PNDT Form F
PNDT Form F
PNDT Form F
14. Result of
(a) Pre-natal diagnostic procedure (give details)…………………………………………………………………….
(b) Ultrasonography Normal/Abnormal
(Specify abnormality detected, if any).
15. Date(s) on which procedures carried out.
16. Date on which consent obtained. (In case of invasive)
17. The result of pre-natal diagnostic procedure was conveyed to ….………………..….on …………….………
18. Was MTP advised/conducted?
19. Date on which MTP carried out.
I, __________________ (name of the person conducting Ultrasonography/image scanning) declare that while
conducting ultrasonography/image scanning on Ms. ___________ (name of the pregnant woman), I have
neither detected nor disclosed the sex of her foetus to any body in any manner.
(i) Ultrasound is not indicated/advised/performed to determine the sex of foetus except for
diagnosis of sex-linked diseases such as Duchenne Muscular Dystrophy, Haemophilia A & B
etc.
(ii) During pregnancy Ultrasonography should only be performed when indicated. The following is
the representative list of indications for ultrasound during pregnancy.
Person conducting ultrasonography on pregnant women shall keep complete record thereof
in the clinic/centre in Form – F and any deficiency or inaccuracy found therein shall
amount to contravention of provisions of section 5 or section 6 of the Act, unless contrary
is proved by the person conducting such ultrasonography.