**[INSTRUCTIONS FOR MEDICAL EXAMINATION]{.underline}**

The following doctors have been approved by the Consulate General to
give medical examinations, immunizations and laboratory tests for
immigrant visa applicants. The examination and immunizations they
provide conform to the standards and terminology prescribed by the
United States Public Health Service (USPHS).

All applicants must have tests performed at Lister Metropolis
Laboratory. You need not schedule an appointment at Lister Metropolis
Laboratory, but should allow several working days before your immigrant
visa interview for any follow-up laboratory tests that must be
completed. Applicants must appear at the laboratory between 8:00 am and
10:30 am in order to receive their laboratory results the same day.

**Lister METROPOLIS Laboratory & Research Center Pvt. Ltd.**

No. 13 (Old No. 6) Jagannathan Road, Nungambakkam, Chennai 600 034

**Tel:** 4205-5555 **Fax:** 4233-3636 **Hours:** 7:30 to 12:00 noon,
Monday through Saturday; report pick-up daily 4:30 to 5:30 pm

The physician's visit must occur after the laboratory tests and should
take place at least three working days before your visa interview at the
Consulate. Although several panel physicians see patients on a walk-in
basis if workload permits, you are strongly encouraged to make an
appointment at the clinic of one of the doctors listed below. Please do
not schedule an appointment with more than one doctor. If you are unable
to visit the doctor with whom you have fixed an appointment, you must
cancel your appointment at least two hours prior to the appointment
time. Bring the laboratory test results with you when you visit the
panel physician. The completed medical reports which will subsequently
be given to you by the physician must be brought to the Consulate
General at the time of your visa interview. You may see any of the
following physicians:

**Dr. Mathai Thomas**, Best Hospital Pvt. Ltd., 9 Vellala Street,
Kodambakkam, Chennai 600 024

**Tel:** 2483-2777, 2483-2781 **Mobile:** 98400-72444 **Hours:** 4:30 pm
to 7:30 pm, Mon. -- Sat.

**Dr. V. Rajkumar**, 1 Club Road, Behind T.B. Hospital, Chetpet, Chennai
600 031

**Tel**: 2836-1582 **Mobile:** 98410-36241 **Hours:** 8:00 am to 12:00
noon & 4:00 pm to 7:00 pm, Mon. -- Sat.

**Dr. Sanjan John,** 9 Dr. T.V. Naidu Road, (off Spurtank Road),
Chetpet, Chennai 600 031

**Tel:** 2836-1519, 2836-0808 **Mobile:** 98410-86804 **Hours:** 4:30 pm
to 7:30 pm, Mon. -- Sat.

**Dr. N. Vijayalaksmi**, Padma Nursing Home, 753 Poonamalle High Road,
Kilpauk, Chennai 600 010

**Tel:** 2641-3445, 2641-3446 **Mobile:** 98404-12063 **Hours**: 10:00
am to 6:00 pm, Mon. -- Sat.

IMPORTANT: Make sure to bring your passport and your original visa
interview appointment notification to both the laboratory
[and]{.underline} the panel physician's office. You should also bring
three visa-type photos for each family member being examined, as well as
complete vaccination records for each examinee.

You should expect to pay the following fees:

Each applicant 15 years-old or older will be charged Rs. 700 for a
general physical check-up and administration of vaccinations. ([This fee
does NOT include the actual cost of the vaccines, for which the
applicant will also be charged]{.underline}.) In addition, each
applicant 15 years-old or older will be expected to pay Rs. 800 for
initial laboratory tests. Laboratory fees may range up to Rs. 3300 if
additional tests are required. Applicants less than 15 years-old will be
charged Rs. 500 for a general physical check-up and administration of
vaccinations. ([This fee does NOT include the actual cost of the
vaccines, for which the applicant will also be charged]{.underline}.)
All fees must be paid in cash directly by you to the laboratory or the
panel physician. If further tests are advised by the panel physician at
the time of your medical examination, you will be expected to bear the
related costs. Normally, children under 15 years of age are not required
to undergo chest x-rays, blood tests, or HIV anti-body testing, but they
must undergo immunizations and a general physical examination.

Medical reports are valid for a period of one year from the date of your
medical examination. The examination must be repeated if the report has
expired or will expire prior to your entry into the United States.

**Reminder: Vaccinations are costly! Be sure to bring complete
vaccination records for each immigrant visa applicant when visiting the
panel physician, or you risk having to pay up to Rs. 9000 or more in
additional fees.**

Date of initial laboratory exam:

Date of physical examination:

Date of follow-up laboratory tests:

Name:

Address:

Place and date of birth:

Passport number:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature of the Applicant

I have reviewed the laboratory results and the x-ray undergone by the
person named above.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature of the Lab Physician

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  Please attach photograph here.

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I have medically examined the person named above and my report is
submitted on the attached DS forms.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signature of the Examining Physician