1957-HKRS30-8-47_Part02 — Page 24

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