38.
218
22nd May.]
[A.D. 1931.
A.D. 1931.
[22nd May. 219
FORM IV (B).
Nurses to be used by Nurses Registered by the General Nursing Council for England and Wales, or for Scotland or by the Joint Nursing and Widwives Council of Nor- thern Ireland or by the General Nursing Council of the Irish Free State to which Section 5 (1) of the Nurses Registration Ordinance, 1931, applies.
To the NURSING BOARD FOR THE
I 1
COLONY OF HONG KONG.
(Full Christian Name and Surname.)
2
3
4
(Place and date of birth)
(State whether married, single or widow.)
If married or widow, give maiden name.
1
NURSING BOARD FOR THE COLONY OF HONG KONG.
Nurses Registration Ordinance, 1931.
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 Ordinance, 1931, applies.
To the NURSING BOARD FOR THE
COLONY OF HONG KONG.
I
(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 registered, 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 or. 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.
(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 Nurses maintained by Register for.. the Board.
I forward herewith the fee of $10 and I promise, in the event of my being so registered, and in con- sideration thereof, to be bound by, and to conform in all respects to the Rules and Regulations for the time being in force.
39