1614
[Sched. contd.]
No. 12 of 1923.
+
VACCINATION.
FORM NO. 3.
[s. 12 (3).]
Hong Kong.
Certificate of successful vaccination other than for a child.
I, the undersigned, hereby certify that I have personally vaccinated [fill in name and sex of person vaccinated] of
and that I have this day satisfied myself by personal inspection that the operation was successful.
Dated the day of , 19
(Signed)
Health Officer, Registered Medical Practitioner or Public Vaccinator.
N.B.-No fee is payable to any public vaccinator for this vaccination or the granting of this certificate.
Hong Kong.
FORM NO. 4.
[ss. 14 (6), 22.]
Certificate of successful vaccination of child.
I, the undersigned, hereby certify that I have personally vaccinated [fill in name, if any, date of birth, sex and parentage of child] of
and that I have this day satisfied myself by personal inspection that the operation was successful.
Dated the day of , 19
(Signed)
Health Officer, Registered Medical Practitioner or Public Vaccinator.
N.B.-No fee is payable for this certificate. This certificate must, within seven days after the date thereof, be produced by the guardian of the child to the Registrar General of Births and Deaths.
* As amended by No. 21 of 1934 [10.8.34].
† As amended by Law Rev. Ord., 1939, Supp. Sched.
1614
[Sched. contd.]
No. 12 of 1923.
+
VACCINATION.
FORM NO. 3.
[s. 12 (3).]
Hong Kong.
Certificate of successful vaccination other than for a child.
I, the undersigned, hereby certify that I have personally vaccinated [fill in mame and sex of person vaccinated] of
and that I have this day satisfied myself by personal inspection that the operation was successful.
Dated the
day of
(Signed)
19
Health Officer, Registered
Medical Practitioner or Public Vaccinator.
N.B.-No fee is payable to any public vaccinator for this vaccination or the granting of this certificate.
Hong Kong.
FORM NO. 4.
[ss. 14 (6), 22.]
Certificate of successful vaccination of child.
I, the undersigned, hereby certify that I have personally vaccinated [fill in name, if any, date of birth, sex and parentage of child] of
and that I have this day satisfied myself by personal
inspection that the operation was successful.
Dated the
day of
, 19
(Signed)
Health Officer, Registered
Medical Practitioner or Public Vaccinator.
N.B.-No fee is payable for this certificate. This certificate must, within seven days after the date thereof, be produced by the guardian of the child to the Registrar General of Births and Deaths.
* As amended by No. 21 of 1934 [10.8.34].
† As amended by Law Rev. Ord., 1939, Supp. Sched.
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