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Institutional Research Cell

Name of the Principal Investigator:

Designation:

Department:

Select ACCIDENT & EMERGENCY ANATOMY ANESTHESIOLOGY BIOCHEMISTRY COMMUNITY MEDICINE DENTISTRY DERMATOLOGY ENT FORENSIC MEDICINE GENERAL MEDICINE GENERAL SURGERY MICROBIOLOGY OBG OPHTHALMOLOGY ORTHOPAEDICS PAEDIATRICS PATHOLOGY PHARMACOLOGY Phys Med & Rehab PHYSIOLOGY PSYCHIATRY PULMONARY MEDICINE RADIODIAGNOSIS SREE GOKULAM NURSING COLLEGE

Date of Submission:

Title of the Protocol:

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Covering Letter forwarded by Guide / Head of the Department

Copy of the Protocol

Undertaking signed by the all investigators/guides

Curriculum vitae of the Principal Investigator & Co-investigators

Consent Form in English

Consent form in local language

Study Tool / Questionnaire / Proforma in English (& in local language if required)

Letter from the Head of the Department stating that the protocol was presented in the Department (In case of PG/UG protocols)

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