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com
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ANDHRA PRADESH MEDICAL COUNCIL

SULTAN BAZAR :: HYDERABAD

Application for Renewal of Medical Registration

See Section-15C of A.P Medical Practitioners Registration
(Amendment) Act, 2013
To
The Registrar,
A.P.Medical Council,
Hyderabad-500095.

Affix recent
Passport size
Photograph duly
attested by any
Civil Surgeon /
Prl.of anyMedical
College/Supdt. of
any Hospital

Sir,
I, undersigned Dr.___________________________________
registered with
A.P.Medical Council under Registration No_______________ dated_________ .
I have
complied with the requirements of Section-15C of A.P.Medical Practitioners Registration Act,
1968 (Amendment Act No.10 of 2013) and the rules made thereunder. Necessary Fee is
paid herewith in the shape of Demand Draft drawn in favour of Andhra Pradesh Medical

Council, and request that my Medical Registration may be renewed and a certificate be
issued. The details are as under.
NAME OF THE DOCTOR:_________________________________________________
(With Surname in full and in block letters)
FATHERS NAME

:__________________________________________________

MOTHERS NAME

:__________________________________________________

BLOOD GROUP

:__________________________________________________

DATE OF BIRTH

:___________________________SEX:___________________

REGN. NO.& DATE

:__________________________________________________

QUALIFICATION /
COLLEGE & UNIVERSITY:_________________________________________________
PERMANENT ADDRESS :__________________________________________________
______________________________________________
E-mail______________________ Pin code No: _____________Phone No. _____________
Medical Qualifications for
which Registration was
granted

Name of the Medical

College / University
where the Degree was
obtained

Details of Registration No. and

Date

P.T.O

:: 2 ::
The originals and the attested copies of the required documents are submitted
herewith. The originals may kindly be returned when no longer required.
The above facts are true to the best of my knowledge.
Yours faithfully,

( Signature of the Doctor)

REQUIREMENTS FOR RENEWAL OF MEDICAL REGISTRATION:

1. D.D. For Rs.1000/- drawn in favour of ANDHRA PRADESH MEDICAL COUNCIL ,
HYDERABAD from ANDHRA BANK.
2. Final Medical Registration Certificate issued by A.P.Medical Council in original
and its copy and certificates of Registration of Additional Qualifications if any.
3. Proof of Date of Birth (SSC, Passport or any relevant certificate).
4. One Recent Passport size photograph.
5. Attendance Certificates of C.M.E programmes having not less than30 credit hours
during the preceding five years.
6. Late Fee of Rs. 100/- per month after 09-09-2014 for a further period of one year.

D.D.No...,Date.,Rs.
.Bank Name:....Branch Name.
,Branch Code.

REGISTRAR
Note:i).

Every Registered Medical Practitioner shall renew his Registration after expiry of
the period of five years from the date of his original Registration.

ii).

Renewal of Registration shall be done before 09-09-2014.

iii).

The Registered Medical Practitioner who fails to renew his registration within the
stipulated period, can renew his registration upto a further period of one year
on payment of late fee. No application for grant of renewal of
Registration
will be accepted on or after the date specified in this regard even on payment of late
fee.

iv).

The name of the Registered Medical Practitioner will be removed from the
Register, if he fails to renew his Registration as specified above.

v).

Fresh Registration will be granted in case of the removal of names of Registered

Medical Practitioners from the Medical Register as per the procedure laid down in
Rules.

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