatment described above
unforeseen conditions are discovered or
unusual conditions develop.
If
the use of anesthesia is indicated, I
consent to the administration of such
anesthetics which may be of surface
anesthesia/infiltrate/block local
anesthesia/general anesthesia/conscious
sedation or any anesthesia as the doctor
may deem advisable and proper.
I
further consent to the taking of
photographs and roentgenograms/X-rays
sonography, CATscan or my other
pathological investigations or my other
investigation for the treatment
to be performed, or for
SURGICAL/MEDICAL
educational or scientific purposes
and the demonstration and publication of
such rontgenograms or photographs etc.

The nature and purpose
of the treatment to be rendered the
possible hazards involved and alternative
methods of treatments have been fully
explained to me and I am free to ask an
explanation of treatment. No
assurance/guarantee/warranty has been made
to me that the results will be to my
complete satisfaction although it is
believed that the results will be
satisfactory.
I have
not concealed and fully disclosed all
material facts regarding the status of my
health relevant to SURGICAL/MEDICAL
treatment.
All
ANESTHESIA /Medical
treatment/procedures/operations carry
inherent risks. I am advised to consult
any other physician/surgeon/doctor before
treatment.
I
consent for taking IV/IM
Injection/drugs/tablets/capsules/syrups/or
any other medicines prescribed for
treatment/Operation.
 

 

                                                                              

 

(Authorized
Signatory.)
 

 

I
certify that to the best of my belief
treatment/SURGICAL/MEDICAL services have
been completed to my satisfaction.
 

 

                                                                              

 

(Authorized
Signatory.)


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MEDICOLEGAL 

      

-:Importance of Record Keeping :-

Ifany legal problem arises than properlymaintained records are of utmostimportance. They are proof of what one hasdone actually for his patient. Recordincludes.

a.)Informed consent.

b.)Chronological order of progress of diseaseand treatment, investigations, opinions,X-rays etc.

c.) Detailsof procedure or surgery or anesthesiagiven.

d.)Record of investigations be itradiological, pathological or reports ofCAT or MRI or any other opinion of specialist or consultant.e.) Recordincludes record of refusal of treatment orinvestigation or surgery.f.) Records of adult patients aremaintained for 3 years and children for 21years. (3+18 years).

 

 

 

 

IMPORTANCEOFINVESTIGATIONS/ X-rays/ MRI/ CAT SCAN/SONOGRAPY

Importanceof investigations: Inmodern time a proof of establishingdiagnosis is most essential.A documentation of such diagnosiscan be done by well-planned outinvestigations. One must avoid unnecessaryinvestigations. One must prefernon-invasive investigation or invasiveone. Routine investigation to get basicknowledge about patient’s condition isessential. Legallyspeaking investigations speaks and vouchesfor correct diagnosis and indication fortreatment and surgery performed by doctor.Few rules for asking investigationsare in following fruitful and beneficial manner:

1.Define the diagnostic dilemma ordifferential diagnosis properly.

2.Ask yourself that after getting theresults of investigation you will narrowdown in your diagnostic dilemma ordifferential diagnosis. 

3.Avoid asking special investigationsroutinely. Only Basic investigations like:Blood count. Stool, urine, etc. could beunder taken routinely. Diseases caused bybacteria should be cultured 

4.Is precise diagnosis must beforeproceeding for management and treatment orgross diagnosis will be sufficient.

5.What difference it will make ifparticular investigation is not done willit harm patient?

6.What possible harms can be done topatient while undertaking particularinvestigation. Can it cause death?

7.Will cost of investigation burdenpatient more than it will benefit him ?

8.Is investigation required urgentlyor can it be postponed ?

9.Is there any way to reach todiagnosis e.g. follow-upetc. which could avoidinvestigation.

10.All the circumstances related to in termsof its need, urgency, cost, benefit shouldbe told to patient.

Top

  

  

 

  

  

 

 

 

 

 

IMPORTANCEOFREFERALTO SPECIALIST

Iftime and condition of patient permits oneshould obtain expert opinion in ” outof the routine” cases and all seriouspatients. Importance of seeking medicalhistory and information from relatives andpatients as described and annexed toconsent from. Whyreference to specialist is needed andwhen?

1.For confirmation of the diagnosisand management plan of a particularpatient.

2.All serious patient should getbenefit of specialist so as to avoid“missed chance” situation lateron whenpatient becomes worse.

3.All unusual cases must be referredto specialist.

4.More than one persons opinion, ifopinion concurs, has better value in thelaw courts in case of any legalproblem,if any, arises later on.

5.References are made to specialistif any procedure can not done with out hishelp. Special skill is needed fortheprocedure which only specialist can offer.eg. Venesection, Lumber puncture

Top

 

 

 

 

 

 

 

 

 

 

 

ANTICIPATINGCOMPLICATIONS

KNOWNAND UNKNOWN COMPLICATIONS OF DISEASE,INVESTIGATIONS AND PROCEDURE:One is expected to take reasonablestandard care for known complication andmust explain patient and relatives indetail and to their satisfaction all thesecomplications. Unknowncomplication arise out of a situation mustbe tackled in goodfaith, sometimes withadventure to save life. One should doutmost to save life and let it be knownand felt by patient and relatives. Fewrules to remember while tacklingcomplications:

    • Calculate drug does properly as perkilo of body weight particularly for drug,which have depressant action onrespiration and heart. Give these drugsafter proper dilutions. Give drugs veryslowly if needed to be given intravenouslyso as to avoid any unknown complications.

    • Anticipate known complications andbe prepared to tackle them in time andeffectively.

      Keep ready lifesupport system.

    • Life threatening unknowncomplication should be tackled with outfear of ” what people will think” Patients life is of supremeimportance and one can not even wait forconsent in unusual life threateningsituations.

      (Unforseencomplication teaches a lesson to eachdoctor and may help in advancing medicaltreatment).

    • Law courts are not going to holdyou responsible for any untoward incidentor even death as a sequel of  any unknowncomplication or any error of judgement ormisadventure. What is required of a doctoris standard, reasonable medical care of anaverage medical professional.

Top

 

 

 

 

 

 

 

 

 

 

INSURANCE

Insuranceand Doctors:

Insurance is aspecial contract where payment by insureris contingent on liability arising out ofcontingent loss. Insured paysconsideration in terms of premium toinsurer. On same principles of insurancedoctor’s indemnity policy is based.

    • Doctors indemnitypolicy:

      Any liabilityarises out of civil litigation insurancecompany will pay for the insured amount(indemnity covered for). Limit of insuredamount per case during the year or allcases during the year should be same.Minimum premium is for physician and is double for surgeon, triple for plasticsurgeon. There are number of exclusionclauses which must be studied beforetaking indemnity cover from insurancecompanies. Generally it is RS 1000/= forRS. 10,00,000/+ of insurance forphysicians.

    • Doctors composite packageinsurance: Itcovers building, contents of dispensary orhospital and consulting room includingfurniture, fixture, fittings, stocks ofmedicines, medical instruments and kitsand electronics items, neon sign board anddoctors professional indemnity etc. Samecontents can be covered for burglary,housebreaking and theft, finalityguarantee for cashier, compounder or otherauthorized employees. Limit for fidelityis 20,000/= also covers money lost intransit.

    • Other insurances:

      a.) Mediclaim: Covers disease, which needshospitalization, all expenses duringhospital stay.b.)Personal accident policy: covers any typeof accidental injuries or death anywherein world and providesfor weeklycompensation for the loss of incomeincurred due to accident.

      c.) Motorcar insurance policy.

Top

 

 

 

 

 

 

 

 

 

 

PROCEDUREBEFORE CONSUMER FORUM

    • Any patient having claims less than/equalto five lakh rupees can approach districtconsumer forum forredressal which is situated in eachdistrict.

    • A patient with claim more then RS.5 lakh but less then /equal to RS. 20 lakhapproaches state commission or prefersan appeal against in 30 days of districtforum’s order.

      A doctor can alsoappeal to state forumagainst forum’s order with in 30 days.

    • Patient having claims of more than20 lakh may approach national commissionare appeal with in 30 days from the orderstate forum.

    • Doctors receive copy of complaintfiled by patient from consumer forum andhave to file written statement return reply with in30 daysof receipt to commission.

      This may beextended upto 15 more days.

    • Complainant is asked to adduceevidence on affidavit so also the oppositeparty.

    • Most of the time simple clean cutdeficiency of services is tried beforeconsumer forum and complaints involvingcomplicated issue of law and evidence arereferred to civil court.

Top

 

 

 

 

 

 

 

 

 

 

 

DOCTORSAS CONSUMERS

1.A Doctor is a consumer if he buysgoods and services for his own consumptionor use.

2.A Doctor is consumer as far asfollowing services are concerned:

a]Insurance claims includingdoctor’s indemnity and doctor’scomposite policy and mediclaim.b]  Bankingservices.c]  Postaland telecommunication services.d]  Electricityservices.e]  ADoctor is a consumer for the purpose ofthe equipment he buys for use for hispatients. He can alsoapproachMonopolistic and restrictive tradepractices commission, MRTP House,Shahjahan Road, NewDehli-110029.f]Soin conclusion whatever doctor buys for thebenefit of his patients he can now claimto be consumerif any defect in goods or deficiency inservice  is found.

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INFORMATIONFROMPATIENTANDMEDICALHISTORY

ONECAN CHOOSE INFORMATION FROM FOLLOWINGMODEL INFORMATION SHEET OR MODIFYI_______________________________________________________________Bornon________________________________ female,Married/single/divorced.R/o____________________________________________________________________________________________________________________Occupation_________________________________________________________CANCEL “NO”IF “YES” THEN GIVE DETAILS:WRITE N.A. FOR NOTAPPLICABLE

1.Do you have diabetes?NO/___________ 

2.Do you have blood pressure(Hypertension) No/_____________ 

3.Do you have heart trouble?NO?_______________ 

4.Do you have lung trouble. (asthmaetc.)? NO/_________________ 

5.Did you have abnormal bleedingafter extraction/surgery/injury?NO/____________

6. Did you have allergy/reaction toany medicine /injection (e.g. penicillin,sulfa etc.)NO/_________ 

7.Are you taking any drug ormedicine? NO/_______________ 

8.Did you have serious illnesses oroperation? No/_______________ 

9.Did you have fits/faintingattacks/giddiness? No/_____________ 

10.Did you have jaundice? NO/______________  

11.Are you HIV positive? No/_______________  

12.Are you Australia Antigen positive?No/______________  

13.Do you have rheumatic disease?NO/____________  

14.Do you suffer from hay fever, eczema or anyother Allergy? NO/___________  

15.Are you an expectant mother/breastfeeding? NO/____________  

16.Is there any matter you wish to discuss?NO/__________  

17.Number of deliveries_____________  

18.Nature of deliveriesNormal/forceps/caesarean/premature/stillbirth/miscarriage/abortion-__________Date of last Menstrual period://  

19.Menstrual period:Regular/irregular/painful/scanty/toomuch_____________ 

20.History of birth defects in any children:No/____________  

21.Did you have swelling of feet/swellingeyelid : NO/______________  

22.Did you have Eclampsia/vesicularmole/placenta praevia/twins/triples/multiplepregnancy:NO/________________  

23.Are you suffering from anaemia :No/_____________  

24.Do you have ulcer/acidity : NO/__________  

25._____________________________________________I hereby declare that Ihave not concealed andfully disclosed allmaterial facts regarding the status of myhealth relevant to medical/SURGICAL/MEDICALtreatment.SAMPLE OF IDEAL CONSENT FORM:ONE CAN CHANGE TO SUITINDIVIDUAL DOCTORS REQUIRMENT Date ../../   Ihereby employDr.____________________________ for thepersonal services for myMEDICAL/SURGICALtreatment. I____________________________________________________R/o__________________________________________________________________________________________________I hereby declare that Iam more than 18 years of age. Ihereby consent to the performance ofSURGICAL /MEDICALtreatment upon myself ormy____________________________________________________Daughter/wife/ward/niece/neighbouror any other _________________________Such treatment toconsistof____________________________________________________________________________________I further consent tosuch other or additional treatment,whether or not described above as may beindicated by reasonably standard andprudent SURGICAL/MEDICAL practices ifduring the courseof treatment described aboveunforeseen conditions are discovered orunusual conditions develop. Ifthe use of anesthesia is indicated, Iconsent to the administration of suchanesthetics which may be of surfaceanesthesia/infiltrate/block localanesthesia/general anesthesia/conscioussedation or any anesthesia as the doctormay deem advisable and proper. Ifurther consent to the taking ofphotographs and roentgenograms/X-rayssonography, CATscan or my otherpathological investigations or my otherinvestigation for the treatmentto be performed, or forSURGICAL/MEDICALeducational or scientific purposesand the demonstration and publication ofsuch rontgenograms or photographs etc.The nature and purposeof the treatment to be rendered thepossible hazards involved and alternativemethods of treatments have been fullyexplained to me and I am free to ask anexplanation of treatment. Noassurance/guarantee/warranty has been madeto me that the results will be to mycomplete satisfaction although it isbelieved that the results will besatisfactory. I havenot concealed and fully disclosed allmaterial facts regarding the status of myhealth relevant to SURGICAL/MEDICALtreatment. AllANESTHESIA /Medicaltreatment/procedures/operations carryinherent risks. I am advised to consultany other physician/surgeon/doctor beforetreatment. Iconsent for taking IV/IMInjection/drugs/tablets/capsules/syrups/orany other medicines prescribed fortreatment/Operation.  

                                                                              

(AuthorizedSignatory.)  

Icertify that to the best of my belieftreatment/SURGICAL/MEDICAL services havebeen completed to my satisfaction.  

                                                                              

(AuthorizedSignatory.)

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