Holding

The District Civil Surgeon is the appropriate authority, and any deficiency in the mandatory records under Form F constitutes a contravention of the PCPNDT Act, making the magistrate’s cognizance proper.

Summary

The District Civil Surgeon, acting as the appropriate authority under the Pre‑Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, conducted a search, seized Dr. Ramesh’s sonography equipment and issued a notice under s.20(1) of the Act. Dr. Ramesh appeared before the Advisory Committee, which found prima facie violations and ordered suspension of his sonography centre; the seizure was later released. The trial court issued process under CrPC s.204 for offences under PCPNDT Act s.23 relating to breaches of s.4(3), s.5, s.6 and s.29 and the corresponding Rules, which Dr. Ramesh challenged on two grounds: that the Civil Surgeon was not the appropriate authority and that deficiencies in Form F were mere technical errors. The High Court upheld the magistrate’s cognizance, holding that the Civil Surgeon is the appropriate authority and that errors in mandatory record‑keeping are not trivial but constitute a substantive offence. The Supreme Court affirmed this view, emphasizing the essentiality of accurate records for the Act’s purpose and rejecting the appellant’s contentions. Consequently, the appeal was dismissed.

Issues considered

Whether the District Civil Surgeon is the appropriate authority under the PCPNDT Act to take cognizance of alleged violations.
Whether deficiencies or blanks in Form F, mandated by the PCPNDT Rules, amount to a substantive offence justifying the magistrate’s cognizance.

Legislation cited

Code of Criminal Procedure, 1973s. 204
Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994s. 20(1), s. 23, s. 28, s. 4(3), s. 5, s. 6
Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Rules, 1996s. 18(9), s. 8(5), s. 9

Headnote

Issue for Consideration Matter pertains to implementation of Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994. Headnotes† Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 – ss.20(1), 23, 4(3), 5, 6 and 29 – Authority conducted appellant and issued notice to him u/s.20(1), calling upon him to offer an explanation – Pursuant thereto, the appellant appeared before the Advisory Committee, and it was concluded that prima facie material existed in so far as the violations under PCPNDT were concerned – Suspension

Subjects

Implementation of Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994Search and seizureAdvisory CommitteeViolations under PCPNDTSuspension of sonography centre and seizure of sonography machineCompetence of Civil SurgeonAppropriate AuthorityMaintenance and updating of records

Judgment

[2026] 7 S.C.R. 75 : 2026 INSC 635

Dr. Ramesh
v.
State of Maharashtra & Anr.
(Criminal Appeal No. 3064 of 2026)
11 June 2026
[Sanjay Karol* and Prashant Kumar Mishra, JJ.]

Issue for Consideration
Matter pertains to implementation of Pre-Natal Diagnostic
Techniques (Prohibition of Sex Selection) Act, 1994.

Headnotes†
Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection)
Act, 1994 – ss.20(1), 23, 4(3), 5, 6 and 29 – Authority conducted
search and seized equipment belonging to the appellant
and issued notice to him u/s.20(1), calling upon him to offer
an explanation – Pursuant thereto, the appellant appeared
before the Advisory Committee, and it was concluded that
prima facie material existed in so far as the violations under
PCPNDT were concerned – Suspension of the sonography
center and seizure of the sonography machine was ordered –
Same was challenged and was released in favour of the
appellant – Proceedings before the trial court, initiated and
trial court directed the issuance of process u/s.204 CrPC for
the offences punishable u/s.23 of PCPNDT for violation of
ss.4(3), 5, 6 and 29 of the Act and Rules 9, 8(5) and 18(9) –
Criminal revision thereagainst on the ground that competence
of the Civil Surgeon, as the appropriate Authority and, the
maintenance and updating of records being the responsibility
of the hospital staff and not the responsibility of the appellant –
Revision dismissed – Thereafter, the High Court rejected
the challenge to the order taking cognizance passed by the
Judicial Magistrate – Correctness:
Held: District Civil Surgeon is the appropriate Authority under the
Act, and as such, the instant proceedings were in accordance with
law – Keeping of records is essential to the Act and its avowed
purpose – Errors in maintaining the records were not a trivial matter
and compromises in maintaining the record apart from being a
* Author
76 [2026] 7 S.C.R.

Supreme Court Reports

substantive offence under the proviso to s.4(3), would also be
offensive to the scope of the Act – Extent and manner of violations
in maintaining the record is a question of trial and had to be
determined in such proceedings – Order of the Magistrate suffered
from no error – Furthermore, in general terms, the declining sex
ratio issue is better and has shown considerable improvement but,
however, diluting the provisions of law, or letting infractions thereof
slide cannot be countenanced – According to official Government
of India data, the country’s sex ratio has shown clear signs of
improvement in recent years – These schemes are indicative of
continued efforts to eradicate the systemic bias suffered by the
girl child in an inherently patriarchal system – Much progress
has been made, and yet, much is left to be desired – While the
situation is markedly better than it was in the mid-1990s, the data
does not support complacency – Statistics show that the progress
made is incomplete and uneven – Thus, the integrity and strict
enforcement of welfare-oriented legislation such as the PCPNDT
Act remain essential along with efforts continued and earnest, till
the time there is a widespread change in mentality and what till
now, is perceived as the ‘inherent weakness’ of the woman, is
replaced by true equality, when there will dawn a realization that
efforts such as these are no longer required. [Paras 7, 14, 16]

Case Law Cited
Voluntary Health Assn. of Punjab v. Union of India [2013] 5 SCR
111 : (2013) 4 SCC 1; Naresh Kumar Garg (Dr.) v. State of Haryana,
2026 INSC 176 : 2026 SCC OnLine SC 295 – referred to.
Suo Motu v. State of Gujarat, 2008 SCC OnLine Guj 294; Sai v.
State of Maharashtra, 2016 SCC OnLine Bom 8812 – referred to.

List of Websites
https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf; https://
sansad.in/getFile/loksabhaquestions/annex/1714/AU926.
pdf?source=pqals; https://pmc.ncbi.nlm.nih.gov/articles/
PMC9234277/; https://www.weforum.org/publications/global-
gender-gap-report-2025/; https://dc.crsorgi.gov.in/assets/download/
Annual-Reports/crs/2023.pdf; https://www.pmindia.gov.in/en/
government_tr_rec/beti-bachao-beti-padhao-caring-for-the-girl-
child/; https://wcdhry.gov.in/schemes-for-children/abhb/; https://
nhm.gov.in/index1.php%3Flang%3D1%26level%3D3%26lid%3D
[2026] 7 S.C.R. 77

Dr. Ramesh v. State of Maharashtra & Anr.

309%26sublinkid%3D841; https://www.google.com/url?sa=t&so
urce=web&rct=j&opi=89978449&url=https://www.tnsocialwelfare.
tn.gov.in/en/specilisationschild-welfare/cradle-baby-scheme&ved=2
ahUKEwj5z8vd9OqUAxXSTWcHHRXuPIoQFnoECBwQAQ&usg=
AOvVaw3RyZQHt28CJ3Ssieg1lNwD; https://www.tnsocialwelfare.
tn.gov.in/en/specilisationschild-welfare/chief-ministers-girl-child-
protection-scheme; https://www.myscheme.gov.in/schemes/
cmkuy; https://www.pib.gov.in/PressReleaseIframePage.
aspx?PRID=2100589&reg=3&lang=2; https://www.pib.gov.in/
PressReleseDetailm.aspx?PRID=2220196&reg=3&lang=2;
h t t p s : / / w w w. p i b . g o v. i n / P r e s s R e l e a s e P a g e .
aspx?PRID=2212352&reg=3&lang=2; https://wcd.delhi.gov.in/
wcd/pradhan-mantri-matru-vandana-yojana-pmmvy; https://www.
nsiindia.gov.in/(S(vfuo55454y3hkhuyhkb3pry0))/InternalPage.
aspx?Id_Pk=89; https://socialwelfare.mn.gov.in/en/rules-
regulations/balika-samridhi-yojna-bys/; https://betul.nic.in/
en/scheme/ladli-laxmi-yojna/; https://www.myscheme.gov.in/
schemes/ksy; https://wbkanyashree.gov.in/kp_scheme.php;
https://health.delhi.gov.in/sites/default/files/Health/covid-19/
PC_PNDT_Act/IS+DFW.pdf; https://wcd.delhi.gov.in/wcd/delhi-
ladli-scheme-2008 – referred to.

List of Acts
Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act,
1994; Code of Criminal Procedure, 1973; Pre-Natal Diagnostic
Techniques (Prohibition of Sex Selection) Rules, 1996.

List of Keywords
Implementation of Pre-Natal Diagnostic Techniques (Prohibition of
Sex Selection) Act, 1994; Search and seizure; Advisory Committee;
Violations under PCPNDT; Suspension of sonography center and
seizure of sonography machine; Competence of Civil Surgeon;
Appropriate Authority; Maintenance and updating of records.

Case Arising From
CRIMINAL APPELLATE JURISDICTION: Criminal Appeal No.
3064 of 2026
From the Judgment and Order dated 26.09.2018 of the High Court
of Judicature at Bombay at Aurangabad in CRLWP No. 1363 of 2017
78 [2026] 7 S.C.R.

Supreme Court Reports

Appearances for Parties
Advs. for the Appellant(s):
Makrand Adkar, Pravin Waman Satale, Rishabh Jain, Sushant
Sarkar, Shantanu Makrand Adkar, Miss.shambhvee Bhushan
Kanade, Bhushan, Ms. Priya, Rajiv Shankar Dvivedi.
Advs. for the Respondent(s):
Aniruddha Joshi, Sr. Adv., Siddharth Dharmadhikari, Aaditya
Aniruddha Pande, Shrirang B. Varma.

Judgment / Order of the Supreme Court

Judgment

Sanjay Karol, J.

Leave granted.
2. In the larger context of this appeal, we are reminded of the words
of Subhadra Kumari Chauhan in the poem ‘Balika ka parichay’. It
powerfully describes the beautiful joy of a mother upon the birth of
her daughter:

“यह मेेरीी गोोदीी कीी शोोभाा, सुख
ु सोोहााग कीी हैै लाालीी
शााहीी शाान भि�खाारन कीी हैै, मनोोकाामनाा मतवाालीी
दीीप-शि�खाा हैै अँँधेेरेे कीी, घनीी घटाा कीी उजि�याालीी
उषाा हैै यह कााल-भृंग�ं कीी, हैै पतझर कीी हरि�याालीी
सुधाु ाधाार यह नीीरस दि�ल कीी, मस्तीी मगन तपस्वीी कीी.
जीीवि�त ज्योोति� नष्ट नयनोंं कीी, सच्चीी लगन मनस्वीी कीी.
बीीतेे हुुए बाालपन कीी यह, क्रीीड़ाापूूर्णण वााटि�काा हैै.
वहीी मचलनाा, वहीी कि�लकनाा,हँँसतीी हुुई नााटि�काा हैै.
मेेराा मंंदि�र,मेेरीी मसजि�द, कााबाा कााशीी यह मेेरीी.
पूूजाा पााठ,ध्याान,जप,तप,हैै घट-घट वाासीी यह मेेरीी.
कृृ ष्णचन्द्र कीी क्रीीड़ााओंं कोो अपनेे आंंगन मेंं देेखोो.
कौौशल्याा केे माातृृ-मोोद कोो, अपनेे हीी मन मेंं देेखोो.
[2026] 7 S.C.R. 79

Dr. Ramesh v. State of Maharashtra & Anr.

प्रभुु ईसाा कीी क्षमााशीीलताा, नबीी मुहु म्मद काा वि�श्वाास.
जीीव-दयाा जि�नवर गौौतम कीी,आओ देेखोो इसकेे पाास.
परि�चय पूूछ रहेे होो मुझ
ु सेे, कैैसेे परि�चय दूँँ� इसकाा.
वहीी जाान सकताा हैै इसकोो, मााताा काा दि�ल हैै जि�सकाा”
Well, to our mind the objective of the Pre-Natal Diagnostic Techniques
(Prohibition of Sex Selection) Act, 19941 is to enable a woman to
feel the joy that has been described above.
From our own scriptures, the once much cherished, but now largely
forgotten value is also worth reminding ourselves of:

“यत्र नाार्ययस्तुु पूूज्यन्तेे रमन्तेे तत्र देेवताः�ः” 2
3. This appeal challenges the judgment and order of the High Court
of Judicature at Bombay, Aurangabad Bench in CrWP No. 1363 of
2017, whereby the challenge to the order taking cognizance dated 9th
June 2016 in RCC No.16 of 2016 passed by the Judicial Magistrate
First Class, Ardhapur3 was rejected.
4. The Trial Court has directed the issuance of process under Section
204 of the Code of Criminal Procedure4 for the offences punishable
under Section 23 of the Pre-Conception and Pre-Natal Diagnostic
Techniques (Prohibition of Sex Selection) Act, 19945 for violation of
Sections 4(3), 5, 6 and 29 of the Act and Rules 9, 8(5) and 18(9).
Also under challenge was the order dated 21st August 2017 which
dismissed the Criminal Revision No. 82 of 2016 preferred by the
appellant against the issuance of process.
5. In short, an Authority (delegation of power to whom is in fact, a
point of challenge raised before us) conducted a search and seized
the equipment belonging to the appellant and issued notice to him
under Section 20(1) of the PCPNDT, calling upon him to offer an
explanation. Pursuant to letter dated 18th March 2016 issued by

1 PCPNDT
2 [‘Yatra naryastu pujyante ramante tatra dewatah’] (where woman is worshipped, there is abode of God).
3 Trial Court
4 CrPC
5 PCPNDT
80 [2026] 7 S.C.R.

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such Authority, he also appeared before the Advisory Committee,
constituted under the Act on 22nd March 2016. Having heard him,
it was concluded that prima facie material existed in so far as the
violations under PCPNDT were concerned. The suspension of the
sonography center and seizure of the sonography machine was
ordered by communication dated 23rd March 2016. Here itself, it may
be noted that this seizure of machine was challenged as per law,
and as on date it stands released in favour of the appellant as also
registration thereof restored. The same is, therefore, a non- issue
before us. Proceedings before the Trial Court, as already noted,
were initiated on 28th April 2016. The order under challenge was
issued on 9th June 2016.
6. A Revision Petition was preferred against this Order which was
disposed of by judgment dated 21st August 2017. Both grounds
raised, i.e., the competence of the Civil Surgeon, as the appropriate
Authority and, the maintenance and updating of records being the
responsibility of the hospital staff and not the responsibility of the
appellant herein were rejected.
7. In the judgment impugned before us, the grounds of challenge raised
by the appellant were two –fold. One, that Civil Surgeon was not
the appropriate Authority under the Act and as such, the cognizance
taken by the Magistrate was without basis; Two, it was urged that the
errors or blanks in Form ‘F’ were technical errors and inadvertent.
They were not errors backed by intention.
Regarding the first contention, notification dated 15th May 2015 was
taken note of which made the District Civil Surgeon, the appropriate
Authority under the Act, and as such, the instant proceedings were
in accordance with law.
About the second contention, it was concluded by the Court that
the errors in maintaining the records were not a trivial matter and
compromises in maintaining the record apart from being a substantive
offence under the proviso to Section 4(3), would also be offensive
to the scope of the Act. The extent and manner of violations in
maintaining the record is a question of trial and had to be determined
in such proceedings. The order of the Magistrate suffered from no
error.
8. The appellant, therefore, has carried the matter in appeal before
this Court. We have heard the learned counsel for the parties and
[2026] 7 S.C.R. 81

Dr. Ramesh v. State of Maharashtra & Anr.

perused the record. The short question to be considered is whether
the Magistrate was correct in taking cognizance.
9. At the outset, we may profitably refer to the observations in Voluntary
Health Assn. of Punjab v. Union of India6, wherein this court
observed:

“14. Female foeticide has its roots in the social thinking
which is fundamentally based on certain erroneous notions,
egocentric traditions, perverted perception of societal norms
and obsession with ideas which are totally individualistic
sans the collective good. All involved in female foeticide
deliberately forget to realise that when the foetus of a girl
child is destroyed, a woman of the future is crucified. To put
it differently, the present generation invites the sufferings
on its own and also sows the seeds of suffering for the
future generation, as in the ultimate eventuate, the sex
ratio gets affected and leads to manifold social problems. I
may hasten to add that no awareness campaign can ever
be complete unless there is real focus on the prowess of
women and the need for women empowerment.”
Even after more than a decade our sentiment is similar.
10. The relevant provisions of the PCPNDT Act are as follows:
2. Definitions.- In this Act, unless the context otherwise
requires,— (a) “Appropriate Authority” means the
Appropriate Authority appointed under section 17
“pre-natal diagnostic procedures” means all gynaecological
or obstetrical or medical procedures such as ultrasonography,
foetoscopy, taking or removing samples of amniotic fluid,
chorionic villi, blood or any other tissue or fluid of a man,
or of a woman for being sent to a Genetic Laboratory
or Genetic Clinic for conducting any type of analysis or
pre-natal diagnostic tests for selection of sex before or
after conception; (j) “pre-natal diagnostic techniques”
includes all pre-natal diagnostic procedures and pre-natal
diagnostic tests;

6 (2013) 4 SCC 1
82 [2026] 7 S.C.R.

Supreme Court Reports

“ CHAPTER III
REGULATION OF PRE-NATAL DIAGNOSTIC
TECHNIQUES
4. Regulation of pre-natal diagnostic techniques.- On
and from the commencement of this Act,—
1. no place including a registered Genetic Counselling
Centre or Genetic Laboratory or Genetic Clinic shall be
used or caused to be used by any person for conducting
pre-natal diagnostic techniques except for the purposes
specified in clause (2) and after satisfying any of the
conditions specified in clause (3);
2. no pre-natal diagnostic techniques shall be conducted
except for the purposes of detection of any of the following
abnormalities, namely:—
…
3. no pre-natal diagnostic techniques shall be used or
conducted unless the person qualified to do so is satisfied
for reasons to be recorded in writing that any of the following
conditions are fulfilled, namely:—
(i) age of the pregnant woman is above thirty-five years;
…
Provided that the person conducting ultrasonography on
a pregnant woman shall keep complete record thereof
in the clinic in such manner, as may be prescribed, and
any deficiency or inaccuracy found therein shall amount
to contravention of provisions of section 5 or section 6
unless contrary is proved by the person conducting such
ultrasonography;
4. …
5. …
“5. Written consent of pregnant woman and prohibition
of communicating the sex of foetus.
1. No person referred to in clause (2) of section 3 shall
conduct the pre-natal diagnostic procedures unless—
[2026] 7 S.C.R. 83

Dr. Ramesh v. State of Maharashtra & Anr.

(a) he has explained all known side and after effects of
such procedures to the pregnant woman concerned;
(b) he has obtained in the prescribed form her written
consent to undergo such procedures in the language
which she understands; and
(c) a copy of her written consent obtained under clause
(b) is given to the pregnant woman.
2. No person including the person conducting pre-natal
diagnostic procedures shall communicate to the pregnant
woman concerned or her relatives or any other person the
sex of the foetus by words, signs or in any other manner.
6. Determination of sex prohibited.- On and from the
commencement of this Act,—
(a) no Genetic Counselling Centre or Genetic Laboratory
or Genetic Clinic shall conduct or cause to be conducted
in its Centre, Laboratory or Clinic, pre-natal diagnostic
techniques including ultrasonography, for the purpose of
determining the sex of a foetus;
(b) no person shall conduct or cause to be conducted any
pre-natal diagnostic techniques including ultrasonography
for the purpose of determining the sex of a foetus;
(c) no person shall, by whatever means, cause or allow
to be caused selection of sex before or after conception.”
(emphasis supplied)
... ... ... ...

23. Offences and penalties.- (1) Any medical geneticist,
gynaecologist, registered medical practitioner or any
person who owns a Genetic Counselling Centre, a Genetic
Laboratory or a Genetic Clinic or is employed in such a
Centre, Laboratory or Clinic and renders his professional
or technical services to or at such a Centre, Laboratory
or Clinic, whether on an honorary basis or otherwise, and
who contravenes any of the provisions of this Act or rules
made thereunder shall be punishable with imprisonment
for a term which may extend to three years and with fine
84 [2026] 7 S.C.R.

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which may extend to ten thousand rupees and on any
subsequent conviction, with imprisonment which may
extend to five years and with fine which may extend to
fifty thousand rupees.
2. The name of the registered medical practitioner shall be
reported by the Appropriate Authority to the State Medical
Council concerned for taking necessary action including
suspension of the registration if the charges are framed by
the court and till the case is disposed of and on conviction
for removal of his name from the register of the Council for
a period of five years for the first offence and permanently
for the subsequent offence.
3. Any person who seeks the aid of a Genetic Counselling
Centre, Genetic Laboratory, Genetic Clinic or ultrasound
clinic or imaging clinic or of a medical geneticist,
gynaecologist, sonologist or imaging specialist or registered
medical practitioner or any other person for sex selection
or for conducting pre- natal diagnostic techniques on any
pregnant women for the purposes other than those specified
in sub-section (2) of section 4, he shall, be punishable with
imprisonment for a term which may extend to three years
and with fine which may extend to fifty thousand rupees
for the first offence and for any subsequent offence with
imprisonment which may extend to five years and with
fine which may extend to one lakh rupees.
4. For the removal of doubts, it is hereby provided, that
the provisions of sub-section (3) shall not apply to the
woman who was compelled to undergo such diagnostic
techniques or such selection.
(emphasis supplied)
... ... ... ...

28. Cognizance of offences.
1. No court shall take cognizance of an offence under this
Act except on a complaint made by—
(a) the Appropriate Authority concerned, or any officer
authorised in this behalf by the Central Government or
[2026] 7 S.C.R. 85

Dr. Ramesh v. State of Maharashtra & Anr.

State Government, as the case may be, or the Appropriate
Authority; or
(b) a person who has given notice of not less than fifteen
days in the manner prescribed, to the Appropriate Authority,
of the alleged offence and of his intention to make a
complaint to the court.
Explanation.—For the purpose of this clause, “person”
includes a social organisation.
2. No court other than that of a Metropolitan Magistrate or
a Judicial Magistrate of the first class shall try any offence
punishable under this Act.
3. Where a complaint has been made under clause (b) of
subsection (1), the court may, on demand by such person,
direct the Appropriate Authority to make available copies
of the relevant records in its possession to such person.”
(emphasis supplied)

11. Section 32 of the Act, although not reproduced supra, provides the
rule-making power. Under this Authority, the Central Government has
framed the Pre-Conception and Pre-Natal Diagnostic Techniques
(Prohibition of Sex Selection) Rules, 1996. The Scheme thereof
was discussed in a recent judgment of this Court speaking through
Bhuyan J., in Naresh Kumar Garg (Dr.) v. State of Haryana7.
12. For our purposes, since the errors or blanks in Form ‘F’ is at ‘front
and centre’ it would be apposite to reproduce the same as prescribed
under the Rules:
“Form F
[See Proviso to Section 4(3), Rule 9(4) and
Rule 10(1-A)]
FORM FOR MAINTENANCE OF RECORD IN CASE
OF PRE-NATAL DIAGNOSTIC TEST/PROCEDURE BY
GENETIC CLINIC/ULTRASOUND CLINIC/IMAGING
CENTRE

7 2026 SCC OnLine SC 295
86 [2026] 7 S.C.R.

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Section A: To be filled in for all Diagnostic Procedures/
Tests
1. Name and complete address of Genetic Clinic/Ultrasound
Clinic/Imaging centre: .......................................................
2. Registration No. (Under PC & PNDT Act, 1994)
...........................................................................................
3. Patient’s name ................................. Age ....................
4. Total Number of living children: ...................................
(a) Number of living sons with age of each living son (in
years or months): .............................................................
(b) Number of living daughters with age of each living
daughter(in years or months): ..........................................
5 . H u s b a n d ’s / W i f e ’s / F a t h e r ’s / M o t h e r ’s N a m e :
...........................................................................................
6. Full postal address of the patient with Contact Number,
if any .................................................................................
7.(a) Referred by (Full name and address of Doctor(s)/
Genetic Counseling Centre): ............................................
(Referral slips to be preserved carefully with Form F)
(b) Self-Referral by Gynaecologist/Radiologist/Registered
Medical Practitioner conducting the diagnostic procedures:
...........................................................................................
(Referral note with indications and case papers of the
patient to be preserved with Form F)
Self-referral does not mean a client coming to a clinic
and requesting for the test or the relative/s requesting
for the test of a pregnant woman
...........................................................................................
8. Last menstrual period or weeks of pregnancy:
.............................................................................................
Section B : To be filled in for performing non-invasive
diagnostic Procedures/Tests only
[2026] 7 S.C.R. 87

Dr. Ramesh v. State of Maharashtra & Anr.

9. Name of the doctor performing the procedure/s:
...........................................................................................
10. Indication/s for diagnosis procedure ..........................
(specify with reference to the request made in the referral
slip or in a self-referral note)
(Ultrasonography prenatal diagnosis during pregnancy
should only be performed when indicated. The following
is the representative list of indications for ultrasound
during pregnancy. (Put a “Tick” against the appropriate
indication/s for ultrasound)
i. To diagnose intra-uterine and/or ectopic pregnancy and
confirm viability.
ii. Estimation of gestational age (dating).
iii. Detection of number of fetuses and their chorionicity.
iv. Suspected pregnancy with IUCD in-situ or suspected
pregnancy following contraceptive failure/MTP failure.
v. Vaginal bleeding/leaking.
vi. Follow-up of cases of abortion.
vii. Assessment of cervical canal and diameter of internal
os.
viii. Discrepancy between uterine size and period of
amenorrhea.
ix. Any suspected adenexal or uterine pathology/
abnormality. x. Detection of chromosomal abnormalities,
fetal structural defects and other abnormalities and their
follow-up.
xi. To evaluate fetal presentation and position.
xii. Assessment of liquor amnii.
xiii. Preterm labor/preterm premature rupture of membranes.
xiv. Evaluation of placental position, thickness, grading
and abnormalities (placenta praevia, retro-placental
hemorrhage, abnormal adherence, etc.).
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xv. Evaluation of umbilical cord-presentation, insertion,
nuchal encirclement, number of vessels and presence
of true knot.
xvi. Evaluation of previous Caesarean Section scars. xvii.
Evaluation of fetal growth parameters, fetal weight and
fetal well being.
xviii. Color flow mapping and duplex Doppler studies.
xix. Ultrasound guided procedures such as medical
termination of pregnancy, external cephalic version, etc.
and their follow-up.
xx. Adjunct to diagnostic and therapeutic invasive
interventions such as chorionic villus sampling (CVS),
amniocenteses, fetal blood sampling, fetal skin biopsy,
amnio-infusion, intrauterine infusion, placement of shunts,
etc.
xxi. Observation of intra-partum events.
xxii. Medical/surgical conditions complicating pregnancy.
xxiii. Research/scientific studies in recognised institutions.
11. Procedures carried out (Non-Invasive) (Put a “Tick”
on the appropriate procedure)
i. Ultrasound
(Important Note : Ultrasound is not indicated/advised/
performed to determine the sex of fetus except for diagnosis
of sex-linked diseases such as Duchene Muscular
Dystrophy, Hemophilia A & B etc.)
ii. Any other (specify) .......................................................
12. Date on which declaration of pregnant woman/person
was obtained: ....................................................................
13. Date on which procedures carried out: .....................
14. Result of the non-invasive procedure carried out (report
in brief of the test including ultrasound carried out)
...........................................................................................
[2026] 7 S.C.R. 89

Dr. Ramesh v. State of Maharashtra & Anr.

15. The result of pre-natal diagnostic procedures was
conveyed to .................................. on ..............................
16. Any indication for MTP as per the abnormality detected
in the diagnostic procedures/tests ...................................
Date: (...........................................)
Place:Name, Signature and Registration Number with
Seal of the Gynaecologist/Radiologist/Registered Medical
Practitioner performing Diagnostic Procedure/s
Section C: To be filled for performing invasive
Procedures/Tests only
17. Name of the doctor/s performing the procedure/s:
...........................................................................................
18. History of genetic/medical disease in the family
(specify): .................................. Basis of diagnosis (“Tick”
on appropriate basis of diagnosis):
(a) Clinical (b) Bio-chemical
(c) Cytogenetic (d) other (e.g. radiological, ultrasonography,
etc. specify)
19. Indication/s for the diagnosis procedure (“Tick” on
appropriate indication/s):
A. Previous child/children with:
(i) Chromosomal disorders (ii) Metabolic disorders
(iii) Congenital anomaly (iv) Mental Disability
(v) Haemoglobinopathy (vi) Sex-linked disorders
(vii) Single gene disorder (viii) Any other (specify)
B. Advanced maternal age (35 years)
C. Mother/father/sibling has genetic disease (specify)
D. Other (specify) .............................................................
20. Date on which consent of pregnant woman/person was
obtained in Form G prescribed in PC & PNDT Act, 1994:
...........................................................................................
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21. Invasive procedures carried out (“Tick” on appropriate
indication/s)
i. Amniocentesis ii. Chorionic Villi aspiration
iii. Fetal biopsy iv. Cordocentesis
v. Any other (specify)
22. Any complication/s of invasive procedure (specify)…
23. Additional tests recommended (Please mention if
applicable)
(i) Chromosomal studies (ii) Biochemical studies
(iii) Molecular studies (iv) Pre-implantation gender diagnosis
(v) Any other (specify)
24. Result of the Procedures/Tests carried out (report
in brief of the invasive tests/procedures carried out)
............................................................................................
25. Date on which procedures carried out: .....................
26. The result of pre-natal diagnostic procedures was
conveyed to ................................... on .............................
27. Any indication for MTP as per the abnormality detected
in the diagnostic procedures/tests ....................................

(.................................................................)
Date: Name, Signature and Registration
Place: Number with Seal of the Gynaecologist/
Radiologist/Registered Medical Practitioner
performing Diagnostic Procedure/s

Section D: Declaration
DECLARATION OF THE PERSON UNDERGOING
PRE-NATAL DIAGNOSTIC TEST/PROCEDURE
I, Mrs./Mr. .................................................... declare that by
undergoing .......................................... Prenatal Diagnostic
Test/Procedure. I do not want to know the sex of my foetus.
[2026] 7 S.C.R. 91

Dr. Ramesh v. State of Maharashtra & Anr.

(..................................................................)
Date: Signature/Thump impression of the person
undergoing the Prenatal Diagnostic Test/Procedure
In Case of thumb Impression:
Identified by (Name) ....................... Age: .......... Sex: ..........
Relation (if any): ................... Address & Contact No.: ..........
Signature of a person attesting thumb impression: .............
Date: ....................
DECLARATION OF DOCTOR/PERSON CONDUCTING
PRE-NATAL DIAGNOSTIC PROCEDURE/TEST
I, .......................... (name of the person conducting
ultrasonography/image scanning) declare that while
conducting ultrasonography/image scanning on Ms./
Mr. ....................... (name of the pregnant woman or the
person undergoing pre-natal diagnostic procedure/test), I
have neither detected nor disclosed the sex of her fetus
to anybody in any manner.
Signature: ............................

Date: ............... (..........................................................)
Name in Capitals, Registration
Number with Seal of the Gynaecologist/
Radiologist/Registered Medical
Practitioner Conducting Diagnostic
procedure

13. The importance and essentiality of the form to the proper functioning
of the Act is no longer up for debate. The position stands settled in
Federation of Obstetrics & Gynaecological Societies of India v.
Union of India8. It was held as follows:
“97. In light of the nature of offences which necessitated
the enactment of the Act and the grave consequences

8 (2019) 6 SCC 283
92 [2026] 7 S.C.R.

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that would ensue otherwise, suspension of registration
under Section 23(2) of the Act serves as a deterrent. ...
98. Non-maintenance of record is springboard for
commission of offence of foeticide, not just a clerical error.
In order to effectively implement the various provisions of
the Act, the detailed forms in which records have to be
maintained have been provided for by the Rules. These
Rules are necessary for the implementation of the Act
and improper maintenance of such record amounts to
violation of provisions of Sections 5 and 6 of the Act, by
virtue of proviso to Section 4(3) of the Act. In addition,
any breach of the provisions of the Act or its Rules would
attract cancellation or suspension of registration of Genetic
Counselling Centre, Genetic Laboratory or Genetic Clinic,
by the appropriate authority as provided under Section
20 of the Act.
99. There is no substance in the submission that provision
of Section 4(3) be read down. By virtue of the proviso to
Section 4(3), a person conducting ultrasonography on a
pregnant woman, is required to keep complete record of
the same in the prescribed manner and any deficiency
or inaccuracy in the same amounts to contravention of
Section 5 or Section 6 of the Act, unless the contrary is
proved by the person conducting the said ultrasonography.
The aforementioned proviso to Section 4(3) reflects the
importance of records in such cases, as they are often
the only source to ensure that an establishment is not
engaged in sex determination.
100. Section 23 of the Act, which provides for penalties
of offences, acts in aid of the other sections of the Act
is quite reasonable. It provides for punishment for any
medical geneticist, gynaecologist, registered medical
practitioner or a person who owns a Genetic Counselling
Centre, a Genetic Clinic or a Genetic Laboratory, and
renders his professional or technical services to or at the
said place, whether on honorarium basis or otherwise
and contravenes any provisions of the Act, or the Rules
under it.
[2026] 7 S.C.R. 93

Dr. Ramesh v. State of Maharashtra & Anr.

101. Therefore, dilution of the provisions of the Act or the
Rules would only defeat the purpose of the Act to prevent
female foeticide, and relegate the right to life of the girl child
under Article 21 of the Constitution, to a mere formality.
102. In view of the above, no case is made out for striking
down the proviso to Section 4(3), provisions of Sections
23(1), 23(2) or to read down Section 20 or 30 of the Act.
Complete contents of Form F are held to be mandatory.
Thus, the writ petition is dismissed. No costs.”
(Emphasis supplied)

We notice that prior to the position having been authoritatively stated
as above, High Courts also echoed similar positions, inter alia,
the Gujarat High Court in Suo Motu v. State of Gujarat9, and the
Bombay High Court in Sai v. State of Maharashtra10.
14. The provisions reproduced above and also the judicial interpretation
thereof leave no room for doubt. The keeping of records is essential
to the Act and its avowed purpose. It is true that in general terms,
the declining sex ratio issue is better and has shown considerable
improvement but, however, diluting the provisions of law, or letting
infractions thereof slide cannot be countenanced. According to official
Government of India data, the country’s sex ratio has shown clear
signs of improvement in recent years, though the story is not entirely
straightforward. The National Family Health Survey-5 (2019–21)11,
conducted under the Ministry of Health and Family Welfare, records
the sex ratio to be 1,020 females per 1,000 males, compared to 991
in NFHS-4 (2015–16).12. At the same time, the sex ratio at birth,
which reflects the number of girls born relative to boys in the five
years preceding the survey, stood at 929 females per 1,000 males.
As per Census Commissioner’s report13, the position is as follows:

9 2008 SCC OnLine Guj 294
10 2016 SCC OnLine Bom 8812
11 https://dhsprogram.com/pubs/pdf/FR375/FR375.pdf
12 https://sansad.in/getFile/loksabhaquestions/annex/1714/AU926.pdf?source=pqals
13 Sample Registration System Statistical Report 2021 and Sample Registration System Statistical Report
2024 released by Office Of The Registrar General & Census Commissioner, India Ministry Of Home
Affairs, Government Of India;
94 [2026] 7 S.C.R.

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CATEGORY 2015-17 2016-18 2017-19 2018-20 2019-21 2022-24
RURAL 898 900 904 907 912 914
URBAN 890 897 906 910 918 928
TOTAL 896 899 904 907 913 918

Although this represents some improvement compared to previous
reports, it remains below the biologically expected level of around
950 or higher.14 On a global level though, unfortunately, the data
does not present a positive outlook. The World Economic Forum’s
Global Gender Gap Report 202515 records a drop in our ranking in
terms of overall gender parity score from the previous year to 131
out of 148, from 129 the previous year.
15. Turning back the page of history confirms this assessment. Census
data shows that the national child sex ratio declined from 945 in 1991
to 927 in 2001 and further to 919 in 2011, reflecting the severity of the
imbalance that prompted stringent implementation of the PCPNDT Act.
The recovery to 929 at birth signals a partial course correction, but
yet, not a path of true equality and acceptability. Differences across
State drive whom this point. For example, Haryana and Punjab, which
recorded child sex ratios below 900 in the years immediately after the
turn of the century have demonstrated improvement in subsequent
surveys showing the success of the regulations as enforced and the
awareness measures being implemented. Nonetheless, several states
still do report sex ratios at birth below the national average. This
shows the continuing presence of deep-seated patriarchal preferences
towards a male child and the ‘behind the curtains’ prevalence of sex
selection practices16. The following extract is from Statistics of India
based on the Civil Registration System 2023:

14 Chakravarty N, Dabla V, Sagar M, Neogi S, Markan M, Segan M, Agnani S, Kapahi P, Neogi S. Cultural
and Social Bias Leading to Prenatal Sex Selection: India Perspective. Front Glob Womens Health. 2022
Accessssible at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9234277/
15 https://www.weforum.org/publications/global-gender-gap-report-2025/
16 Vital Statistics of India Based on the Civil Registration System 2023 as on 10.10.2025 https://dc.crsorgi.
gov.in/assets/download/Annual-Reports/crs/2023.pdf
[2026] 7 S.C.R. 95

Dr. Ramesh v. State of Maharashtra & Anr.

The current scenario, good, or not so good, with scope of improvement,
as it may be, is a result of continued efforts by Central and State
Governments. We may only observe that more than seventy-five
years after we have set out to chart our own path, even today seeing
posters for education and upliftment, including financial security,
of a girl child is not a sight out of the ordinary, in any town or city,
96 [2026] 7 S.C.R.

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including Delhi, where it is most often visible on the buses of the
Delhi Transport Corporation. The various schemes brought in over
the years are inter-alia as follows:

NAME OF THE IMPLEMENTED AIMS OF THE SCHEME
SCHEME BY
SCHEME WITH EMPHASIS TO CURB FEMALE FOETICIDE
Beti Bachao Beti Central This scheme was launched on
Padhao17 Government 22nd January, 2015 (addresses
the declining child sex ratio and
promotes the survival, protection,
and education of the girl child.
Janani Suraksha Central It is a safe motherhood intervention
Yojana18 Government under the National Health Mission.
It is being implemented with the
objective of reducing maternal and
neonatal mortality by promoting
institutional delivery among poor
pregnant women. The scheme,
launched on 12 April 2005 by the
Hon’ble Prime Minister, is under
implementation in all states and
Union Territories (UTs), with a
special focus on Low Performing
States (LPS).
Aapki Beti Hamari Haryana scheme by the Haryana
Beti19 Government government provides financial
support to empower girls, offering
₹2,500 per year for five years to
registered beneficiaries, regardless
of caste or income. The scheme
aims to improve the child sex ratio,
promoting the birth and education
of girls. It applies to first-born girls
in SC/BPL families and all second-
born girls.

17 https://www.pmindia.gov.in/en/government_tr_rec/beti-bachao-beti-padhao-caring-for-the-girl-child/
18 https://nhm.gov.in/index1.php%3Flang%3D1%26level%3D3%26lid%3D309%26sublinkid%3D841
19 https://wcdhry.gov.in/schemes-for-children/abhb/
[2026] 7 S.C.R. 97

Dr. Ramesh v. State of Maharashtra & Anr.

Cradle Baby Tamil Nadu Programme that allows mothers
Scheme20 Government to safely surrender unwanted girl
children.
Chief Minister’s Girl Tamil Nadu S o c i a l We l f a r e a n d Wo m e n
Child Protection Government Empowerment Department,
Scheme-I 21 Government of Tamil Nadu. The
scheme aims to provide financial
assistance to girl children of poor
families as well as to promote
girl child education, small family
norms, increase the child sex
ratio, discourage the preference
for male child & eradicate female
infanticide.
Chief Minister Bihar This is a scheme to stop female
Kanya Utthan Government feticide, encourage girl birth,
Yojana22 encourage birth registration,
complete vaccination of 02-year-
old girls, increase the gender
ratio, reduce girl child mortality
rate, promote girl education, Curb
child marriage, reduce the total
fertility rate and bring girls into
the mainstream of society by
making them self-reliant, as a
result of which girls will contribute
significantly to the development of
family and society.
Nirbhaya Kadhi, Odisha Schemes launched for adolescent
Mo Gelha Jiya, Government girls to prevent child marriages, to
Kalpana Avijan, combat sex selection and female
Swarna Kalika foeticide, and to boost Self-Esteem
and Veerangana and Confidence
Yojana under BBBP
Scheme23

20 https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.tnsocialwelfare.
tn.gov.in/en/specilisationschild-welfare/cradle-baby-scheme&ved=2ahUKEwj5z8vd9OqUAxXSTWcHH
RXuPIoQFnoECBwQAQ&usg=AOvVaw3RyZQHt28CJ3Ssieg1lNwD
21 https://www.tnsocialwelfare.tn.gov.in/en/specilisationschild-welfare/chief-ministers-girl-child-protection-
scheme
22 https://www.myscheme.gov.in/schemes/cmkuy
23 https://www.pib.gov.in/PressReleaseIframePage.aspx?PRID=2100589&reg=3&lang=2
98 [2026] 7 S.C.R.

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SCHEMES WITH EMPHASIS TO IMPROVE CONDITION OF
WOMEN IN SOCIETY
Vigyan Jyoti Central Implemented by the Department
Scheme24 Government of Science & Technology to
encourage meritorious girls to
pursue careers in STEM (Science,
Technology, Engineering, and
Math) fields.
Bal Vivah Mukt Central Campaign aimed at eradicating
Bharat25 Government child marriage through strict
enforcement of the Prohibition of
Child Marriage Act, 2006.
Pradhan Mantri Central Under Mission Shakti, this maternity
Matru Vandana Government benefit scheme provides financial
Yojana26 assistance for the first living child.
It was revamped to offer ₹6,000
for the second child if it is a girl,
encouraging families to embrace
a second daughter.
The Sukanya Central Small savings scheme under
Samriddhi Government the ‘Beti Bachao, Beti Padhao’
Account27 campaign designed for the girl
child, offering a high-interest rate
(currently 8.2%) and tax benefits.
Parents can open this account for
a girl under 10, with a minimum
yearly deposit of ₹250 and a
maximum of ₹1.5 lakh until 15
years, maturing in 21 years.
Balika Samriddhi Central Initiative supporting girl children
Yojana28 Government born on or after August 15, 1997, to
below-poverty-line (BPL) families.
It provides a ₹500 post-birth grant
and annual education scholarships
(₹300-₹1,000) through a dedicated
interest-bearing account, aimed at
promoting education and delaying
marriage.

24 https://www.pib.gov.in/PressReleseDetailm.aspx?PRID=2220196&reg=3&lang=2
25 https://www.pib.gov.in/PressReleasePage.aspx?PRID=2212352&reg=3&lang=2
26 https://wcd.delhi.gov.in/wcd/pradhan-mantri-matru-vandana-yojana-pmmvy
27 https://www.nsiindia.gov.in/(S(vfuo55454y3hkhuyhkb3pry0))/InternalPage.aspx?Id_Pk=89
28 https://socialwelfare.mn.gov.in/en/rules-regulations/balika-samridhi-yojna-bys/
[2026] 7 S.C.R. 99

Dr. Ramesh v. State of Maharashtra & Anr.

Ladli Lakshmi Madhya Scheme provides financial deposits
Yojana29 Pradesh/ that mature into a lump sum of ₹1
lakh when the girl turns 21.
Delhi/Goa
Government
Mukhyamantri Uttar Pradesh Scheme provides financial
Kanya Sumangala Government assistance up to ₹25,000 in six
Yojana30 instalments.
Kanyashree West Bengal Scheme provides annual
Prakalpa 31 Government scholarships and a one-time grant
for unmarried girls between 13-18
years.
Informer reward Delhi The government provides cash
scheme under PC Government rewards to expose illegal sex-
& PNDT Act, 199432 determination centres and
practices. Informers who provide
actionable tips receive up to
₹50,000, while pregnant women
who act as decoy patients during
stings are eligible for up to
₹1,50,000.
Delhi Lakhpati Delhi A revamped version of the former
Bitiya Yojana33 Government Ladli scheme. It provides a phased
financial support, to girl child of
families having annual income not
more than Rs.1,20,000 (One Lakh
Twenty Thousand).

16. These schemes are indicative of continued efforts to eradicate the
systemic bias suffered by the girl child in an inherently patriarchal
system. Much progress has been made, and yet, much is left to be
desired. In sum, while the situation is markedly better than it was in
the mid-1990s, the data does not support complacency. The statistics
referred to above show that the progress made is incomplete and
uneven. Consequently, the integrity and strict enforcement of welfare-
oriented legislation such as the PCPNDT Act remain essential along

29 https://betul.nic.in/en/scheme/ladli-laxmi-yojna/
30 https://www.myscheme.gov.in/schemes/ksy
31 https://wbkanyashree.gov.in/kp_scheme.php
32 https://health.delhi.gov.in/sites/default/files/Health/covid-19/PC_PNDT_Act/IS+DFW.pdf
33 https://wcd.delhi.gov.in/wcd/delhi-ladli-scheme-2008
100 [2026] 7 S.C.R.

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with efforts continued and earnest, till the time there is a widespread
change in mentality and what till now, is perceived as the ‘inherent
weakness’ of the woman, is replaced by true equality, when there will
dawn a realization that efforts such as these are no longer required.
This is not to say that the laws protecting women within legislation
such as IPC/BNS will no longer be required but at least, there will
no longer be a question on whether a girl child deserves to be born.
17. The appeal, in view of the cumulative assessment above, is bereft
of merit and is accordingly dismissed. Pending applications (if any)
shall be disposed of.

Result of the case: Appeal dismissed.

†
Headnotes prepared by: Nidhi Jain