111716-1927-Supplementary-Draft-Order-in-Council--Asylums — Page 2

374

FORM NO. 2.

Order by a magistrate or justice of the peace authorizing the removal to an asylum for

the purpose of detention and observation of a person alleged to be of unsound mind.

Asylums Ordinance, 1906, s. 7.

Whereas.....

.of

that there is reason to believe that

is of unsound mind, I hereby order that the said.....

...has satisfied me the undersigned

..of.....

.....be conveyed to the

(Government) Asylum and be there detained under observation for a period not exceed- ing seven days from and including the date of this order.

Dated the........

...day of

19......

Magistrate. Justice of the Peace.

NOTE.-The period of detention authorized by this order will expire at midnight on the seventh day, counting the date of the order as the first day.

We..

FORM NO. 3.

Certificate of medical practitioners as to unsoundness of mind.

Asylums Ordinance, 1906, s. 9.

and...

medical practitioners, hereby

certify that..

..at present detained for observation

under the authority of the Asylums Ordinance, 1906, is in our opinion a person of in- sound mind.

The reasons for my opinion are as follows :---

(Here state reasons).

Dated the

...day of.

The reasons for my opinion are as follows :-

(Here state reasons).

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

19......

Medical Practitioner.

19......

Medical Practitioner,