A 6
[Subsidiary]
L.N. 50/82.
CAP. 212] Termination of Pregnancy Regulations
FORM 2A
(*Delete as appropriate)
CONFIDENTIAL
[1982 Ed.
[reg. 3.]
Not to be destroyed within five years of the date of operation
OFFENCES AGAINST THE PERSON ORDINANCE (Chapter 212)
CERTIFICATE TO BE COMPLETED IN RELATION TO THE TERMINATION
OF A PREGNANCY OF MORE THAN 24 WEEKS DURATION UNDER
SECTION 47A(2C) OF THE ORDINANCE
I,
(Name and qualifications of practitioner in block capitals)
of
(Full address of practitioner,
and I,
(Name and qualifications of practitioner in block capitals)
of
(Full address of practitioner.
hereby certify that we
are*
were
of the opinion, formed in good faith, that it
was*
is*
necessary to terminate the pregnancy of
(Full name of pregnant woman in block capitals)
of
(Usual place of residence of pregnant woman in block capitals:
(Ring appropriate letter)
in order to save the life of the pregnant woman.
This certificate of opinion is given--
A. before the commencement of the treatment for the termination of the
pregnancy to which it relates;
B.
or, if that is not reasonably practicable, then
not later than 24 hours after such termination.
Signed
Signed
Date
Date