State Mental Health Rules, 1990
[State
Mental Health Rules, 1990]
[29th December, 1990]
In exercise of the powers conferred by the proviso to sub-section (2) of
Section 94 of the Mental Health Act, 1987 (14 of 1987), read with Section 22 of
the General Clauses Act, 1897 (10 of 1897), the Central Government hereby makes
the following rules, namely.
CHAPTER I PRELIMINARY
Rule - 1. Short title and commencement.
(1)
These rules
may be called the State Mental
Health Rules, 1990.
(2)
They shall
come into force in a State on the date of commencement of the Act in that
State.
Rule - 2. Definitions.
In these rules unless the context otherwise requires,
(a)
“Act” means
the Mental Health Act, 1987 (14 of 1987);
(b)
“applicant”
means the person who makes an application to the licensing authority for grant
of a licence;
(c)
“Authority”
means the State Mental Health Authority constituted under Section 4 of the Act;
(d)
“Chairman”
means the Chairman nominated under Rule 5;
(e)
“Form” means
Form annexed to these rules;
(f)
“licence”
means licence granted under Section 8 of the Act;
(g)
“member”
means a member of the Authority appointed under Rule 3;
(h)
“membership”
means membership of the Authority established under Section 4 of the Act;
(i)
“non-official
Member” means a member appointed under sub-rule (2) of Rule 3;
(j)
“Official
Member” means a member appointed under sub-rule (1) of Rule 3;
(k)
“Secretary”
means Secretary to the Authority appointed under Rule 13;
(l)
words and
expressions used herein and not defined but defined in the Act shall
respectively have the meanings assigned to them in the Act.
CHAPTER II STATE MENTAL HEALTH AUTHORITY
Rule - 3. Constitution of the Authority.
The Authority shall consist of the following members, namely.
(1)
Official
Members:
(a)
Secretary,
Department of Health;
(b)
Joint Secretary,
Department of Health dealing with Mental Health;
(c)
Director of
Health Services;
(d)
Medical
Superintendent, Government Mental Hospital or Head of the Department of
Psychiatry, Government Medical College and Hospital.
(2)
Non-official
Members: Three members including one social worker, one Clinical Psychologist
and one Medical Psychiatrist, who in the opinion of the State Government, have
special interest in the field of Mental Health.
Rule - 4. Disqualification.
A person shall be disqualified for being appointed as a member or shall
be removed from membership by the State Government, if he,
(a)
has been
convicted and sentenced to imprisonment for an offence which in the opinion of
the State Government involves moral turpitude; or
(b)
is an
undischarged insolvent; or
(c)
is of
unsound mind and stands so declared by a competent court; or
(d)
has been
removed or dismissed from the service of the Government or a body corporate
owned or controlled by the Government.
Rule - 5. Chairman.
(1)
The State
Government may nominate any official member to act as the Chairman of the
Authority.
(2)
The Chairman
shall cease to hold office when he ceases to be a member of the Authority.
Rule - 6. Term of office of members.
(1)
Every
official member shall hold office as such member so long as he holds the office
by virtue of which he was so appointed.
(2)
Every
non-official member shall hold office for a period of three years from the date
of his appointment and shall be eligible for re-appointment.
(3)
A non-official
member may at any time resign from membership of the Authority by forwarding
his letter of resignation to the Chairman and such resignation shall take
effect only from the date on which it is accepted.
(4)
Where a
vacancy occurs by resignation of a non-official member under sub-rule (3) or
otherwise, the State Government shall fill the vacancy by appointing from
amongst category of persons referred to in sub-rule (2) of Rule 3 and the
person so appointed, shall hold office for the remainder of the term of office
of the member in whose place he was so appointed.
(5)
Where the
term of office of any non-official member is about to expire, the State
Government may appoint a successor at any time within three months before the
expiry of the term of such member but the successor shall not assume duty until
the term of the member expires.
CHAPTER III PROCEEDINGS OF THE AUTHORITY
Rule - 7. Meetings of the Authority.
(1)
The
Authority shall ordinarily meet once in every six months at such time and place
as may be fixed by the Chairman:
Provided that the Chairman,
(i)
may call a
special meeting at any time to deal with any urgent matter requiring the
attention of the Authority;
(ii)
shall call a
special meeting if he receives a requisition in writing signed by not less than
four members and stating the purposes for which they desire the meeting to be
called.
(2)
The first
meeting of the Authority to be held in any calendar year shall be the annual
meeting for that year.
Rule - 8. Subjects for Special Meeting.
Where a meeting referred to in the proviso to sub-rule (1) of Rule 7 has
been convened, only the subjects for the consideration of which the meeting was
convened, shall be discussed.
Rule - 9. Subjects for the Annual Meeting.
At the Annual Meeting of the Authority, the following subjects shall be
considered and disposed of, namely.
(a)
review of
the progress of implementation of the various provisions of Mental Health Act
during the preceding one year;
(b)
other
business on the agenda, and
(c)
any other
business brought forward with the consent of the Chairman or where he is
absent, with the consent of the Officer presiding at the meeting.
Rule - 10. Procedure for holding meetings.
(1)
Every notice
calling for a meeting of the Authority shall,
(a)
specify the
place, date and hour of the meeting;
(b)
be served
upon every member of the Authority not less than twenty-one clear days in the
case of annual meeting and fifteen clear days in the case of other meetings
before the day appointed for the meeting.
(2)
The
Secretary shall prepare and circulate to the members along with the notice of
the meeting, an agenda for such meeting showing the business to be transacted.
(3)
A member who
wishes to move a resolution on any matter included in the agenda shall give
notice thereof to the Secretary not less than seven days before the date fixed
for the meeting.
(4)
A member who
wishes to move any motion not included in the agenda shall give notice thereof
to the Secretary not less than fourteen days before the date fixed for the
meeting.
Rule - 11. Proceedings of the Authority.
(1)
The Chairman
or in his absence any member authorised by him, shall preside at the meetings
of the Authority.
(2)
The quorum
for the meeting of the Authority shall be four members.
(3)
If within
half an hour from the time appointed for holding a meeting of the Authority,
quorum is not present, the meeting shall be adjourned to the same day in the
following week at the same time and place and the presiding officer of such
meeting shall inform the members, present and send notice to other members.
(4)
If at the
adjourned meeting also, quorum is not present within half an hour from the time
appointed for holding the meeting, the members present shall constitute the
quorum.
(5)
In the
adjourned meeting if the Chairman is not present and no member has been authorised
to preside at such meeting, the members present shall elect a member to preside
at the meeting.
(6)
Each member
including the Chairman shall have one vote. In the case of an equality of
votes, the Chairman or any member presiding over such meeting, shall in
addition, have a casting vote.
(7)
All
decisions of the meeting of the Authority shall be taken by a majority of the
members present and voting.
Rule - 12. Approval by circulation.
Any business which may be necessary for the Authority to transact except
such as may be placed before the annual meeting, may be carried out by
circulation among all members and any resolution so circulated and approved by
a majority of members, shall be valid and binding as if such resolution had
been passed at the meeting of the Authority.
Rule - 13. Secretary to the Authority.
(1)
The Chairman
shall cause to be appointed a Secretary to the Authority from amongst person
possessing postgraduate degree in Psychiatry and having three years' experience
in the field of psychiatry.
(2)
The
Secretary shall be a full-time or part-time servant of the Authority and shall
function as the Administrative Officer of the Authority.
(3)
The
Secretary shall be responsible for the control and management of office
accounts and correspondence.
(4)
The Secretary
shall attend and take notes of the proceedings of the meeting of the Authority.
(5)
The
Secretary shall cause to be appointed such members of the ministerial and
non-ministerial staff which are essential for efficient functioning of the
Authority.
(6)
The Secretary
shall exercise such other powers and discharge such other functions as may be
authorised in writing by the Chairman for the efficient functioning of the
Authority.
Rule - 14. Forwarding of copies of the proceedings of the Authority to the State Government.
The Secretary shall forward copies of the proceedings of the Authority
to the State Government periodically.
CHAPTER IV LICENCE
Rule - 15. Application for licence.
(1)
Every
application for a licence under sub-section (1) or sub-section (2) of Section 7
of the Act shall be,
(a)
made to the
licensing authority in Form I or Form II, as the case may be;
(b)
accompanied
by a fee of rupees two hundred in the form of a bank draft drawn in favour of
the licensing authority.
Rule - 16. Grant of licence.
If the licensing authority is satisfied that the applicant fulfils the
conditions laid down in clauses (a),
(b) and (c) of Section 8 of the Act, it shall
grant the licence in Form III.
Rule - 17. Refusal of licence and manner of communicating the order.
(1)
If the
licensing authority is satisfied that the applicant does not fulfil the
conditions laid down in Section 8 of the Act, it may, after giving the
applicant a reasonable opportunity of being heard against the proposed refusal
of licence, by order setting out the reasons therein, refuse to grant the
licence.
(2)
Every order
refusing to grant a licence under Section 8, shall be communicated to the
applicant by sending a copy of the order by registered post to the address
given in the application.
(3)
A copy of
the order shall also be conspicuously displayed on the notice-board of the
office of the licensing authority.
Rule - 18. Application for renewal.
Every application for renewal of a licence under sub-section (5) of
Section 9 of the Act shall be,
(a)
made to the
licensing authority in Form IV,
(b)
accompanied
by a fee of rupees one hundred in the form of a bank draft drawn in favour of
the licensing authority.
Rule - 19. Refusal of licence.
(1)
If the
licensing authority is satisfied that the conditions mentioned in the proviso
to sub-section (5) of Section 9 of the Act are not attracted, it shall, renew
the licence.
(2)
If the
licensing authority is of the opinion that the licence should not be renewed in
view of the fact that the conditions mentioned in the proviso to sub-section
(4) of Section 9 are attracted, it may, after giving the applicant a reasonable
opportunity of being heard against the proposed refusal of renewal of the
licence, by order setting out the reasons therein, refuse to renew the licence.
(3)
Every order
refusing to renew the licence under the proviso to sub-section (5) of Section 9
shall be communicated to the applicant by sending a copy of the order by
registered post to the address given in the application for renewal.
Rule - 20.Manner and conditions of maintaining psychiatric hospitals or psychiatric nursing homes.
Every psychiatric hospital or nursing home shall be maintained subject
to the condition that,
(A)
such
hospital or nursing home is located only in an area approved by the local authority;
(B)
such
hospital or nursing home is located in a building constructed with the approval
of the local authority;
(C)
the
building, where such hospital or nursing home is situated, has sufficient
ventilation and is free from any pollution which may be detrimental to the
patients admitted in such hospital or nursing home;
(D)
such
hospital or nursing home has enough beds to accommodate the patients;
(E)
the nurses
and other staff employed in such hospital or nursing home are duly qualified
and competent to handle the work assigned to them;
(F)
the
supervising officer-in-charge of such hospital or nursing home is a person duly
qualified having a postgraduate qualification in Psychiatry recognised by the
Medical Council of India.
Rule - 21. Time for appeal.
(1)
Any person aggrieved
by the order of the licensing authority refusing to grant or renew a licence or
revoking a licence, may prefer an appeal to the State Government, within sixty
days of the communication of such order; Provided that the State Government may
entertain an appeal preferred after the expiry of the period specified in
sub-rule (1) if it is satisfied that the applicant was prevented by sufficient
cause from preferring the appeal in time.
(2)
The appeal
shall be in ‘Form V’ and shall be sent to the State Government by registered
post or by appearing in person before and delivering the same to the Secretary
to State Government, Department of Health or any other officer nominated by him
in this behalf.
(3)
Every appeal
shall be accompanied with a fee of rupees five hundred.
CHAPTER V PSYCHIATRIC HOSPITAL AND NURSING HOME
Rule - 22. Minimum facilities for treatment of out-patients.
The minimum facilities required for every psychiatric hospital or
psychiatric nursing home for treatment of patients mentioned in Section 14 of
the Act shall be as follows.
(1)
Staff for 10 bedded hospital or nursing home.
(a)
One
full-time qualified Psychiatrist.
(b)
One Mental
Health Professional Assistant (Clinical) Psychologist or Psychiatric Social
Worker.
(c)
Staff Nurses
in the nurse: patient ratio 1: 3.
(d)
Attenders in
the attender: patient ratio 1: 5.
(2)
Physical features.
Adequate floor space depending on the number of beds shall be provided.
(3)
Support facilities.
The minimum support/facilities shall be as under.
(a)
Provision
for emergency care for out-patients and for handling medical emergencies for
out-patients and in-patients;
(b)
A
well-equipped Electro-Convolsive Therapy facility;
(c)
Psychodiagnostic
facilities;
(d)
Provision
for recreational/rehabilitation activities; and
(e)
Facilities
for regular out-patient care.
Rule - 23. Revocation of licence.
(1)
Where the
licensing authority is satisfied that the licence of any psychiatric hospital
or nursing home is required to be revoked in pursuance of clause (a) or (b) of sub-section (1) of Section 11 of the Act, it may, after
giving the licensee a reasonable opportunity of being heard against the
proposed revocation, by order setting out the grounds therein, revoke the
licence.
(2)
Every order
revoking the licence under sub-rule (1) shall be communicated to the licensee
by sending a copy of the order by registered post to the address given in the
application.
(3)
A copy of
the order shall also be conspicuously displayed on the notice-board of the
office of the licensing authority and in the psychiatric hospital or nursing
home.
Rule - 24. Maintenance of records.
Every psychiatric hospital or a psychiatric nursing home shall maintain
the records of the treatment of patients in Form VI.
CHAPTER VI MISCELLANEOUS
Rule - 25. Admission and detention in Psychiatric Hospital or Psychiatric Nursing Home.
(1)
Application
by Medical Officer-in-charge.
(a)
the
application for reception order may be made by the Medical Officer-in-charge of
a psychiatric hospital or psychiatric nursing home in ‘Form VII’ or
(b)
by the
husband, wife or any other relative of the mentally ill person in Form VIII'.
(2)
Application
from husband or wife.
(a)
Every
application by the husband or wife, relative or friend of a person who is
alleged to be mentally ill shall be accompanied by necessary medical
certificates;
(b)
Such
application shall be signed either by the husband or wife or a relative or a
friend, as the case may be, and verified by two independent witnesses;
(c)
The name,
address, occupation and other details of all the applicants and the attesting
witnesses shall be clearly given in such application.
Rule - 26. The qualifications and functions of the Visitors.
(1)
The
qualifications of persons to be appointed as Visitors under Section 37 of the
Act shall be as follows.
(a)
A degree in
Medicine with postgraduate degree in psychiatry awarded by any University in
India recognised by the Medical Council of India and having at least ten years'
standing in the profession, who has held/is holding the post of Medical
Superintendent/Professor in psychiatric hospital or psychiatric wing of a
hospital; or
(b)
Experience
as a social worker/clinical psychologist/psychiatric nurse connected with any
mental hospital for a period of not less than ten years.
(2)
The Visitors
appointed by the Government under Section 37 of the Act shall be responsible
for
(a)
review of
admission and discharge of patients;
(b)
inspection
of the wards, outdoor patient department and kitchen;
(c)
facilities
to be provided;
(d)
suggestions
for improvement; and
(e)
functioning
as liaison officer between the Government and hospital.
Rule - 27. Leave or absence.
Every application by a relative or any other person on behalf of the
patient for leave or absence under Section 45 of the Act shall be made in ‘Form
IX’.
Rule - 28. Interception of the letters and other communications addressed to the mentally ill persons.
(1)
No letter or
other communication addressed to a mentally ill person intended for delivery
either through the postal department or otherwise shall be intercepted,
detained or destroyed except under following circumstances, namely.
(i)
any letter
or other communication intended for delivery to a mentally ill person shall be
opened only if the person having the supervisory control over the hospital or
nursing home is of the opinion that such letter or communication contain any
information or material which if communicated to such patient will be
detrimental to his health; or
(ii)
that the
interception, detention or destruction of any letter or communication intended
to be delivered to the mentally ill person is necessary in the interests of the
public or the State.
FORM I
(See Rule 15)
Application for
Maintaining a Psychiatric Hospital/Nursing Home
To
The . . . . . . . . . . . .Officer,
Government of . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
Dear Sir/Madam,
I/We intend to establish/maintain a Psychiatric Hospital/Psychiatric
Nursing Home in respect of which I am/we are holding a valid licence for the
establishment/maintenance of such hospital/nursing home. The details of the
hospital/nursing home are given below:
(1)
Name of
Applicant.
(2)
Details of licence
with reference to the name of the Authority issuing the licence and date.
(3)
Age.
(4)
Professional
experience in Psychiatry.
(5)
Permanent
address of the applicant.
(6)
Location of
the proposed Hospital/Nursing Home.
(7)
Address of
the proposed Hospital/Nursing Home.
(8)
Proposed
accommodations:
(a)
Number of
rooms.
(b)
Number of
beds.
(9)
Facilities
provided:
(a)
Out-patient
facilities.
(b)
Emergency
services.
(c)
Inpatient
facilities.
(d)
Occupational
and recreational facilities.
(e)
ECT
facilities.
(f)
X-Ray
facilities.
(g)
Psychological
testing facilities.
(h)
Investigation
and Laboratory facilities.
(i)
Treatment
facilities.
(10)
Staff
Pattern:
(a)
Number of
Doctors.
(b)
Number of
Nurses.
(c)
Number of
Attenders.
(d)
Others.
I am sending herewith a bank draft for Rs . . . . . . . . . . . . . .
drawn in favour of . . . . . . . . . as licence fee.
I hereby undertake to abide by the rules and regulation of the Mental
Health Authority.
I request you to consider my application and grant the licence for
establishment/maintenance of Psychiatric Hospital/Nursing Home.
Yours faithfully,
Signature . . . . . . . . . .
Name . . . . . . . . . . . . .
Date . . . . . . . . . . . . .
FORM II
(See Rule 15)
Application for
establishment of Psychiatric Hospital/Nursing Home under sub-section (2) of
Section 7
To
The . . . . . . .
Government of . . . . . . . . . . . . . . .
. . . . . . . . . . .
Dear Sir/Madam,
I/We intend to establish a Psychiatric Nursing Home/Psychiatric Hospital
at . . . . . . . . . . (mention the place). I am herewith giving you the
details.
(1)
Name of the
Applicant.
(2)
Qualification
of Medical Officer to be in charge of Nursing Home/Hospital (Certificates to be
attached).
(3)
Age.
(4)
Professional
experience in Psychiatry.
(5)
Permanent
Address of the applicant.
(6)
Location of
the proposed Hospital/Nursing Home,
(7)
Address of
the proposed Hospital/Nursing Home.
(8)
Proposed
accommodations:
(a)
Number of
rooms.
(b)
Number of
beds.
(9)
Facilities
provided:
(a)
Out-patient
facilities.
(b)
Emergency
services.
(c)
Inpatient
facilities.
(d)
Occupational
and recreational facilities.
(e)
ECT facilities.
(f)
X-ray
facilities.
(g)
Psychological
testing facilities.
(h)
Investigation
and laboratory facilities.
(i)
Treatment
facilities.
(10)
Staff
Pattern:
(a)
Number of
Doctors.
(b)
Number of
Nurses.
(c)
Number of
Attenders.
(d)
Others.
I am herewith sending a bank draft for Rs . . . . . . . . . . . . . .
drawn in favour of . . . . . . . . . as licence fee.
I hereby undertake to abide by the rules and regulations of the Mental
health Authority. I request you to consider my application and grant the
licence.
Yours faithfully,
Signature . . . . . . . . . . . . .
Date . . . . . . . . . . . . . . . .
FORM III
(See Rule 16)
Grant of Licence for
Establishment of Psychiatric Hospital/Nursing Home
(1)
I, . . . .
., being the licensing authority under the Mental Health Act, 1987, after
considering the application received under Section 7 and satisfying the
requirements provided for in Section 8 and the other provisions of the Mental
Health Act, 1987 (Central Act 14 of 1987) and the rules made thereunder, hereby
grant the licence for establishment/maintenance of a psychiatric hospital or
nursing home in favour . . . . . . (the applicant).
(2)
The licence
shall be valid for the period commencing from . . . . . . . . andendin with . .
. . . . . . . The licence shall be subject to the conditions laid down on the
Mental Health Act, 1987 (14 of 1987) and the rules made thereunder.
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Licensing
Authority
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Place:
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Date:
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Seal
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FORM IV
(See Rule 18)
Application for Renewal
of Licence
From
Dr . . . . . .
. . . . . . . . . . . .
. . . . . . . . . . .
To
District Health Officer,
. . . . . . . . . . . . . .
. . . . . . . . . . . . . .
Sir,
Subject: Renewal Licence No. . . . . dated . . . . .
I request you to kindly renew my licence No. . . . . . dated the . . . .
. for the next 5 years. I am providing the facilities as prescribed by the Act
and the rules framed thereunder. I have herewith attached a demand draft for Rs
100 only.
Thanking you,
Yours faithfully,
Signature. . . . . . . .
Name . . . . . . . . . .
Place:
Date:
FORM V
(See Rule 21)
Application for Appeal
To
The Appellate Authority
Government of . . . . . . . . . . . . . . . . . .
Sir,
I, Dr . . . . of . . . . . had applied for a licence for establishing a
Psychiatric Nursing Home/Hospital at . . . . . . . . . (Copy of the earlier
application to be attached). My application was rejected by the licensing
authority as per his/her letter No. . . . . . . . dated . . . . . . . with the
following reasons:
(Copy enclosed)
The above reason(s) appear to be not valid. I request you to reconsider
my application. My justifications are:
I am willing to appear before you for a personal hearing, if necessary.
I am herewith enclosing a draft for Rs 500.
Thanking you,
Yours faithfully,
Signature . . . . . . . . . . . .
Name . . . . . . . . . . . . . .
Place:
Date:
FORM VI
(See Rule 24)
Pro forma of Case-Record
Name of the hospital/nursing home . . . . . . . . Patient's Name . . . .
. Age . . . . . . . . . Sex . . . . ., Date of admission . . . . . ., Date of
discharge . . . . . ., Mode of admission . . . . . ., Voluntry Reception Order.
Complaints (report from relatives/other sources)
Mental State Examination
Physical examination
Laboratory investigations
Provisional diagnosis
Initial treatment
Treatment and Progress notes
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Date
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Clinical
State and Side effect Treatment
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Final diagnosis
Condition at discharge
Follow-up recommendations.
FORM VII
(See Rule 25)
Application for Reception
Order
(By Medical Office-in-charge of a Psychiatric Hospital)
From
Dr . . . . . . . .
To
*The Magistrate
. . . . . . . . . . .
. . . . . . . . . . .
Sir,
Subject: Reception order for . . . . . son/daughter of . . . .
I, Dr. . . . . . ., maintain psychiatric hospital/nursing home at . . .
. . . . . . under licence No. . . . . . . dated . . . . . . . . .
I request you to issue reception order in respect of Sh/Smt . . . . . .
. . . ., son/daughter of . . . . . . ., who is being treated at my hospital as
a voluntary patient and is not willing to continue. He/she has, the following
symptoms and/or signs.
He/She requires to be in the hospital for treatment/personal
safety/others' protection.
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Thanking
you
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Yours
sincerely
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Place:
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Signature
. . . . . . . .
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Date:
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Name . . . . . . .
“Magistrate” means,
(1)
In relation
to a metropolitan area within the meaning of clause (k) of Section 2 of the Code of Criminal Procedure, 1973, a
Metropolitan Magistrate;
(2)
in relation
to any other area, the Chief Judicial Magistrate, Sub-Divisional Judicial
Magistrate or such other Judicial Magistrate of the first class as the State
Government may, by notification, empower to perform the functions of a
Magistrate under this Act.
FORM VIII
(See Rule 25)
Application for Reception
Order
(By relative or other)
To
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
Sir,
Subject: Admission of . . . . . . . . . son/daughter of . . . . . . . .
. into psychiatric hospital/nursing home as inpatient.
I, . . . . . . . .., son/daughter of . . . . . . . . ., residing at . .
. . . . . . ., request you to kindly arrange for admission in respect of Sh/Smt
. . . . . . . . . aged . . . . . . . . . years . . . . . . . . . son/daughter
of . . . . . . . . . an inpatient to . . . . . . . . . (name of the hospital)
or any other hospital/nursing home. He/She has the following suggestive of
mental illness:
I, who is . . . . . . . . . (relationship) of Sh/Smt . . . . . . . . .
ha*ve an income Rs . . . . . . . . and agree to pay the charges of treatment if
any, according to the rules and also assure that I shall abide by the rules and
regulations of the Institution. I state that, I have/have not made any such
previous application with regard to the mental condition of . . . . . . . . .
as required, I herewith enclose the two medical certificates needed for the
purpose.
Yours faithfully,
Witnesses:
Signature . . . . . . . . .
Name in Capital . . . . . . . . .
(1)
Name:
Address:
(2)
Occupation:
-do-
FORM IX
(See Rule 27)
Application for Leave of
Absence
(By relative or others)
To
Dr . . . . . . . . .
. . . . . . . . .
. . . . . . . . .
. . . . . . . . .
Sir,
Subject: Request for leave of absence of Sh/Smt . . . . . . . . . aged .
. . . . . . . . years admitted on . . . . . . . . . to your Institute.
I request that Sh/Smt . . . . . . . . ., son/daughter of . . . . . . . .
., be delivered to my care and custody on leave of absence.
I hereby bind myself that on the said Sh/Smt . . . . . . . . . being
made over to my care and custody, I will have him/her properly taken care of
and prevent from doing injury to himself/herself or to others.
Yours faithfully,
Signature . . . . . . . . . . . .
Name . . . . . . . . . . . .
Noti. No. G.S.R. 1005(E), dated December 29,
1990, published in the Gazette of India, Extra., Part II, Section 3(i), dated
29th December, 1990, pp. 16-24. [F. No. 11018/4/87/(B)PMS]