How to Start a Clinic in India: Registrations, Licences and a Cost Checklist

Quick answer: to open a clinic in India you need your own registration with the State Medical Council, registration of the clinic as a clinical establishment under your state's law, a biomedical waste authorisation from the State Pollution Control Board, and local licences such as a shop or trade licence from the municipality. A drug licence is needed only if you run a pharmacy that sells to the public, and X-ray or ultrasound need their own registrations. The exact list and fees depend on your state.

This guide walks through each registration in order, the rules on signboards and advertising, and a cost checklist you can fill in for your own city.

Step 1: Your own registration

Before anything else, you must be registered with your State Medical Council (or the national register for your system of medicine). Keep the registration number handy — it has to appear on your signboard, prescriptions, certificates and receipts.

If you are moving to another state, check whether that state's council needs you to register there too before you practise.

Step 2: Choose the type and structure

Decide early, because the registrations depend on it:

• Type of clinic: single-doctor OPD, polyclinic with several doctors, day-care, or a clinic with beds (nursing home). Clinics with beds usually face more requirements — fire safety, staffing, minimum areas.
• Ownership: most single-doctor clinics start as a sole proprietorship. If partners or investors may join later, talk to a CA about a partnership, LLP or private limited company from the start.
• Services: pharmacy, lab, X-ray or ultrasound each bring their own licence.

Step 3: Register the clinic as a clinical establishment

Most states require clinics — generally including small, single-doctor clinics — to register as a clinical establishment before treating patients.

• The central Clinical Establishments (Registration and Regulation) Act, 2010 applies in states and union territories that have adopted it. The official portal lists Arunachal Pradesh, Assam, Bihar, Haryana, Himachal Pradesh, Jharkhand, Mizoram, Rajasthan, Sikkim, Telangana, Uttar Pradesh, Uttarakhand and all union territories except Delhi.
• Other states have their own laws — for example Karnataka's Private Medical Establishments Act, Kerala's and West Bengal's Clinical Establishments Acts, and nursing-home registration laws in Maharashtra and Delhi.

Registration is done with the district health authority or the state health department, often online. Many states give provisional registration first and permanent registration after an inspection.

Step 4: Biomedical waste authorisation

Every clinic that produces biomedical waste — used syringes, dressings, swabs — must get an authorisation under the Bio-Medical Waste Management Rules, 2016 from the State Pollution Control Board, regardless of how little waste it produces.

• Clinics without beds get a one-time authorisation; clinics with beds have an authorisation linked to their consent to operate.
• You also need an agreement with a Common Bio-medical Waste Treatment Facility (CBWTF) that collects your segregated waste, and colour-coded bins in the clinic.

Step 5: Local licences

These vary most from city to city. Common ones:

• Shop and establishment registration or trade licence from the municipal corporation or panchayat.
• Fire safety NOC, depending on the building, its height and whether you have beds.
• Signboard permission in some municipalities.
• A rent agreement or ownership papers, and the building's occupancy certificate where required.

Ask the municipal office for its current checklist before signing a lease — some licences depend on the building itself.

Step 6: Medicines, pharmacy and lab

• Supplying medicines to your own patients: under Schedule K of the Drugs Rules, a registered medical practitioner can supply medicines to their own patients without a drug licence, provided they do not run an open shop or sell across the counter. Buy only from licensed dealers and keep purchase records with batch numbers and the supplier's details.
• Running a pharmacy that sells to the public: you need a retail drug licence from the State Drugs Control department and a registered pharmacist on duty. The medical council's rules also say a doctor should not run an open shop dispensing other doctors' prescriptions.
• Lab: declare any in-house lab when you register the clinic, and check with your state health department whether it needs a separate registration.

Step 7: X-ray and ultrasound

• X-ray equipment needs a licence from the Atomic Energy Regulatory Board (AERB) through its online e-LORA system before use.
• Ultrasound machines must be registered under the PC-PNDT Act, with strict record-keeping for every scan.

Step 8: Tax

• Healthcare services given by a clinical establishment or a registered doctor are exempt from GST.
• If you also sell medicines, your pharmacy sales may need GST registration once they cross the threshold — ask your CA.
• Get a PAN in the clinic's name if it is a firm or company, and a current account for clean books.

Rules on signboards and advertising

The medical council's conduct rules matter from day one:

• Your signboard and prescription paper may show only your name, qualifications from a university or statutory body, titles, speciality and registration number with your State Medical Council — and the signboard should not be unusually large (clause 7.13).
• Soliciting patients, directly or indirectly, is unethical (clause 6.1.1). You may make a formal announcement in the press when you start practice, change its type, change address, or are temporarily away.
• A nursing home or hospital may be advertised in the press with its name, type of patients admitted, facilities and fees (clause 7.12).
• Commissions for referrals — giving or taking — are not allowed (clause 6.4.1).

Records you must keep

• Indoor patients: keep medical records for 3 years from the start of treatment (clause 1.3.1).
• Patient requests: if a patient or a legal authority asks for records, acknowledge it and provide them within 72 hours (clause 1.3.2).
• Certificates: keep a register and a copy of every medical certificate — see our medical certificate format guide.
• Prescriptions, bills and biomedical waste records should also be kept in an orderly way for inspections.

Cost checklist

Costs vary enormously by city and specialty, so instead of a single number, fill in this list with quotes for your area:

Item	Your estimate
Deposit and first months' rent
Interiors: reception, consultation room, waiting area, signboard
Medical equipment (examination table, BP apparatus, sterilizer, etc.)
Furniture, computer or tablet, printer, internet
Registrations, licences and professional fees
Biomedical waste bins and CBWTF contract
Opening stock of medicines and consumables
Staff salaries for the first few months
Clinic software, phone and WhatsApp
A reserve for the first 3–6 months, before the clinic pays for itself

Before your first patient

• Registration certificate displayed, with your registration number on the signboard and pad
• Prescription pad and certificate format ready — see what a prescription must include
• Biomedical waste bins in place and the CBWTF pickup started
• A simple way to book patients, give tokens and collect payments — see what clinic software costs
• A Google Business Profile with correct address, timings and phone number

How OPDly helps: OPDly gives a new clinic a ready front desk from day one — patient registration, appointments and a token queue, prescriptions on your letterhead with your registration number, medical certificates with a register, GST-ready billing, and a free public page with online booking and a QR code. It runs in a browser on any phone, tablet or PC, with no installation. Start a free 30-day trial.

Frequently asked questions

Is registration compulsory for a small single-doctor clinic?

In most states, yes. Clinical establishment laws generally cover clinics of every size, including a single doctor's OPD. Check with your district health office, since states differ in how and when they enforce it.

Do I need a drug licence to give medicines to my own patients?

Not under Schedule K of the Drugs Rules, as long as you supply medicines only to your own patients, do not run an open shop or sell across the counter, buy from licensed dealers and keep purchase records. A pharmacy selling to the public needs a retail drug licence and a registered pharmacist.

Is GST charged on consultation fees?

No. Healthcare services by a clinical establishment or a registered doctor are exempt from GST. Medicines sold from a pharmacy are a different matter — speak to a CA.

Can I advertise my new clinic?

You may make a formal announcement in the press when you start practice or change address. Advertising that promotes your skills, cures or achievements, or soliciting patients, is unethical under the medical council's rules. A nursing home or hospital may advertise its name, services and fees.

How long does it take to start a clinic?

It depends mostly on the clinical establishment registration and local licences in your state, and on how quickly the premises are ready. Apply for registrations as soon as the premises are fixed, since some licences need the address and an inspection.

---

This guide is general information, not legal advice. Requirements, fees and timelines differ by state and city — confirm with your district health office, State Pollution Control Board, municipal corporation and a CA before you start. Last updated 10 October 2026.

Sources: Clinical Establishments (Registration and Regulation) Act, 2010 and the official clinical establishments portal · Bio-Medical Waste Management Rules, 2016 · Drugs Rules, 1945, Schedule K and Rule 65 · Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, clauses 1.3.1, 1.3.2, 6.1.1, 6.3, 6.4.1, 7.12 and 7.13 · GST Notification 12/2017-Central Tax (Rate), entry 74.