註
注册官
ち
發給報死執照事照得今因 0楣約内有
有為
腾
(BO)
مد
入
城
於一千九百四十
理合發給執照一紙以便持照安
配
大英一千九百四十
M
年
十紙
轻身
年
身故經該家屬遵例前來禀報業
註
日注册
月
サ
*Y
e
日發
No.
G.
R.
(M.D. 830)
35-7-0.
HONG KONG
THE BIRTHS AND DEATHS REGISTRATION ORDINANCE, 1934.
!
(Section 17 (1).)
Form No.11.
Certificate of Registration of Death.
I,
Sab Inspecti
CL C. L.
Shium...
a registrar of
deaths in the district of
of
ho SING 40 ....
mal
27th.
registered by me on the
day of
2716.
Dated the
day of...
may
do hereby certify that the death
has been duly May 19$3.
1943.
• Huis
A Registrar of Births & Deathe.
NO FEE IS PAYABLE FOR THis CertificaTE. 費繳須無書證此領
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