Countersigned,
Magistrate.
Dated the.......day of........
375
19......
FORM NO. 4.
Certificate of medical practitioners for extension of period of detention for observation.
Asylums Ordinance, 1906, s. 10.
We...
....and....
hereby certify that it is our opinion necessary that.
medical practitioners, .now detained
in the (Government) Asylum for observation under the authority of the Asylums Ordi- nance, 1906, should be detained there for the purpose of observation for a further period of (seven) days from and after the expiration of the order of the magistrate (or justice of the peace) under section 7, which is dated the............day of...
(or, for a further period of seven days from and after the............day of.............. 19......, on which day the first extension expired).
The reasons which in my opinion render it necessary to detain the said.......
for further observation are as follows:---
(Here state reasons).
Dated the...............day of.....
19......
19......
Medical Practitioner.
The reasons which in my opinion render it necessary to detain the said..
...for further observation are as follows:--
(Here state reasons).
Dated the..
....day of...
Countersigned,
Magistrate.
Dated the....
...day of..
19......
Medical Practitioner.
19......
NOTE. The period of each extension in limited to seven days. The first day of the first ex- tended period will be the day immediately after the expiration of the order under section 7: see the note to Form No. 2. There cannot be more than two extensions,
*