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"In the treasury of nature, there are many Gems; those only are worth carrying away, which we know how to set" --Honigberger

samuelNon Inutilis Vixi (Not lived in vain)
Dr. C. F. Samuel Hahnemann

Registration Form

Registration FormIndex

 

 

FORM A

(See Regulation 4)

Form of application for Direct Registration under Section 23 of the Homoeopathy Central Council Act, 1973.

To

The Registrar,
Central Council of Homoeopathy. New Delhi.

Dear Sir,

I hereby request that my name and other particulars as mentioned below may be entered in the Central Register of Homoeopathy as required under Section 23 of the Homoeopathy Central Council Act, 1973.

1 :
(in block letters beginning with surname)
2 Maiden Name

 

:
if the applicant is a married woman and surname (in block letters beginning with surname)
3 Email

 

:
4 Nationality :
5 Residential Address :
6 Professional Address :
7 Date of Birth (Christian Era) :
8 Qualifications    
 
(a) Qualifications for registration
possessed by the applicant.
:
(b) Date on which the applicant obtained the qualification.. :
(c) Authority which conferred or granted the qualification :
(d) The place where the applicant received training. for such qualifications and the period of such training  
(e) The name of the Council/Board where he had registered earlier, if any :
II I Forward herewith    
 
(i) My Birth Certificate/Matriculation Certification/Secondary School Leaving Certificate/School Leaving Certificate in original :
(ii) Diploma/Degree Certificate in original in respect of the qualifications possessed by me together with two attested copies there of. :
iii The originals may kindly be returned to me after verification by you :
iv Registration fee of Rs.1000/- (Rupees One Thousand only) is remitted by    
  Postal Order/Bank Draft No. :
I certify that the particulars furnished above are true to the best of my knowledge and belief
   

Yours Faithfully

(Signature of applicant Upload scanned image)

  Date :
  Place :
  N.B. The following documents/information may also be furnished
1 Father's Name :
2 Mother's Name :
3 Two recent passport size photographs of applicant out of which one duly attested by a Gazetted Officer or an Officer authorized in this behalf by the Board under whose jurisdiction the applicant resides or the Principal of a recognized Homoeopathic Medical College of a member of the Legislative Assembly of the State within whose jurisdiction the applicant resides or a Member of Parliament and should be affixed on the application form.
4 Two attested copies of the registration certificate issued by the State Board /Council of the concerned State where you resides/practicing.
5 Copy of Oath Form (enclosed) must be signed by the applicant and duly attested by a registered medical practitioner of Homeopathy with his registration number and seal.

Declaration And Oath

At the time of registration, each applicant shall submit the following declaration and oath read and signed by him to the Registrar concerned attested by Registrar himself or by a registered practitioner of Homeopathy:-

  1. I solemnly pledge myself to consecrate my life to the service of humanity.
  2. Even under threat, I will not use my medical knowledge contrary to laws of humanity.
  3. I will maintain the utmost respect of human life.
  4. I will not permit considerations of religion, nationality, race, political beliefs or social standing to intervene between my duty and my patient.
  5. I will practice my profession with conscience and dignity in accordance with principles of homeopathy.
  6. The health of my patient shall be my first consideration.
  7. I will respect the secrets which are confined to 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 honour and noble traditions of my medical profession.
  10. My colleagues will be my brothers and sisters.
  11. I make these promises solemnly, freely and upon my honour.

Hahnemannian Oath

On my honour I swear that I shall practise the teachings of homeopathy, perform my duty, render justice to my patients and the sick whosoever comes to me for treatment.

May the teachings of Master Hahnemann inspire me and may I have the strength for fulfillment of my mission.

Signature of the candidate

Name :
Date :
Attested by Sign :
Name of Attesting Doctor  
Regn. No. & Qualification of Attesting Doctor  
N.B The Declaration & Oath should be Signed by the applicant and duly attested by a Registered Medical Practitioner of Homoeopathy.
   
   

FORM B

(See Regulation 5)

Form of application for registration of additional qualification.

To

The Registrar,

The Central Council of Homoeopathy,

New Delhi.

Dear Sir,

I am a registered practitioner of Homoeopathy my Registration Number is I have acquired an additional qualification in Homoeopathy and desire to register the same under Regulation 5 of the Homoeopathy Central Council (Registration) Regulations, 1982. My particulars are as under:-

1
(in block letters beginning with surname)
:
2 Maiden Name
if the applicant is a married woman and surname (in block letters beginning with surname)
:
3 Email

 

:
4 Nationality :
5 Residential Address :
6 Professional Address :
7 Date of Birth (Christian Era) :
8 Additional qualifications sought to be entered in the register.
 
(a) The authority which conferred or granted the additional qualification. :
(b) The date on which the qualification was conferred/granted. :
(c) Details of training leading to conferment of the additional qualification, including the period of such training. :
9
Number and date of registration in the Central Register. :
10
Number and date of registration in the State Register,. :
II I Forward herewith
 
(i) The additional Title/Diploma/other qualification (in original). :
(ii) two attested copies thereof, attested by one of the persons referred to in clause (iii) of sub-regulation (2) of regulation 4 of the Homoeopathy Central Council (Registration) Regulations, 1982. :
(iii) A fee of Rs.500/- (Five Hundred Rupees including service charges of Sixty Rupees ) by crossed Postal Order/Bank Draft in the name of The Central Council of Homoeopathy, New Delhi
  Postal Order/Bank Draft No. :
III The originals may kindly be returned to me after verification by you.
  Yours Faithfully : (Signature of applicant Upload scanned image)
  Date :
  Place :
     
     

FORM C

(See Regulation 6(3) AND (8)

CENTRAL COUNCIL OF HOMOEOPATHY

Jawahar Lal Nehru Bhartiya Chikitsa Avum Homeopathy Ansandhan Bhavan No. 61-65, Institutional Area, Opp. 'D' Block, Janakpuri, New Delhi- 110058.

[Certification Under Section 23 of Homeopathy Central Council Act, 1973 (59 of 1973)]

(Registration Certificate)

1 :
2 Candidate's Name

 

:
3 Father's Name :
4 Mother's Name :
5 Address :
6 Qualification :
7 Seal for Water Mark Image :
  Registrar : (Signature of applicant Upload scanned image)
  Date :
  Place :
     

FORM D

(See Regulation 9(1) AND (8)

 

Form of General Notice

General Notice is hereby given to all the Registered Practitioners incluede in Parts I and II of the Central Council of Homeopathy maintained under ther Homoeopathy maintained under ther Homeopathy Central Council Act, 1973 that they have to make an application to the Registrar for Continuance of their names on ther Said Register as Provided in regulation 9(1) of the Homeoeopathy Centeral Council (Registration ) Regulaion, 1982, Framed under The said Act.

Individual Notices alongwith the prescribed form of application are being sent under certificate of posting to every registerede practitioner to the address entered in the said registered Practitioner to the addresse entered in the said Register. An Application in Form F for continuation of ther Name of Register should be returned to the undersigned duly completed within 30 days of the issue of this notice. Any Registered Practitioner not receiving the form by port may obtain it from ther office of ther Registrar.

Registrar : (Signature of the Registrar)
Date :
Place :
   

FORM E

[See Regulation 9(2)]

Central Concil of HOmeopathy

Notice to Registered Pracitioners for Continuation of their names in ther Central Register

To

Dr.

Subject : Individual Notices for continuation of name in ther Central Register.

 

Dear Sir,

 

Notice is hereby given to you calling upon you to return to ther Registrar within thirty days hereof the enclosed application form (form F) duly filled in by you for continuanceof your name in ther central Register of Homoeopathy.

Your Faithfully : (Signature of the Registrar)
Date :
Place :
   

 

FROM F

[See Regulation 9(2) and (3)]

Application for the continuation of name in the Central Register

To

The Registrar,

Central Council of Homoeopathy,

New Delhi.

Sub:- Continuation of name in the Register.

Sir,

I request that my name may be continued in the Central Register maintained by the Central Council in Part .

1. My particular are submitted as under:-    
(i) :
(in block letters beginning with surname)
(ii) Maiden Name

 

:
if the applicant is a married woman and surname (in block letters beginning with surname)
(iii) Registation No. :
(iv) Date upto which it is renewed :
(v) Permanent Address :
(vi). Email ID :
3. *A restoration fee of Rs. 75/- (Rs. 25/- for restoration and Rs. 50/- as service charges) is enclosed by way of crossed Postal Order/Bank Draft in the name of the Central Council of Homoeopathy, New Delhi.
  Date :
  Yours Faithfully : (Signature of applicant Upload scanned image)
  Full Name :
  Date :
  Place :
     

Note:- The fee of Seventy five rupees shall be for restoration of the registration, and not for the purpose of renewal of registration


 

FROM G

(See regulation 10)

Appeal for restoration of name in the Register.

To

The Secretary

to the Govt. of India

Ministry of Health and Family Welfare,

New Delhi.

Sir.

1 the undersigned (full name in block letters beginning with Surname) holding qualification of do solemnly declare that the following are (state the qualification) the facts of my case on which I seek restoration of my name in the Register:
2 My name was duly registered in the State Register of ( )having (name of the State) registration number dated .
3 My name was duly registered in the Central Register of Homoeopathy on having registration No.
4 At an enquiry held on the day of by the Board, my name was directed to be removed from the State Register and the offence for which the Board directed the removal of my name was (use separate sheet for details if necessary).
5 Since the removal of my name from the Register I have been residing at and my occupation has been .
6 It is my request that my name be restored in the Register of State
7. The grounds, for the present, of application are    
(i)
(ii)
(iii)
8. The prescribed fee of Rs. 75/- (Rs. 25/- for restoration and Rs. 50/- as service charges) has been deposited by Bank Draft No. dated payable to Secretary, Ministry of Health and Family Welfare, New Delhi.
9. I request that orders may be passed for restoration of my name in the State Register of (State).
  Judicial/Executive Magistrate,
: (Signature of Commissioner of Oath Upload scanned image)
  Full Name :
  Date :
  Declared at  
  Before me  
  Place :