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FORM NO. 2.
Order by a magistrate or justice of the peace authorizing the removal to an asylum for
the purpose of detention and observation of a person alleged to be of unsound mind.
Asylums Ordinance, 1906, s. 7.
Consigned,
Magistrute.
Dated the...............day of....
19......
Whereas...
that there is reason to believe that
.....has satisfied me the undersigned
..of..
is of unsound mind, I hereby order that the sail...
....be conveyed to the (Government) Asylum and be there detained under observation for a period not excoed- ing seven days from and including the date of this order.
Dated the.........
..day of
19......
Magistrate. Justice of the Peace.
NOTE. The period of detention authorized by this order will expire at midnight on the seventh day, counting the date of the order as the first day.
FORM No. 4.
Certificate of medical practitioners for extension of period of detention for observation.
We.
Asylums Ordinance, 1906, s. 10.
...and....
medical practitioners, ..now detained in the (Government) Asylum for observation under the authority of the Asylums Ordi- nance, 1906, should be detained there for the purpose of observation for a further perio of (seven) days from and after the expiration of the order of the magistrate (or justice. of the peace) under section 7, which is dated the............day of........
19..... (or, for a further period of seven days from and after the...
hereby certify that it is our opinion necessary that.............
19.
....., on which day the first extension expired).
........day of....
The reasons which in my opinion render it necessary to detain the said...............
..for further observation are as follows:-
FORM NO. 3.
Certificate of medical practitioners as to unsoundness of mind.
Asylums Ordinance, 1906, s. 9.
(Here state reasons).
Dated the..
..lay of..
19......
Medical Practitioner.
We.........
certify that......
and..
medical practitioners, hereby
...at present detained for observation under the authority of the Asylumns Ordinance, 1906, is in our opinion a person of un- sound mind.
The reasons for my opinion are as follows:-
(Ilere state reasous).
The reasons which in my opinion render it necessary to detain the said........ .for further observation are as follows:-
Here state reasons).
Dated the...............................dlay of....
19......
Dated the.
The reasons for my opinion are as follows :—
(Here state reasons).
Dated the...............day of.
19......
Medical Practitioner.
19....
Medical Practitioner.
Countersigned,
Magistrate,
Medical Practitioner.
Dated the....
....day of..............
NOTE. The period of each extension in limited to seven days. The first day of the first ex- tended period will be the day inmediately after the expiration of the order under section 7; see the note to Form No. 2. There cannot be more than two extensions.
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