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Body-donation

 

VOLUNTARY BODY DONATION

DEPARTMENT OF ANATOMY

ESIC Medical College and PGIMSR, Rajajinagar, Bangalore.

GENERAL INFORMATION ON BODY DONATION

Anatomical donation (also called whole body donation) is the ultimate gift. It is the donation of your remains – not for transplant, but for scientific research and medical education. Such a “gift” has the power to impact the quality of medical care and breakthroughs to cures for life threatening illnesses for generations to come.

In medical research and education, there is no substitute for human tissue, of which there is a major shortage. The experience and education gained through the use of human tissue is far superior to any learning provided by artificial substitutes.

There is no maximum age limit to be an anatomical donor. The interested person may voluntarily donate his/her body and express his/her will in writing (form can be downloaded from website or available in the Anatomy Office, ESIC MC & PGIMSR) and inform his next kith & kin about the same. The body should be preferably transported to the Department of Anatomy, ESIC MC & PGIMSR within working hours (9 am to 4pm). If the body is brought in out of working hours, it may be temporarily kept in the Mortuary of the hospital which is open 24 hours on all days.

 

What we have done for ourselves alone dies with us; what we have done for others and the world remains and is immortal. ~Albert Pike

 

 

 

 

 

 

 

INSTRUCTIONS FOR THE DONORS

1. The ESIC Medical College and PGIMSR, Bangalore, accepts donation of body after death for teaching and scientific advancement.

 

2. The Donor and consent forms are duly completed by the donor should be submitted to the office of the Head of the Department of Anatomy, ESIC Medical College and PGIMSR, Bangalore, for registration.

                                                                                   

3. The body of the voluntary donor with death certificate, from competent medical personnel should be handed over by the next kin, to the Department of Anatomy.

 

4. Body after accident, medico-legal case or any other form of unnatural death will not be accepted.

 

5. After the death of the donor, the information should be conveyed to the ESIC Medical College and PGIMSR, Bangalore. The telephone numbers are indicated below:

 

 

Department of Anatomy :  9845985515, 9986568482, 9845913798         

           

           

 

 

 

 

 

 

 

 

 

 

 

FORM-I

DONOR APPLICATION FORM

Registration No……………………….. (To be allotted by the institution)

To:

The Dean/ HOD- Anatomy

ESIC Medical College and PGIMSR, Bangalore

 

I (Mr/Mrs/Miss………………………………………….) born on…………………aged

……...... Years,   W/O, H/O, S/O, D/O, ……………………….. (Please strike out which is not applicable) wish to donate my body after my death (if medically acceptable) to the Department of Anatomy, ESIC Medical College and PGIMSR, Bangalore.

I declare that at the time of writing this donor application form, I am in sound state of mind and I propose to donate my body voluntarily, for the cause of humanity. I understand that my body will be used for the purpose of medical education and research and I have no objection whatsoever for this utility including transplantation of any organ to other patients and may loan my body to other institutions for the purpose of medical or surgical teaching and research. I am not seeking any gains, monetary or otherwise in this donation. I am also not appending any conditions, binding on ESIC Medical College and PGIMSR, Bangalore, in offering this donation.

I have made no declarations to the effect of donation of my dead body to any other agency/ medical institution till date.

I have informed my near kith & kin relatives regarding this. Their No Objection Certificate for the same is enclosed together with the details. The members of my family and any of my relatives do not have any right whatsoever to claim my body after my death. There will be no religious, social or legal objection to this proposal. I have given instructions to them that, after my death they should hand over my dead body (as soon as any religious ceremonies are over) to the Department of Anatomy, ESIC Medical College and PGIMSR, Bangalore

Thanking you,

Yours Sincerely

_____________________

(Signature of the Donor)

 

Witness:

1.                                                                                            

Signature                                                                                           

Name & Address                                                                    Relationship with Donor

 

2.                                                                                            

Signature

Name & Address                                                                    Relationship with Donor

 

FORM II

DETAILS OF THE BODY DONOR

 

      Registration No:                                                                         Date:

1. Name of the Donor                                                               Recent Passport size

Photograph

2. Sex: Male/ Female

      

3. Age                                                                                        

 

4. Marital Status: Married/Unmarried

 

5. Education:

 

6. Employment Details:

Employed/Unemployed/Housewife/                                                           Retired/Own business                                                                                                                                                                                                                                                  

7. No. of dependents & their details:

Wife/Husband

Sons

Daughters

Father

Mother

 

8. Designation and Office address with phone no:

 

9. Present residential address with phone no:

 

 

10. Permanent residential address if it is different from the present address:

 

 

Donor’s Signature:

 

Note:

• The body starts decomposing after 6-8 hours after death. So the body should reach the department within 6-8 hours after death.
• Death certificate by registered Medical Practitioner is Mandatory.

 

 

 

 

 

 

FORM III

CONSENT/NO OBJECTION CERTIFICATE

 

                                                                                                                       Dated:

 

This certificate is to be issued by one or more of the following: near relations of the deceased (as may be applicable): Sons / Daughters / Husband / Wife / Legal guardian.

 

I / We the undersigned individuals solemnly affirm and declare as under:

 

I / We have no objection whatsoever for this donation.

 

I / We declare to abide by the donor’s wish and agree to inform the Head, Department of Anatomy, ESIC Medical College and PGIMSR, Bangalore,  and transfer the body to the department of Anatomy,

Donor’s Registration No………………..

(To be allotted by the institution)

 

              Date:

              Place:                                                                                                            Signature/s

 

              Name and address of each of the signatories together with phone and fax numbers.  

              Mention the relation to the Donor.

 

 

               ____________________________________________________________________

 

 

 

 

 

Last updated / Reviewed : 2022-03-08