1986 Ed.]
Births and Deaths Registration
[CAP.174
19
FORM 13
[s. 18(a).]
Certificate of still-birth
I, A.B., registered medical practitioner in Hong Kong, hereby certify that I was in attendance at the birth of the child of Mrs. C.D. [or have examined the body of the child of Mrs. C.D.] and that such child was not born alive.
Dated the day of .19
I, A.B., of
本人某甲現居於
(Signed.) A.B., Registered medical practitioner. (Amended, 67 of 1984, s. 10)
FORM 14
[s. 18(b).]
表格十四
〔條例第一八條(乙)款〕
Declaration as to still-birth
有關死產之聲明書
I solemnly and sincerely declare that no registered medical practitioner was present
謹以至誠聲明
當某乙女士於at the birth of the child of Mrs. C.D. which occurred on the day of 19........., (or that E.F., registered medical practitioner, was present at the birth of the child of Mrs. C.D. which occurred on the day of 19.. but that his certificate according to Form 13 in the Second Schedule to the Births and Deaths Registration Ordinance, (Chapter 174), cannot be obtained) and that the child of Mrs. C.D. which was born on the day of 19.. was not born alive.
並無註冊醫生在場 (或註冊醫生某丙在某乙女士於日分娩時在場 惟未能獲其依照生死註冊條例 (香港法例第174章) 第二附表內表格十三發給證書) 此外某乙女士於一九年月日所分娩之嬰兒在出世時已經死亡。
And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Ordinance.
本人謹根據宣誓及聲明條例, 表誠提出此項聲明, 並確信其為真實無訛
(Signed) A.B. (簽署) 某甲
Legal Informant. 法定呈報人
(Cap. 11.)
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