Exhibit 10.3


 


NEITHER THIS SECURITY NOR ANY SECURITIES
WHICH MAY BE ISSUED UPON EXERCISE OF THIS SECURITY HAVE BEEN REGISTERED WITH THE U.S. SECURITIES AND EXCHANGE COMMISSION OR THE
SECURITIES COMMISSION OF ANY U.S. STATE OR OTHER JURISDICTION OR ANY EXCHANGE OR SELF-REGULATORY ORGANIZATION, IN RELIANCE UPON
EXEMPTIONS FROM REGISTRATION UNDER THE U.S. SECURITIES ACT OF 1933, AS AMENDED, AND SUCH OTHER LAWS AND REQUIREMENTS, AND, ACCORDINGLY,
MAY NOT BE OFFERED OR SOLD, EXCEPT PURSUANT TO AN EFFECTIVE REGISTRATION STATEMENT OR LISTING OR PURSUANT TO AN AVAILABLE EXEMPTION
FROM, OR IN A TRANSACTION NOT SUBJECT TO, SUCH REGISTRATION AND/OR LISTING REQUIREMENTS AS EVIDENCED BY A LEGAL OPINION OF COUNSEL
TO THE TRANSFEROR TO SUCH EFFECT, THE SUBSTANCE OF WHICH WILL BE REASONABLY ACCEPTABLE TO THE COMPANY.


.


 


MILLENNIUM HEALTHCARE INC.


 


COMMON STOCK PURCHASE WARRANT


 


	Number: _______________	Issue Date: April      , 2015


 


Millennium Healthcare
Inc., a Delaware corporation (the “Company”), having an address at 400 Garden City Plaza, Suite 440 Garden City,
New York 11530, hereby certifies that, for value received, ___________, having an address at ______________, Fax Number: ________,
its permissible transferees, designees, successors and assigns (collectively, the “Holder”), is entitled, subject
to the terms set forth below, to purchase from the Company at any time commencing on the date hereof (the “Effective Date”)
and terminating on the third anniversary of the Issue Date (or such earlier date provided in paragraph 5 hereof), up to 10,000,000
shares (each, a “Share” and collectively the “Shares”) of the Company’s common stock
(the “Common Stock”), at an exercise price per Share equal to $0.025 (the “Exercise Price”).
The number of Shares purchasable hereunder and the Exercise Price are subject to adjustment as provided in Section 4 hereof. The
Company may reduce the Purchase Price for some or all of the Warrants, temporarily or permanently, provided such reduction is made
as to all outstanding Warrants for all Holders of such Warrants. Capitalized terms used and not otherwise defined herein shall
have the meanings set forth in that certain Securities Purchase Agreement (the “Subscription Agreement”), dated
of even date herewith, entered into by the Company, the Holder and the other signatories thereto.


 


As used herein the
following terms, unless the context otherwise requires, have the following respective meanings:


 


(A)           The term “Fair
Market Value” of a share of Common Stock as of a particular date (the “Determination Date”) shall
mean:


 


(a)           If the Company's
Common Stock is traded on an exchange or is quoted on the NASDAQ Global Market, NASDAQ Global Select Market, the NASDAQ Capital
Market, the New York Stock Exchange or the American Stock Exchange, LLC, then the average of the closing sale prices of the Common
Stock for the five (5) Trading Days immediately prior to (but not including) the Determination Date;


 






    	-1-



    	 



    

 


(b)           If the Company's
Common Stock is not traded on an exchange or on the NASDAQ Global Market, NASDAQ Global Select Market, the NASDAQ Capital Market,
the New York Stock Exchange or the American Stock Exchange, Inc., but is quoted on the OTC Bulletin Board or in the over-the-counter
market or Pink Sheets, then the average of the closing bid and ask prices reported for the five (5) Trading Days immediately prior
to (but not including) the Determination Date;


 


(D)           The term “Other
Securities” refers to any stock (other than Common Stock) and other securities of the Company or any other person (corporate
or otherwise) which the holder of the Warrant at any time shall be entitled to receive, or shall have received, on the exercise
of the Warrant, in lieu of or in addition to Common Stock, or which at any time shall be issuable or shall have been issued in
exchange for or in replacement of Common Stock.


 


(E)           The term “Warrant
Shares” shall mean the Common Stock issuable upon exercise of this Warrant.


 


1.           Method of Exercise; Payment.


 


(a)           Cash Exercise.
The purchase rights represented by this Warrant may be exercised by the Holder, in whole or in part, at any time, or from time
to time, by the surrender of this Warrant, together with the notice of exercise form (the "Notice of Exercise")
attached hereto as Exhibit A duly executed, at the principal office of the Company, and by payment to the Company of an
amount equal to the Exercise Price multiplied by the number of the Warrant Shares being purchased, which amount (the “Purchase
Price”) may be paid, at the election of the Holder, by wire transfer or certified check payable to the order of the Company.
The person or persons in whose name(s) any certificate(s) representing Shares shall be issuable upon exercise of this Warrant shall
be deemed to have become the holder(s) of record of, and shall be treated for all purposes as the record holder(s) of, the Shares
represented thereby (and such Shares shall be deemed to have been issued) immediately prior to the close of business on the date
or dates upon which this Warrant is exercised.


 


(b)           Cashless Exercise.


 


(i)           If the Warrant
Shares are not registered pursuant to an effective registration statement at the time of the exercise of this Warrant, then payment
of the Purchase Price may be made at the option of the Holder either in (i) cash, wire transfer or by certified or official bank
check payable to the order of the Company equal to the applicable aggregate Purchase Price, (ii) by delivery of Warrant Shares
in accordance with Section (ii) below or (iii) by a combination of any of the foregoing methods, for the number
of Common Stock specified in such form (as such exercise number shall be adjusted to reflect any adjustment in the total number
of shares of Common Stock issuable to the holder per the terms of this Warrant) and the holder shall thereupon be entitled to receive
the number of duly authorized, validly issued, fully-paid and non-assessable shares of Common Stock (or Other Securities) determined
as provided herein. Notwithstanding the immediately preceding sentence, payment upon exercise may be made in whole or in part in
the manner described in Section (ii) below only with respect to Warrant Shares not included for unrestricted public resale
in an effective Registration Statement on the date notice of exercise is given by the Holder.


 






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(ii)           Subject to
the provisions herein to the contrary, if the Fair Market Value of one share of Common Stock is greater than the Exercise Price
(at the date of calculation as set forth below), then in lieu of exercising this Warrant for cash, the holder may elect to receive
Warrant Shares equal to the value (as determined below) of this Warrant (or the portion thereof being cancelled) by delivery of
a properly executed Notice of Exercise delivered to the Company by any means described in Section 11, in which event the
Company shall issue to the holder a number of shares of Common Stock computed using the following formula:


 


	 	X=	Y (A-B)
	 		     A
	 	 	 
	Where 	X=	the number of Warrant Shares to be issued to the Holder
	 	 	 
	 	Y=	the number of shares of Warrant Shares purchasable under the Warrant or, if only a portion of the Warrant is being exercised, the portion of the Warrant being exercised (at the date of such calculation)
	 	 	 
	 	A=	Fair Market Value
	 	 	 
	 	B=	Exercise Price (as adjusted to the date of such calculation)


 


For purposes of Rule
144 promulgated under the 1933 Act, it is intended, understood and acknowledged that the Warrant Shares issued in a cashless exercise
transaction in the manner described above shall be deemed to have been acquired by the Holder, and the holding period for the Warrant
Shares shall be deemed to have commenced, on the date this Warrant was originally issued pursuant to the Subscription Agreement.


 


(c)           Stock Certificates.


 


(i)           Upon the exercise of this Warrant
in compliance with the provisions hereof, the Company shall promptly issue and cause to be delivered to the Holder a certificate
for the Shares purchased by the Holder. Each exercise of this Warrant shall be effective immediately prior to the close of business
on the date (the “Date of Exercise”) that the conditions set forth in Section 1(a) or have been satisfied. On
the first Business Day following the date on which the Company has received each of the Notice of Exercise and the aggregate Exercise
Price (the “Exercise Delivery Documents”), the Company shall transmit an acknowledgment of receipt of the Exercise
Delivery Documents to the Company’s transfer agent (the “Transfer Agent”). On or before the third Business
Day following the date on which the Company has received all of the Exercise Delivery Documents (the “Share Delivery Date”),
the Company shall (X) provided that the Transfer Agent is participating in The Depository Trust Company (“DTC”)
Fast Automated Securities Transfer Program, upon the request of the Holder, credit such aggregate number of shares of Common Stock
to which the Holder is entitled pursuant to such exercise to the Holder’s or its designee’s balance account with DTC
through its Deposit Withdrawal Agent Commission system, or (Y) if the Transfer Agent is not participating in the DTC Fast Automated
Securities Transfer Program, issue and dispatch by overnight courier to the address as specified in the Notice of Exercise, a certificate,
registered in the Company’s share register in the name of the Holder or its designee, for the number of shares of Common
Stock to which the Holder is entitled pursuant to such exercise. Upon delivery of the Exercise Delivery Documents, the Holder shall
be deemed for all corporate purposes to have become the holder of record of the Warrant Shares with respect to which this Warrant
has been exercised, irrespective of the date of delivery of the certificates evidencing such Shares.


 






    	-3-



    	 



    

 


(ii)           This Warrant
shall be exercisable, either in its entirety or, from time to time, for part only of the number of Warrant Shares referenced by
this Warrant. If this Warrant is exercised in part, the Company shall issue, at its expense, a new Warrant, in substantially the
form of this Warrant, referencing such reduced number of Shares that remain subject to this Warrant.


 


(d)           Taxes.
The issuance of the Shares upon the exercise of this Warrant, and the delivery of certificates or other instruments representing
such Shares, shall be made without charge to the Holder for any tax or other charge in respect of such issuance.


 


2.           Warrant.


 


(a)           Exchange,
Transfer and Replacement. At any time prior to the exercise hereof, this Warrant may be exchanged upon presentation and surrender
to the Company, alone or with other warrants of like tenor of different denominations registered in the name of the same Holder,
for another warrant or warrants of like tenor in the name of such Holder exercisable for the aggregate number of Shares as the
Warrant or Warrants surrendered.


 


(b)           Replacement
of Warrant. Upon receipt of evidence reasonably satisfactory to the Company of the loss, theft, destruction, or mutilation
of this Warrant and, in the case of any such loss, theft, or destruction, upon delivery of an indemnity agreement reasonably satisfactory
in form and amount to the Company, or, in the case of any such mutilation, upon surrender and cancellation of this Warrant, the
Company, at its expense, will execute and deliver in lieu thereof, a new Warrant of like tenor.


 


(c) Cancellation;
Payment of Expenses. Upon the surrender of this Warrant in connection with any transfer, exchange or replacement as provided
in this Section 2, this Warrant shall be promptly canceled by the Company. The Holder shall pay all taxes and all other
expenses (including legal expenses, if any, incurred by the Holder or transferees) and charges payable in connection with the preparation,
execution and delivery of Warrants pursuant to this Section 2.


 


(d) Warrant Register.
The Company shall maintain, at its principal executive offices (or at the offices of the transfer agent for the Warrant or such
other office or agency of the Company as it may designate by notice to the holder hereof), a register for this Warrant (the “Warrant
Register”), in which the Company shall record the name and address of the person in whose name this Warrant has been
issued, as well as the name and address of each transferee and each prior owner of this Warrant.


 


3.           Rights and Obligations
of Holders of this Warrant. The Holder of this Warrant shall not, by virtue hereof, be entitled to any rights of a stockholder
in the Company, either at law or in equity; provided, however, that in the event any certificate representing shares
of Common Stock or other securities is issued to the Holder hereof upon exercise of this Warrant, such holder shall, for all purposes,
be deemed to have become the holder of record of such Common Stock on the date on which this Warrant, together with a duly executed
Election to Purchase, was surrendered and payment of the aggregate Exercise Price was made, irrespective of the date of delivery
of such Common Stock certificate.


 






    	-4-



    	 



    

 


4.           Adjustments.


 


(a)           Stock Dividends,
Reclassifications, Recapitalizations, Etc. While this Warrant is outstanding, in the event the Company: (i) pays a dividend
in Common Stock or makes a distribution in Common Stock, (ii) subdivides its outstanding Common Stock into a greater number
of shares, (iii) combines its outstanding Common Stock into a smaller number of shares or (iv) increases or decreases
the number of shares of Common Stock outstanding by reclassification of its Common Stock (including a recapitalization in connection
with a consolidation or merger in which the Company is the continuing corporation), then (1) the Exercise Price on the record
date of such division or distribution or the effective date of such action shall be adjusted by multiplying such Exercise Price
by a fraction, the numerator of which is the number of shares of Common Stock outstanding immediately before such event and the
denominator of which is the number of shares of Common Stock outstanding immediately after such event, and (2) the number
of shares of Common Stock for which this Warrant may be exercised immediately before such event shall be adjusted by multiplying
such number by a fraction, the numerator of which is the Exercise Price immediately before such event and the denominator of which
is the Exercise Price immediately after such event.


 


(b)           Combination:
Liquidation. While this Warrant is outstanding, (i) in the event of a Combination (as defined below), each Holder shall
have the right to receive upon exercise of the Warrant the kind and amount of shares of capital stock or other securities or property
which such Holder would have been entitled to receive upon or as a result of such Combination had such Warrant been exercised immediately
prior to such event (subject to further adjustment in accordance with the terms hereof), and (ii) in the event of (x) a Combination
where consideration to the holders of Common Stock in exchange for their shares is payable solely in cash or (y) the dissolution,
liquidation or winding-up of the Company, the Holders shall be entitled to receive, upon surrender of their Warrant, distributions
on an equal basis with the holders of Common Stock or other securities issuable upon exercise of the Warrant, as if the Warrant
had been exercised immediately prior to such event, less the Exercise Price. Unless paragraph (ii) is applicable to a Combination,
the Company shall provide that the surviving or acquiring Person (the “Successor Company”) in such Combination
will assume by written instrument the obligations under this Section 4 and the obligations to deliver to the Holder
such shares of stock, securities or assets as, in accordance with the foregoing provisions, the Holder may be entitled to acquire.
“Combination” means an event in which the Company consolidates with, merges with or into, or sells all or substantially
all of its assets to another Person, where “Person” means any individual, corporation, partnership, joint venture,
limited liability company, association, joint-stock company, trust, unincorporated organization, government or any agency or political
subdivision thereof or any other entity. In case of any Combination described in this Section 4, the surviving or acquiring
Person and, in the event of any dissolution, liquidation or winding-up of the Company, the Company, shall deposit promptly with
an agent or trustee for the benefit of the Holders such funds, if any, necessary to pay to the Holders the amounts to which they
are entitled as described above. After such funds and the surrendered Warrant are received, the Company shall be required to deliver
a check in such amount as is appropriate (or, in the case or consideration other than cash, such other consideration as is appropriate)
to such Person or Persons as it may be directed in writing by the Holders surrendering such Warrants.


 






    	-5-



    	 



    

 


(c)           Stock
Splits. In the event of a reverse split or a forward split with regard to the Company’s Common Stock (either referred
to as a “Split”), the number of Warrant Shares and the Exercise Price shall adjusted automatically and simultaneously
using the same ratio as used in connection with the Split. For example, in the event of a 1 for 2 reverse split, the Exercise
Price would be doubled and in the event of a 4 for 1 forward split, the Exercise Price would be 1/4th of the pre-Split
Exercise Price.


 


(d)           Notice of
Adjustment. Whenever the Exercise Price or the number of shares of Common Stock and other property, if any, issuable upon exercise
of the Warrant is adjusted, as herein provided, the Company shall deliver to the holders of the Warrant in accordance with Section 10
a certificate of the Company’s Chief Financial Officer setting forth, in reasonable detail, the event requiring the adjustment
and the method by which such adjustment was calculated and specifying the Exercise Price and number of shares of Common Stock issuable
upon exercise of Warrant after giving effect to such adjustment.


 


(e)           Notice of
Certain Transactions. While this Warrant is outstanding, in the event that the Company shall propose (a) to pay any dividend
payable in securities of any class to the holders of its Common Stock or to make any other non-cash dividend or distribution to
the holders of its Common Stock, (b) to offer the holders of its Common Stock rights to subscribe for or to purchase any securities
convertible into shares of Common Stock or shares of stock of any class or any other securities, rights or options, (c) to
effect any capital reorganization, reclassification, consolidation or merger affecting the class of Common Stock, as a whole, or
(d) to effect the voluntary or involuntary dissolution, liquidation or winding-up of the Company, the Company shall, within
the time limits specified below, send to each Holder a notice of such proposed action or offer. Such notice shall be mailed to
the Holders at their addresses as they appear in the Warrant Register (as defined in Section 2(d)), which shall specify
the record date for the purposes of such dividend, distribution or rights, or the date such issuance or event is to take place
and the date of participation therein by the holders of Common Stock, if any such date is to be fixed, and shall briefly indicate
the effect of such action on the Common Stock and on the number and kind of any other shares of stock and on other property, if
any, and the number of shares of Common Stock and other property, if any, issuable upon exercise of each Warrant and the Exercise
Price after giving effect to any adjustment pursuant to Section 4 which will be required as a result of such action.
Such notice shall be given as promptly as possible and (x) in the case of any action covered by clause (a) or (b) above, at least
ten (10) days prior to the record date for determining holders of the Common Stock for purposes of such action or (y) in the case
of any other such action, at least twenty (20) days prior to the date of the taking of such proposed action or the date of participation
therein by the holders of Common Stock, whichever shall be the earlier.


 


5.           Call. If,
after the first anniversary of the Issue Date (x) the Fair Market Value of the Common Stock on such date is 150% greater than the
Fair Market Value of the Common Stock on the Issue Date, (y) the Warrant Shares have been registered under the Securities Act of
1933, as amended (the “1933 Act”) or otherwise upon issuance will be free trading shares without restriction,
and (z) the average ten day trading volume then is at least $250,000, then the Company shall have the right, by delivery to the
Holders of a written notice to such effect (the “Call Notice”) to require the Holders to exercise the Warrants
represented hereby no later than 10 trading days after delivery of the Call Notice, failing which the Warrants will expire and
become forfeited.


 






    	-6-



    	 



    

 


6.           Fractional Shares.
In lieu of issuance of a fractional share upon any exercise hereunder, the Company will issue an additional whole share in lieu
of that fractional share, calculated on the basis of the Exercise Price.


 


7.           Legends.
Unless and until the Warrant Shares are registered under the Securities Act of 1933, or exempt from registration and otherwise
unrestricted as to sale or other transfer, all certificates representing Warrant Shares shall bear a restrictive legend to the
effect that the Shares represented by such certificate have not been registered under the 1933 Act, and that the Shares may not
be sold or transferred in the absence of such registration or an exemption therefrom, such legend to be substantially in the form
of the bold-face language appearing at the top of Page 1 of this Warrant.


 


8.           Disposition
of Warrants or Shares. The Holder of this Warrant, each transferee hereof and any holder and transferee of any Shares, by his
or its acceptance thereof, agrees that no public distribution of Warrants or Shares will be made in violation of the provisions
of the 1933 Act. Furthermore, it shall be a condition to the transfer of this Warrant that any transferee thereof deliver to the
Company his or its written agreement to accept and be bound by all of the terms and conditions contained in this Warrant.


 


9.           Merger or Consolidation.
The Company will not merge or consolidate with or into any other corporation, or sell or otherwise transfer its property, assets
and business substantially as an entirety to another corporation, unless the corporation resulting from such merger or consolidation
(if not the Company), or such transferee corporation, as the case may be, shall expressly assume, by supplemental agreement reasonably
satisfactory in form and substance to the Holder, the due and punctual performance and observance of each and every covenant and
condition of this Warrant to be performed and observed by the Company.


 


10.           Notices.
Any notice, request or other document required or permitted to be given or delivered to the Holder by the Company shall be delivered
in accordance with the notice provisions of the Subscription Agreement between the Company and the Holder.


 


11.           Reserved.


 


12.           Governing Law.
This Warrant shall be governed by and construed in accordance with the laws of the State of New York applicable to contracts made
and to be performed in the State of New York.


 


13.           Successors
and Assigns. This Warrant shall be binding upon and shall inure to the benefit of the parties hereto and their respective successors
and assigns.


 


14.           Headings.
The headings of various sections of this Warrant have been inserted for reference only and shall not affect the meaning or construction
of any of the provisions hereof.


 


15.           Severability.
If any provision of this Warrant is held to be unenforceable under applicable law, such provision shall be excluded from this Warrant,
and the balance hereof shall be interpreted as if such provision were so excluded.


 


16.           Modification
and Waiver. This Warrant and any provision hereof may be amended, waived, discharged or terminated only by an instrument in
writing signed by the Company and the Holder.


 






    	-7-



    	 



    

 


17.           Specific Enforcement.
The Company and the Holder acknowledge and agree that irreparable damage would occur in the event that any of the provisions of
this Warrant were not performed in accordance with their specific terms or were otherwise breached. It is accordingly agreed that
the parties shall be entitled to an injunction or injunctions to prevent or cure breaches of the provisions of this Warrant and
to enforce specifically the terms and provisions hereof, this being in addition to any other remedy to which either of them may
be entitled by law or equity.


 


18.           Assignment.
This Warrant may be transferred or assigned, in whole or in part, at any time and from time to time by the then Holder by submitting
this Warrant to the Company together with a duly executed Assignment in substantially the form and substance of the Form of Assignment
which accompanies this Warrant, as Exhibit B hereto, and, upon the Company’s receipt hereof, and in any event,
within five (5) business days thereafter, the Company shall issue a warrant to the Holder to evidence that portion of this Warrant,
if any as shall not have been so transferred or assigned.


 


(signature page immediately follows)


 




    	-8-



    	 



    

IN WITNESS WHEREOF, the Company has caused
this Warrant to be duly executed, manually or by facsimile, by one of its officers thereunto duly authorized.


 


	
         

         

         

        Date: April  __, 2015
	
        MILLENNIUM HEALTHCARE INC.

         

         

        By:____________________________________

        Name:    Dominick Sartorio

        Title:      CEO



 


    	-9-



    	 



    
 

EXHIBIT A

TO

WARRANT


 


ELECTION TO PURCHASE


 


To Be Executed by the Holder

in Order to Exercise the Warrant


 


The undersigned Holder hereby elects to
purchase _______ Shares pursuant to the attached Warrant, and requests that certificates for securities be issued in the name of:


 


 


 



(Please type or print name and address)









 



 





 








 



(Social Security or Tax Identification Number)


 


and delivered


to:_________________________________________________________________

___________________________________________________________________.


 


(Please type or print name and address if
different from above)


 


If such number of Shares being purchased
hereby shall not be all the Shares that may be purchased pursuant to the attached Warrant, a new Warrant for the balance of such
Shares shall be registered in the name of, and delivered to, the Holder at the address set forth below.


 


In full payment of the purchase price with
respect to the Shares purchased and transfer taxes, if any, the undersigned hereby tenders payment of $__________ by check, money
order or wire transfer payable in United States currency to the order of [_________]


 


	 	
        HOLDER:

        

        

        

        By:_____________________________________

                   Name:

                   Title:

                   Address:

	
         

         

        Dated:_______________________
	 


 


    	-10-



    	 



    

 


EXHIBIT B

TO

WARRANT


 


FORM OF ASSIGNMENT

(To be signed only on transfer of Warrant)


 


For value received, the undersigned hereby
sells, assigns, and transfers unto _____________ the right represented by the within Warrant to purchase ______ shares of Common
Stock of Millennium Healthcare Inc., a Delaware corporation, to which the within Warrant relates, and appoints ____________________
Attorney to transfer such right on the books of Millennium Healthcare Inc., a Delaware corporation, with full power of substitution
of premises.


 


	Dated:	
 

    By:_______________________________
            Name:
            Title:
            (signature
    must conform to name
            of
    holder as specified on the fact of the Warrant)
	 	
         

         

        Address:



 


 


Signed in the presence of :


 


Dated:


 








    	-11-