O/C

Segregation Training Programme

Hospital/Clinic/Lab/NH
Owner
Date of Training
Training given to:

1.
3.
5.

Trained by:

1. Mr. __________________
2. Mr. __________________

Receipt No:

No. of Beds
2.
4.
6.

Responsible man of segregation at source

Mr./Ms./Mrs._______________________(Name with designation)
Authorised Signature with stamp

Segregation Training Conducted by: Center for Pollution Control (CPC)

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I/C

Receipt No:

Segregation Training Programme

Hospital/Clinic/Lab/NH
Owner
Date of Training
Training given to:

1.
3.
6.

Trained by:

1. _____________________
2. _____________________

No. of Beds
2.
4.
6.

Responsible man of segregation at source

Mr./Ms./Mrs._______________________(Name with designation)
Authorised Signature with stamp

Segregation Training Conducted by: Center for Pollution Control (CPC)