The Transplantation of Human Organs Rules, 1995 - Form 9

FORM 9
             (See rule 4(3) (b))                

I, Mr/Mrs....................................son of / wife of.......................resident of...........................hereby authorise removal of the organ/organs namely..................................for therapeutic purposes from the dead body of my son/daughter . Mr/Ms...............................................................aged.........................whose brain stem death has been duly certified in accordance with the law
                                                                                             

   Signature..............................

                                                                                                Name....................................

                                                                                    Place.....................................

                                                                                               Date........................................