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1. Specific Medical Conditions: Details of any existing medical conditions that require special consideration or treatment protocols - include when the patient has chronic conditions

2. Religious or Cultural Preferences: Specific religious or cultural considerations affecting medical decisions - include when the patient has specific religious or cultural requirements for treatment

3. Alternate Authority Holders: Secondary or tertiary persons authorized to make decisions if primary cannot be reached - include when multiple backup decision-makers are desired

4. Prohibited Treatments: Specific medical procedures or treatments that are explicitly not authorized - include when there are specific treatments the patient wishes to exclude

5. Mental Health Provisions: Specific provisions for mental health treatment decisions - include when mental health care may be needed

1. Schedule A - Authorized Medical Procedures: Detailed list of specific medical procedures and treatments for which authority is granted

2. Schedule B - Healthcare Facilities: List of approved healthcare facilities where the authority is valid

3. Appendix 1 - Identification Documents: Copies of CNIC cards and other identification documents of all parties

4. Appendix 2 - Medical History Summary: Brief medical history of the patient including allergies, current medications, and previous surgeries