A.D. 1931.]

Confidential.

[22nd May. 217

To the NURSING BOARD FOR THE

COLONY OF HONG KONG.

I hereby certify that I have known.. personally for...

years, and that she has discharged her professional duties at all times in such a manner as to enable me to recommend her for registration by the Board, and that she is of good moral character.

REMARKS.

Signature

Address

Professional Position

Date..

(Note. This testimonial is to be sent to the Director of Medical and Sanitary Services.)

FORM IV (A).

NURSING BOARD FOR THE COLONY OF HONG KONG.

Nurses Registration Ordinance, 1931.

Application for Registration on the..

Part of the Register for...

37

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