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Body Donation Form

This document is a body donation form for an individual wishing to donate their body after death to the Department of Anatomy at Grant Medical College and JJ Group of Hospital or Lokmanya Tilak Municipal Medical College and Sion Hospital in Mumbai, India. The form includes spaces for the donor's contact information and signature consenting to the donation, as well as contact information for the medical colleges. It also includes a section for signatures of close relatives with no objection to the donation.

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poorva shah
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375 views1 page

Body Donation Form

This document is a body donation form for an individual wishing to donate their body after death to the Department of Anatomy at Grant Medical College and JJ Group of Hospital or Lokmanya Tilak Municipal Medical College and Sion Hospital in Mumbai, India. The form includes spaces for the donor's contact information and signature consenting to the donation, as well as contact information for the medical colleges. It also includes a section for signatures of close relatives with no objection to the donation.

Uploaded by

poorva shah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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BODY DONATION FORM

FROM:
_________________________________________

_________________________________________

Tel. No.: _________________________________

To,

The Professor & Head,


Department of Anatomy, Grant Medical College ,
J. J. Group Hospital, Mumbai - 400 008.
Phone Nos.: 022-2376 9400 / 0943 / 2373 5555

OR

Lokmanya Tilak Municipal Medical Collage,


Sion Hospital, Sion, Mumbai - 400 022.
Phone Nos.:022-2407 6381 / 6382/2409 5099

Date :

Dear Doctor,

I desire to donate my entire body after my death for study and other uses.

Kindly accept the same.

Thanking you,

Yours faithfully,

________________

Signature

No objection from close relatives

We have no objection to donate the Body of Shri. / Ms. __________________________________

age _______________ after his / her death, for educational and other purpose to Anatomy

Department, grant Medical College & Sir J. J. Group of Hospital & Sion Hospital.

Tel No. Name Relation


Signature

N.B. : - Close Relation – Father, Mother, Husband, Wife, Son, Daughter, Brother, Sister etc.

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