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I/We have full consent for anaesthesia, any investigation,
Operation, Ampu- tation, treatment necessary for the Patient/myself,
I/We agree to pay the full charges of the clinic.
I/We consent to the performance of operation or procedures in
addition to or different from those now contemplated, whether
or not arising from presently unf- orseen conditions which the
above named doctor, his associate or assistant may consider
necessary or advisable to be done in the course of the treatment
and or operation.
No medical personnel or the clinic is to be held responsible
for any event arising, either with regard to myself or my ward,
as a consequence of operation, an anaesthesia or any other procedure.
I/We consent to the disposal by clinic authorities, or any tissues
or part which may be removed at the operation.
I/We have been explained the nature and grievousness of the
disease.
I/We are abide by the rules & regulation of the clinic.
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