Consent Letter of Parent / Guardian 
                    To  
                    The Principal 
                    Institute of Pharmacy and Technology, Salipur, 
                    At/PO-Salipur, Dist.: Cuttack-754202, Odisha. 
                     
                    Sub: Covid-19 pandemic – Consent letter of parent or guardian for their son or daughter to 
                    attend the physical classes at college - reg. 
                    Sir, 
                    I am willingly giving my consent to allow my ward to attend offline classes at your college from 
                    date ______________ and shall own related accountability. My ward is in good health. I am fully 
                    aware of covid-19 pandemic and also fully aware of the precautionary measures to be taken while 
                    sending my ward to your college. 
                    I  will follow all the instructions given by the Principal Institute of Pharmacy and Technology, 
                    Salipur regarding Covid-19 pandemic. 
                     
                    Signature of the Student                                              Signature of the Parent 
                    Name of the Student:                                                  Name of the Parent: 
                    Student Mobile No.:                                                             Parent’s Mobile No.: 
                    Address:                                                              Address: 
                     
                                                                  Declaration by student: 
                         1.  I am vaccinated/partially vaccinated/not get vaccinated with COVID-19 vaccination on 
                              dtd._____________ & dtd.___________ vide Cowin portal id ____________________.  
                         2.  I shall follow the prescribed COVID appropriate behaviour at my stay and study at college 
                              campus, IPT, Salipur. 
                         3.  I shall be responsible towards all related accountabilities involved. 
                         4.  My COVID test status today (dt.:______________) is ________ (Positive/Negative). 
                               
                              Signature of the Student                                               
                              Name of the Student:                                                   
                              Registration Number:                                                  Mobile No.:                              
                              Year/Semester:                                                        Name of the Course: 
                    N.B.: Signed Parent Consent letter with Declaration form and Vaccination Certificate to be 
                            deposited at institute on the day of class joining.