BEST HIGH / HIGHER SECONDARY SCHOOL

CONSENT FORM FOR VACCINATION

To,
Principal,
Best High / Higher Secondary School,
Kankaria, Ahmedabad.

Subject : Consent for vaccination of my child.

Resp. Sir,

My Son / Daughter
…………………………………………………………………………………………..
is studying in std …….. , div ………. , having roll no ………… .
In relation to above mentioned subject, I give my consent for vaccination of my child under
government vaccination program for students in the age group of 15 to 18 years. I abide by the rules
and regulations along with SOP guidelines of government.

Your’s faithfully,

……………………………………….

Name and signature of Parent

Date :

Mobile No of Parent : _______________

Student’s Aadhar Card Number : ________________________