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Genaral Consent

Doc.no : 73452

I here by give consent authorization to being examined in the OPD by the doctors appointed in the OPD.I understand the Doctor will be assisted by other health care professionals & such others he/she feels necessary. I agree with their participation in my care.

I gave consent to carry out necessary tests or investigations and I am willing to pay all the charges for the treatment. I am fully aware that treatment is being performed in good faith & that no guarantee or assurance has been given for the results to be obtained.I am responsible for my personal belongings and I do not hold doctors/staff hospital responsible in case of any loss of personal belongings.

I am aware that photography/ videography/ Audio recording in hospital premises is strictly prohibited.

I am aware that smoking and consumption of alcohol is strictly prohibited.

I have read this consent and/or it has been read over to me and explained to me in the language that I understand.

To attest my consent I hereby affix my signature/left hand thumb Impression voluntarily.

Signature/Thumb Impression of Patient/ Relative