The Haryana Medical Council form serves as a crucial facilitator for the provisional or permanent registration of medical practitioners within the state. This document, aimed at the Registrar of Haryana Medical Council situated at the Civil Hospital in Panchkula, is the first step for individuals seeking validation and acknowledgment of their professional qualifications under the Punjab Medical Registration Act II of 1916. Applicants are required to furnish a spectrum of documents including but not limited to, detailed marks certificates from their MBBS examination, matriculation certificate, internship completion certificate, and if applicable, registration certificates from other State Medical Councils. This array of documents underscores the comprehensive nature of the verification process, ensuring that only qualified individuals are granted registration. Furthermore, the form stipulates a non-refundable registration fee, contingent on the type of registration sought, and outlines the conditions under which the provisional certificate is valid. In addition to personal and professional details, the applicant must attest to their conduct and character, reinforcing the Council's commitment to maintaining high ethical standards within the medical profession in Haryana. The inclusion of a solemn declaration at the time of registration emphasizes the ethos expected of medical practitioners, spanning the respect for human life, professional dignity, and adherence to ethical codes. This comprehensive approach ensures that the medical profession in Haryana upholds the highest standards of service and integrity.
| Question | Answer |
|---|---|
| Form Name | Haryana Medical Council Form |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | hmc registration form, haryana medical council registration form, haryana medical form, haryana medical council |
HARYANA MEDICAL COUNCIL Form of provisional/permanent registration
To
The Registrar,
Haryana Medical Council, Room No 46,Civil Hospital Opp. Swasthya Bhawan, Sector 6,Panchkula
Sir,
Photo
I have to request that my name be registered under the Punjab Medical Registration Act II of 1916 and that I may be furnished with a certificate of Registration.
The Information necessary for registration is specified on the reverse. The Registration Fee of Rs. 250/- for provisional registration/Rs.
500/- for permanent registration is sent by Bank Draft payable at Chandigarh.
Yours faithfully,
Dated
Name
Professional Address
Required Documents:-
1)Photostat attested copies of first, second and final year detailed marks certificates of passing of MBBS examination.
2)Photostat attested copy of matriculation certificate.
3)Photostat attested copy of internship completion certificate.
4)Original copy of provisional registration certificate issued by Haryana Medical Council or other State Medical Council.
5)Original as well as two Photostat attested copies of registration certificate issued by previous Council, if already registered with other State Medical Council.
6)Candidates seeking registration from other States should produce an affidavit on stamp paper of Rs. 3/- duly attested by the First Class magistrate to the effect that he/she not been already registered with any other Medical Council in India.
Note
1.) The registration fee is not refundable whether the registration form is accepted or rejected.
2.) The provisional certificate is valid only for completion of internship for one year from the date of passing of MBBS examination and it will not be used for any other purpose.
1)Applicant’s full Name (In Block Letters)
2)Father’s Name
3)Date of Birth(With Proof)
4)Nationality
5)Postal Address of Permanent residence:-
6)Correspondence Address:-
7)Medical Qualification of which registration is required.(All Medical Qualification should be entered in this column)
8)University or Institution where obtained:-
9)Year of passing of Degree or Diploma:-
10)Any matter or incident reflecting adversely upon the applicant’s previous character and conduct.
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Signature of Applicant |
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HARYANA MEDICAL COUNCIL
DECLARATION
At the time of registration, each applicant shall be given a copy of the
following declaration by the Registrar concerned and the applicant shall read and
agree to abide by the same:-
1.) I solemnly pledge myself to consecrate my life to service of humanity.
2.) Even under threat, I will not use any medical knowledge contrary to the laws of Humanity.
3.) I will maintain the utmost respect for human life from the time conception.
4.) I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient.
5.) I will practice my profession with conscience and dignity.
6.) The health of my patient will be my first consideration.
7.) I will respect the secrets which are confined in me.
8.) I will give to my teachers the respect and gratitude which is their due.
9.) I will maintain by all means in my power, the honor and noble traditions of medical profession.
10.) I will treat my colleagues with all respect and dignity.
11.) I have read and shall abide by the code of medical ethics as enunciated in the Indian Medical Council (Professional Conduct. Etiquette and Ethics) Regulations 2002.
I make these promises solemnly, freely and upon my honour.
Signature:-
Name:-
Place:-
Address:-
Date:-