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DECLARATION

I.Dr. _______________________________declare that, I shall abide to the rules


adn regulations formulated in Andhra Pradesh Medical Care Establishment
(Registration & Regulation) Act - 2002 issued in G.O.Ms.No.135 HMFW(K2), Dept.,
DtL28.04.2007

Place: Signature of the Doctor/MD/Director/


Date: Proprietor/Correspondent
Hospital Seal /Stamp

(Note: Please get this affidavit typed on Rs.20/- Bond paper and signed by the
proprietor / Correspondent with hospital seal before submission

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