(L.)

(Discharge from Hospital.)

"THE CONTAGIOUS DISEASES ORDINANCE, 1883."

In pursuance of the above-mentioned Ordinance, I hereby discharge A.B. of , from this Hospital (add according to the fact), and certify that she is now free from a contagious disease.

Dated this day of 18 at the Hospital.

(Signed)

G.H., Visiting Surgeon,

(M.)

(Application to be relieved from examination.) "THE CONTAGIOUS DISEASES ORDINANCE, 1883,"

To L.M., Esq., Registrar General.

I, A.B. of , being in pursuance of the above-mentioned Ordinance, subject to a periodical medical examination on my own submission [or under your order, as the case may be], dated the day of , do hereby apply to be relieved therefrom.

Dated this day of 18

Witness, G.W. (Signed) A.B.

(N.)

(Notification in Gazette that a house is declared an Unregistered Brothel.)

"THE CONTAGIOUS DISEASES ORDINANCE, 1883."

It is hereby notified that the house [or part of a house] hereinafter mentioned, that is to say, [describe the same], was, on the day of 18, in pursuance to section 23 of the above Ordinance, declared by me under my hand to be an unregistered brothel.

(O.)

(Certificate of Hospital charges.)

"THE CONTAGIOUS DISEASES ORDINANCE, 1883."

In pursuance of the above-mentioned Ordinance, I do hereby certify that of registered brothel No. an inmate of certified Hospital of [ ] has been ( ) from the to the day of day of , and that the charges hereto marked A. are in accordance with the scale of charges fixed by me with the approval of His Excellency the Governor pursuant to section 39 of the above-mentioned Ordinance.

Dated this day of 18

Inspector of Hospitals.

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