35840-1914-Regulations-under-the-Cremation-Ordinance-1914 — Page 3

172

THE HONGKONG GOVERNMENT GAZETTE, MAY 15, 1914.

Regulation No. 8.

of

I,

of

Schedule.

Form No. 1..

The Cremation Ordinance, 1914.

Application for permission to cremate,

* Executor

being the

nearest surviving relative in Hongkong

who died at

on the

rest relative

day 19 hereby apply for permission to cremate the remains of the deceased in the Crematorium at

and I solemnly and sincerely declare that to the best of my knowledge and belief it was not contrary to the wishes of the deceased that h remains should be cremated.

I append hereto the certificates required by No. 9 of the Regulations.

Dated this

day of

Signature

Address

19

* Delete where inapplicable..

Regulation No. 9 (a).

FORM NO. 2.

The Cremation Ordinance, 1914.

Confirmatory Certificate of Cause of Death.

I hereby certify that to the best of my knowledge and belief the death of

who died at

on the

¿

day of

19

was not due to poison or to violence or to any illegal operation or to privation or neglect.

Dated this

day of

19

Signature....

Registered Qualification.....

Address.

Regulation No. 9 (b).

FORM NO. 3.

The Cremation Ordinance, 1914.

Certificate of cause of death after post-mortem examination.

Ι

We

examination of the remains of

19

at

hereby certify that have made a post-mortem

I

we

who died on the

day of

and that to the best of

my

our

knowledge and