T
1 therefore, in pursuance of section 4 of the said Ordinance, give you notice that you are required to attend for, and submit to medical examination within
of
days of the
19 by a medical practitioner.
*
day Medical
examination under this heading will be made free of charge if undergone in a government social hygiene clinic.
To:
7
FORM 4-section 5).
Treatment Notice.
(under section 5 of the Venereal Disease Ordinance, 1952).
In pursuance of section 5 of the Venereal Disease Ordinance, 1952, I hereby give you notice to attend for and submit to further examination and treatment of
in accordance with direction given by
and to continue to do so, until a clearance certificate in respect of yourself has been issued.
FORM 3-(section 5).
Clearance Certificate.
(under section 5 of the Venereal Discase Ordinance, 1954).
To: Deputy Director of Health Services,
Dated this
day of
. 19
(Signed)
Medical Practitioner.
Medical Department Headquarters.
Passed the Legislative Council of Hong Kong, this 9th day
I
of January, 1952.
(medical practitioner) hereby certify that I have this day examined (insert name of contact)
(a) the said
and I am of opinion that :
is not, at the
date hereof, suffering from a venereal disease in a communicable form;
(b) the said
any further treatment.
* strike out whichever is not applicable.
does not require
Dated this
day of
1 19
(Signed)
Medical Practitioner.
Note:-The contact may be informed by the medical practitioner of the contents of the certificate but it should not be handed to the contact.
Clerkip!
Deputy Clerk Councils.