1964_MEDICAL_CLINICS_(FORMS)_REGULATIONS — Page 2

A 2

[Subsidiary] L.N. 47/67.

L.N. 47/67.

CAP. 343]

Medical Clinics (Forms) Regulations

[1980 Ed.

FORM 2

Certificate of Registration of clinic not exempted from section 7 of the Ordinance

MEDICAL CLINICS ORDINANCE (Chapter 343)

CERTIFICATE of Registration No.

(Valid until 19 >)

[reg. 3.]

THIS IS TO CERTIFY that the undermentioned clinic is registered in the register of clinics under the Medical Clinics Ordinance-

Particulars of clinic-

Name (In English)

(In Chinese)

Address

Particulars of person registered in respect of above clinic-

Name (In English)

(In Chinese)

Address

Particulars of registered medical practitioner appointed pursuant to section 7 of the Medical Clinics Ordinance-

Name (In English)

(In Chinese)

Address

Note: Registration of the above-named person in respect of the above-named clinic is subject to the conditions specified (here indicate where conditions are specified, e.g. overleaf, or in the annexure hereto marked or as the case may be).

Dated this day of 19.........

Registrar of Clinics

FORM 3

Certificate of Registration of clinic exempted from section 7 of the Ordinance

MEDICAL CLINICS ORDINANCE (Chapter 343)

CERTIFICATE OF REGISTRATION AND EXEMPTION No.

(Valid until 19 >)

[reg. 3.]

THIS IS TO CERTIFY that the undermentioned clinic is registered in the register of clinics under the Medical Clinics Ordinance, but is exempted from the provisions of section 7 of the aforesaid Ordinance-

Particulars of clinic-

Name (In English)

(In Chinese)

Address