3
4
16
(State whether married, single or widow.)
If married or widow, give maiden name.
(Full Permanent Postal Address.)
hereby request the Nursing Board for the Colony of Hong Kong to enter my name upon the Part of the Register for.....
Nurses maintained by the Board.
I forward herewith the fee of $10 and I promise in the event of my being regis- tered, and in consideration thereof, to be bound by, and to conform to the Rules and Regulations for the time being in force.
I forward herewith my Certificate of Registration by the General Nursing Council for....
.under the Seal of the said Council.
I am further prepared to produce such evidence as the Board may require to establish my identity and good character.
FORM IV (B).
NURSING BOARD FOR THE COLONY OF HONG KONG.
Nurses Registration Ordinance, 1929.
Application for Registration on the.....
Part of the Register for Nurses to be used by Nurses that have been trained in any place outside the Colony to which Section 5 (2) of the Nurses Registration Ordi- nance, 1929, applies.
To the NURSING BOARD FOR THE COLONY OF HONG KONG.
(Full Christian Name and Surname.)
born at
.on
(Place and date of birth.)
(State whether married, single or widow.) If married or widow give maiden name.
(Full Permanent Postal Address.)
hereby request the Nursing Board for the Colony of Hong Kong to enter my name upon the Part of the Register for..
...Nurses maintained by the Board.
I forward herewith the fee of $10 and I promise, in the event of my being so regis- tered, and in consideration thereof, to be bound by, and to conform in all respects to the Rules and Regulations for the time being in force.
I forward herewith particulars of my training and certificates which I have received.
37