ASYLUMS.
No. 6 of 1906.
1673
SCHEDULE.
[s. 9.]
FORM A.
We,
and
, (medical practitioners) hereby certify that
at present detained for observation
under the authority of the Asylums Ordinance, 1906, is in our opinion a person of unsound mind.
The facts observed by me indicating that the said
is of unsound mind are as follows:-
(Here state facts.)
Dated the
day of
19
(Signed).
(Medical Practitioner.)
The facts observed by me indicating that the said
is of unsound mind are as follows:-
(Here state facts.)
(Signed)...
(Medical Practitioner.)
Dated the
day of
19
Countersigned.
Dated the
day of
19
(Magistrate.)
FORM B.
[s. 10.]
We,
and
(medical practitioners) hereby certify that it is in our opinion necessary to detain
now detained for observation under the authority of the Asylums Ordinance, 1906, in an asylum for a further period of
days observation.
The reasons which in my opinion render it necessary to detain the said
for further observation are as follows :-
(Here state reasons.)
(Signed).
(Medical Practitioner.)