1955-HKRS29-8-22_Part03 — Page 18

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VACCINATION CERTIFICATE FOR CHOLERA.

International Certificate of Vaccination or Hevaccination Against Cholern,

Certificat International de Vaccination On De Revaccination

This is to

certify that

Ja somanigne (e)

certifie que

Contre la Cholera.

date of

birth ne (e)

aex

****

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Passed the Legislative Council of Hong Kong, this 14th day of September, 1955.

}

Deputy Clerk of Councils.

(Secretariat 1/2061/46)

whone signa-

ture followa

dont la

signature Buit

has on the date indicated been vaccinated or revaccinated against cholera.

a sto vaccine (e) ou revaccine (e) contre le cholera a la date indiquée.

Date

Signature and professional status of vaccinator.

Signature et qualite pru. fessionnelle du vaccinateur.

Approved stamp.

Cocket d'authentification.

2

3

4

5

0

1

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