CO129-312 - Acting Governor Major Gen Sir Gascoigne Governor Sir Blake - 1902 [7-9] — Page 385

186

Enclosure No. 2 to Despatch No.399 of the 5th. September, 1902. INSTRUCTIONS to CLAIMANTS for REWARDS of the ROYAL HUMANE SOCIETY, 382

setting forth the particulars of the Case of...........

who risked his own life in rescuing.

drowned, at...

..on the....

.from being

1902.

Y 9 C C

♫

.dƒð edt lo

.ok dodaqesĈ of ↑ „ck equacions

„SCGI „nadaadqal

a'asilog jo fastnatcinequë nistysĉ sdt mori Joantxë

.scer timb „djes total rotted

Pecuniary Rewards are limited to Cases only which occur in or near

the Metropolis.

edt no tratani „d301 odt to sdgin edt n0"

I ne

szodasrol edt ¿nillorteq aaw [[santo..0.9 (noodqy) s to noissoo0 Jead of Eis ¿airotner to seogrug sđt no】 nottata items! to dtrok el aao¬juil ni staod out wae ed icitnok Ja neft regnat ni elgong elid glad eroa dotel að nið đtin saw oin aidatano) saecid¤ ad♬ Jnee ¿laste of ¿d roon soirrot s of Esfostte sgor a ¿risios „lesaid of -1091* ad♪ taknoms Įnisuot aan doldw gol a novo yow aid olan Hesaid .snoda of pelsa atosqlooo ed‡ to ↑ paigaird ai Ist9soole insets toitquette ai ina „etsod wit to ano no ti lo yod s fecisser Hits 979ɗT Leqor sit to Elod sid 38of Enggila liesmoC ..C.9 xid doser of ed aint to etiga mi‘„dţlon vişnitmore aɛw doldu,notow sắt otai [Is) elsa „elituita trad a notls „mið þaird las yed ont doner of leteram no niaga Jlo Jaow Fas..K.4 Zb.II te noktatƐ of tearter of „fari of of næter aid m© „K.A COLE [1i3 Juo fonisson Ins „„K.A 08.SI te gji dosmota eit ni gaano srevas dtin fosion Bar of mod tedd de noitstů dywordt avojoanoom sasoed ina,972aoque ins nianta edt sort ¡nitiveSt .\sa ot teig as I,asd las ysi 2xea Istiqaoi! of Insa aaw of ‚ning oft "JLE Foalser las josita ait mori fersvocat

Name, Address, Age &

Occupation of Claimant.

2. Name, Address, Age

Occupation of Person saved.

3. Time of Day, Date, and

Place at which the Accident occurred, Depth of Water, &c., to be here stated.

4. The precise nature of

the exertions used and risk incurred in Saving the Person, and other particulars.

5. What was the actual Time of

Immersion of the person

saved, and the state of the body when first rescued ?

6. What was done with the

body and where taken to ?*

7. Who was sent for; who came;

what was then done, and what kind of treatment was adopted ?

41671

0

SCOT QU

See Answers attached.

This Paper to be accompanied by Certificates of one or more Bye-witnesses,

who should add their Profession or Trade after Signature, and state folly IN THEIR OWN HAND-WRITING, the precise nature of the Claimant's exertions, showing the actual risk he thereby incurred.

*Should the Patient have been taken to a Public House, a Certificate of the Landlord, verified also by the Medical Attendant, should be attached, and stating what accommodation was afforded.