108324-1927-Order-under-section-4-of-the-Asylums-Ordinance-1906 — Page 1

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THE HONG KONG GOVERNMENT GAZETTE, OCTOBER 7, 1927.

EXECUTIVE COUNCIL.

No. 577.

Order made by the Governor in Council under section 4 of the Asylums Ordinance, 1906, Ordinance No. 6 of 1906, on the 4th day of October, 1927.

The following forms are prescribed.

COUNCIL CHAMBER,

4th October, 1927.

FORM NO. 1.

D. W. TRATMAN,

Clerk of Councils.

Application for an order for the removal to an asylum for the purpose of detention and

observation of a person believed to be of unsound mind.

Asylums Ordinance, 1906, s. 7.

I...

that.

.of..

..of.

mind. The reasons for my belief are as follows:-

(a) (Result of personal observation).

Strike out the inappro- priate parargahı.

(b) (Facts communicated to me by others).

of..

.have reason to believe

...is a person of unsound

who is said to be a relative of the person in question, has been communicated with, with the following result--

Or

No relative of the person in question can be found in the Colony.

I therefore apply under section 7 of the Asylums Ordinance, 1906, for a written order authorizing the said.....

Asylum and to be detained there under observation for a period not exceeding seven to be conveyed to the (Government) days.

Dated the..... ....day of...

19......

Signature of applicant.