Form of Nomination paper [See Rule 5(6)]

Election to the Uttaranchal Medical Council, Dehradun (To be filled in by the candidate) I hereby offer my candidature for the election to the Uttaranchal Medical Council I further I declare that I shall work for Uttaranchal Medical council, if elected. Date Signature of the Candidate (To be filled in by the proposer) I hereby nominate ... as a candidate for the forthcoming election to the Uttaranchal Medical Council. (1) Full name of the Candidate (2) Full postal address of the Candidate (3) Serial number of the candidate in the electoral roll (4) Full name of the proposer (5) Full postal address of the proposer (6) Serial number of the proposer in the electoral roll Dated Signature of the proposer (To be filled in by the Seconder) I second the above nomination. (1) Full name of the Seconder (2) Full postal address of the Seconder (3) Serial number of the Seconder in the electoral roll Dated Signature of the Seconder (To be filled by the Returning Officer) Serial No. of nomination paper. This nomination paper was delivered to me at my office at (hour) on (date) Date Returning Officer Decision of Returning Officer accepting or rejecting the Nomination Paper. I have examined this Nomination Paper in accordance with the provisions of the Uttaranchal Medical Council Rules 2003 and decided as follows:- Date. Returning Officer