THE TRANSPLANTATION OF HUMAN ORGANS RULES, 1995
(GSR NO. 51(E), dr. 4-2-1995)
[As amended vide GSR 571(E), dt.31-7-2008]


FORM 9
[Refer rule 4(3) (a) (b)]

I, Shri/Smt. .............. s / o. w / o, Shri ................ resident of ........... hereby authorize removal of the organ / organs, namely, ......... for therapeutic purpose from the dead body of my son / daughter Shri / Km. ...........aged ............. Whose brain-stem death has been duly certified in accordance with the law.

Signature........................
Name.................
Date................
Place....................