14
FIRST SCHEDULE.
FORM 1.
MEDICAL REGISTRATION ORDINANCE, 1957. (No. 26 of 1957).
MEDICAL PRACTITIONERS | REGISTRATION AND DiscIPLINARY Procedece) REGULATIONS, 1957.
Nature
of
Name
Address
|ONNETON
[reg. 3.1
REGISTER.
اشا اسرة
Dete of' Addltkr)
degrees
Cand
eatfome
mod qualit
cation
dem mod qualit
antle
Photo-
Keraph
Begin
on Care tificate No
Bertulit
15
(3) that during the said period the applicant has been engaged in
Surgery as
(Name of post) in ...
(Title of hospital/s or stitution/s in full in capital letters) for a period of not less than six months, namely
mooths, and that his service while so employed has been satisfac- tory.
(4) that any time spent in Midwifery which has been counted for the purposes of the foregoing paragraphs (2) and (3) as time spent in Medicine/Surgery is a period not exceeding six months, namely
months.
(5) that the University of Hong Kong is satisfied that the said
(Name of applicant for full registration} has satisfied the conditions required by section 9 of the Medical Registration Ordinance, 1957 (No. 25 of 1997). Dated this
day of
195
Dean. Faculty of Medicine University of Flung Kong –
Form 2.
MEDICAL REGISTRATION ORDINANCE. 1957.
(No. 25 of 1957).
MEDICAL PRACTITIONERS (REGISTRATION AND DISCIPLINARY PROCEDERE) REGULATIONS, 1967.
CERTIFICATE OF EXPERIENCE.
[reg. 5.1
In accordance with section 9 of the Medical Registration Ordinance. 1957, it is hereby certified-
(1) that
of
(Name of applicant)
(Addresa)
has been employed as shown in a resident medical capacity (as defined in section of the Medical Registration Ordinance. 1967 (No. 25 of 1967)) in the undermentioned approved Hospitals or Institutions for a period of not less than twelve months, namely
months. Period of Employment-From
То
(2) that during the said period the applicant has been engaged in
Medicine at
h (Name of post) in
(Title of hospital/a or institution/s in full in capital letters) for a period of not less than six months, namely
months, and that his service while no employed has been satlifae- tory.
1.
of
FORM 2.
MEDICAL REGISTRATION ORDINANCE, 1967.
(No. 26 of 1957).
MEDICAL PRACTITIONERS (REGISTRATION AND DISCIPLINARY PROCEDURE) REGULATIONS, 1857.
[reg. G.]
APPLICATION FOR REGISTRATION AS A REGISTERED MEDICAL PRACTITIONER.
apply for registration as a registered medical practitioner in eccordance with section 13 of the Medical Registration Ordinance, 1967. I hold the following qualifications-
and have had the experience prescribed in the Medical Registration Ordinance, 1967.
Declared at Hong Kong
this
VANÉ LAMMELLORAL
day of
19.
Before me,
Justice of the Peace
OT
Commissioner for Oaths Hồng Hung.
Photograph