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No Objection Certificate / Permission Form

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I am preparing the following work to be published:


Book
ISBN
and
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Title:

Author/Editor(s):
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By Narosa Publishing House Pvt. Ltd, 22
Association Road, New Delhi110 002, INDIA.

Daryaganj,

Delhi

Medical

I request your permission to include the following material in this and


in all subsequent editions of this work to be published by Narosa
Publishing House Pvt. Ltd., for distribution throughout the world, in
all media including electronic and microfilm and to use the material in
conjunction with computer based electronic and information retrieval
systems, to grant permissions for photocopying, reproductions and
reprints, to translate the material and to publish the translation, and
to authorize document delivery and abstracting and indexing services.
Book

Journal

Title :

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Author

Editor(s):

___________________________________________________
Volume
________________________________________________________

Number:

Year

of

Publication :

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Description

of

Material :

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Page(s):
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Due acknowledgement of the original source will be clearly given.


Signed: ______________________________

Date: _____________________

I / we hereby grant permission to use the material requested above.


Signed:
_______________________________________________________________
Copyright

holder:

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Publisher :
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Date: _________________________________________________________________

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