1950_NURSES_REGISTRATION_REGULATIONS — Page 22

CAP. 164]

Second Schedule, cont.

I

Nurses Registration.

To the NURSES BOARD FOR THE

COLONY OF HONG KONG.

I,

born at

(Full Christian name and surname.)

on

(Place and date of birth.)

(State whether married, single or widow. If married or widow, give maiden name.)

(Full permanent postal address.)

hereby request the Nursing Board for the Colony of Hong Kong to enter my name upon the Part of the register for

...nurses maintained by the board.

I forward herewith the fee of $25 and I promise, in the event of my being so registered, and in consideration thereof, to be bound by and to conform in all respects to the rules and regulations for the time being in force.

I forward herewith particulars of my training and certificates which I have received.

I am further prepared to produce such evidence as the board may require to establish my identity and good character and to undergo any examination upon any subject or subjects which the board may consider necessary in accordance with the provisions of subsection (2) of section 5 of the Ordinance.

Reg. No.

THIRD SCHEDULE.

[reg. 17.]

NURSING BOARD FOR THE COLONY OF HONG KONG.

NURSES REGISTRATION ORDINANCE.

(Chapter 164 of the Revised Edition).

I hereby certify that

was admitted by examination on

to the General Part of the Register maintained by the Nursing Board for the Colony of Hong Kong and that she is entitled, in pursuance of the Nurses Registration Ordinance to take and use the title of "Registered Nurse".

SEAL

OF THE BOARD.

262

Chairman of the Board.