Online Medical/Clinical Waste Disposal form

1.Applicant's Name:
2.Organization Name:



Disposal type:Medical   Clinical
3.Address
      Village:
      Thana:
      Post:
      Dist:

4.Holding No:


5.Mobile No:


6.Details:



Application's Signature



7.Application Date: (yyyy-mm-dd)
Cli_Waste Rs.2500 * Med_Waste Rs.10000 *
Form Number:-