SURGICAL RISK NOTE Address of the Hospital......................... I, ..................S/o Shri............... Resident of Village/City.......District............... here by declare that this.................. .. presented for (Kind of Animal) treatment belongs to me. All complications and the risk involved in anesthesia /surgery have been fully explained to me. I, therefore, willingly give my consent for the operation to be performed on my animal and will not hold the doctor/departmental authorities responsible for any mishap. Date............ Signature of the Owner......... Address............... ..............
