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Approval of private clinics for Comprehensive Abortion Care (CAC) services
(Under the provisions of the MTP Act 1971) National Health Mission, Uttar Pradesh
Home
> Clinc Registration ( Form A )
FORM A
[Refer sub-rule (2) of rule 5]
FORM OF APPLICATION FOR THE APPROVAL OF A PLACE UNDER CLAUSE (B) OF SECTION 4
All Fields are mandatory.
Please print this form after online submission and submit the signed hardcopy of this form to CMOs office in your district.
Category of approved place:
A
. Pregnancy can be terminated upto 12 weeks
State, if the following facilities are available at the place
Gynaecological examination/labour table
Resuscitation equipment
Sterilization equipment
Facilities for treatment of shock, including emergency drugs
Facilities for transportation, if required
B
. Pregnancy can be terminated upto 20 weeks
State, if the following facilities are available at the place
Gynaecological examination/labour table
Resuscitation equipment
Sterilization equipment
Facilities for treatment of shock, including emergency drugs
Facilities for transportation, if required
An operation table and instruments for performing abdominal or gynaecological surgery.
Drugs and parental fluid in sufficient supply for emergency cases.
Anaesthetic equipment, resuscitation equipment and stertilization equipment.
Name of the place
Address
Type
Select Type
Non-Government
Private
Nursing Home
Other Institutions
District
Choose District
AGRA
ALIGARH
AMBEDKAR NAGAR
CSM NAGAR (AMETHI)
AMROHA (JP NAGAR)
AURAIYA
AYODHYA
AZAMGARH
BAGHPAT
BAHRAICH
BALLIA
BALRAMPUR
BANDA
BARABANKI
BAREILLY
BASTI
BIJNOR
BUDAUN
BULANDSHAHR
CHANDAULI
CHITRAKOOT
DEORIA
ETAH
ETAWAH
FARRUKHABAD
FATEHPUR
FIROZABAD
GAUTAM BUDDHA NAGAR
GHAZIABAD
GHAZIPUR
GONDA
GORAKHPUR
HAMIRPUR
HAPUR
HARDOI
HATHRAS
JALAUN
JAUNPUR
JHANSI
KANNAUJ
KANPUR NAGAR
KANPUR DEHAT
KASGANJ
KAUSHAMBI
KUSHI NAGAR
LAKHIMPUR KHIRI
LALITPUR
LUCKNOW
MAHARAJGANJ
MAHOBA
MAINPURI
MATHURA
MAU
MEERUT
MIRZAPUR
MORADABAD
MUZAFFARNAGAR
PILIBHIT
PRATAPGARH
PRAYAGRAJ
RAEBAREILI
RAMPUR
SAHARANPUR
SAMBHAL
SANT KABIR NAGAR
SRN BHADOHI
SHAHJAHANPUR
SHAMLI
SHRAWASTI
SIDDHARTH NAGAR
SITAPUR
SONEBHADRA
SULTANPUR
UNNAO
VARANASI
Pincode
Phone / Mobile
Email
Confirm Email
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Approval Process
Steps to be followed to get your private clinic approved under the MTP Act
Application in Form A to be addressed to Chief Medical Officer (CMO) by place seeking approval.
CMO /District Level Committee (DLC) members verify and inspect the place to satisfy that termination can be done under safe and hygienic conditions.
CMO recommends approval to the DLC committee.
Committee considers application and recommendation and may approve and issue certificate of approval in Form B
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