1969 Ed.]
Midwives (Registration and Disciplinary Procedure) Regulations.
A 19
[Subsidiary]
FIRST SCHEDULE.
[reg. 3.]
PARTICULARS TO BE ENTERED IN THE REGISTER.
Registration No.
Name.
Date of Registration.
Married/Single/Widow.
Age.
Address.
Hospital, where trained.
Details of training:-
(a) General Nursing.
(b) Registration with the Nursing Board of Hong Kong.
(c) Other Work.
(d) Midwifery.
Name of Licensing Body, if by virtue of reciprocity.
Certificate of character by.
Passport or Identification Certificate.
Midwives Board of Hong Kong Examination.
Signature of Applicant.
Signature of secretary of Midwives Board of Hong Kong.
SECOND SCHEDULE.
FORM 1.
CERTIFICATE OF REGISTRATION.
MIDWIVES BOARD
[reg. 5.]
L.N. 185/69.
Number
HONG KONG.
Date
We, the undersigned, hereby certify that
whose photograph is appended hereto is
a registered midwife in accordance with
the provisions of the Midwives Registration Ordinance (Chapter 162).
特定へ依附查
此獲第照貼
證准一助於 第 明爲六產本
年 註二士證~
日
册章註上其號 月助一册者照
產之榮一片 土規例經係
Photograph
Chairman,
Midwives Board of Hong Kong.
Secretary.