FORM - 6
[(See rule 4(2) (b)]
I................................... s/o,d/o,w/o .......................
aged ...................resident of. ..............................
having lawful possession of the dead body Sri/Smt/km .....................s/o,d/o,w/o ..................................
aged........... resident of..................................................... having known that the deceased has not expressed any objection to his/her organ/organs being removed for therapeutic purposes after his/her death and also having reasons to believe that no near relative of the said deceased person has objection to any of his/her organs
being used for therapeutic purposes authorise removal of his/her body organs,
Signature.....................
name. .......................
Dated..........................
Place …………………. .........
Person in lawful possession of the dead body
Address..................................................................
..............................................................................
Place: Hyderabad
Date:22.08.2014
J Place: Chennai
Date:28.11.2013
Place: Chennai
Date:31.08.2013
Place: Hyderabad
Date:07.04.2013
Place: Bengaluru
Date:04.12.2012
Place: Hyderabad
Date:26.10.2012