ORIGINAL

OfficeTiming Maharashtra State Dental Council

Fees Accepted only between: Address: Govt. Dental College & Hospital,
11 a.m. and 2 p.m. Monday To Friday 3 floor, St. George Hospital Compound,
Office is Closed on 2nd And 4th Saturday Near CST Railway Station,
and Public Holiday. Fort, Mumbai-400001
Website: msdcmumbai.org.in
Fax: +91 022 22617634
Telephone: +91 022 22617644

Receipt No.: 183999 Date: 12-03-2019

Received with thanks from SALUNKHE AJAY SHIVAJI Online A-33001 Amount mentioned in item b below
Renewal Fee For Dentist Of Rs 200 For Year 2019
(Including of 10% Service Charges )
Total Amount (Rs.):- 220/- Registrar
Maharashtra State Dental Council

Your registration is valid up to 31-December-2019

(a) Registration fee-Dentists Rs. 500 /- Dental Hygienists Rs. 200 /- Dental Mechanics Rs. 200 /-
(b) Renewal fee-Dentists Rs. 200 /- Dental Hygienists Rs. 80 /- Dental Mechanics Rs. 80 /- For Year 2019
(c) Duplicate Copy of Certificate fee-Dentists Rs. 500 /- Dental Hygienists Rs. 200 /- Dental Mechanics Rs. 200 /-
(d) Rs. ______ being the price of the Maharashtra State Dentists/Hygienists/Mechanics. Register____________
(e) Penalty Fee under rule 65(3) for Dentists Rs. 100 /- Dental Hygienists Rs. 50 /- Dental Mechanics Rs. 50 /- For Year 2019 to 2018
(f) Rs. 100 under section 40.
(g) Rs. 50/- being the for registration of a change of name.
(h) Fee For restoration of a name to the Register under section 42-Dentist Rs. 0 /- Dental Hygienists Rs. 0 /- Dental Mechanics Rs. 0 /-
(j) As Deposite Only.
(k) As Bank commission.
(l) Miscellaneous.

FORM C-3
[See rule 65 (2)]
Certificates of renewal of registration under section 39(3) of the Dentists Act, 1948 (XVl of 1948).

Extension Office Administration Office

Govt. Dental College and Hospital,Third 211, Anand Complex, 2nd Floor, 189 - Sane
Floor, ST. George Hospital Compound,Near Guruji Mar& Aurthor Road
C.S.T. Railway - Station,Mumbai-4oo001 Naka,Chinchpokali (West), Mumbai - 400
011
This is to certify that the registration of Dentist SALUNKHE AJAY SHIVAJI
Registered at No.: A-33001 is renewed on the 12 day of Mar2019 and will remain in force up to the 31st day of December 2019

Registrar,
Maharashtra State Dental Council,
Mumbai
These Rules were last amended by Government Notification Urban Development Public Health and Housing
Department, No.AGT-1373/68888/5, Dated 12th July 1974, published on p.342 in Maharashtra Government
Gazette, Part lV-A, Dated 25th July 1974.
This is a computer generated receipt and does not require any signature.