To,
The Director,
AYUSH Council of Medical and Paramedical Science (ACMPS)
Maharashtra, India.

Sir,
I, hereby request that I am Manager/Chairman/Director as mentioned below,I have carefully read all the rules & regulations of AYUSH Council of Medical and Paramedical Science (ACMPS) and am fully satisfied with them. I want to have my clinic / hospital / wellness center authorized from your esteemed organization.

Clinic / Hospital / Wellness Center Name

Address

Applicant / Director Name

Email

Phone

Management Type
IndividualNGO/Trust/SocietyOthers

Name of NGO/Trust/Society

Registration Number

Upload Aadhar Card

Upload Pan Card

Applicant Photo

Upload clinic / hospital / wellness center Photo

Upload Registration Proof of NGO /Trust/ Society