66756-1920-Amendment-of-the-Cremation-Regulations — Page 3

310 THE HONGKONG GOVERNMENT GAZETTE, SEPTEMBER 10, 1920.

give rise to any suspicion that the death was due wholly or in part to any other cause

disease than

or which makes it desirable that the body should not be cremated. accident

Dated this

day of

Signature.. Address

Registered qualifications

19

NOTE.-The Certificate in Forms 1A and 2 must be handed to the applicant to be attached to Form 1.

Re

Cremation Ordinance, 1914.

FORM NO. 2.

Confirmatory Medical Certificate.

deceased.

I have examined the foregoing medical certificate, and have made personal inquiry as stated in my answers to the questions below :-

1. Have you seen the body of the deceased?

2. Have you carefully examined the body

externally?

3. Have you made a post-mortem examination? 4. Have you seen and questioned the medical practitioner who gave the above certi- ficate?

5. Have you seen and questioned any other medical practitioner who attended the deceased?

6. Have you seen and questioned any person who nursed the deceased during his last illness, or who was present at the death?

7. Have you seen and questioned any of the

relatives of the deceased?

8. Have you seen and questioned any other

person?

(In the answers to questions 5, 6, 7, and 8, give names and addresses of persons seen and say whether you saw them alone.)

I am satisfied that the cause of death was

and I certify that I know of no circumstance which can give rise to any suspicion that

death was due wholly or in part to any other cause than desirable that the body should not be cremated.

accident disease

or which makes it

Dated this

day of

Signature....

Address

Registered qualifications Office....

19

•

NOTE. The Certificate in Forms 1A and 2 must be handed to the applicant to be attached to Form 1.