1964_MEDICAL_PRACTITIONERS_(REGISTRATION_AND_DISCIPLINARY_PROCEDURE)_REGULATIONS — Page 20

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CAP. 161]

Medical Practitioners (Registration and Disciplinary Procedure) Regulations

[1982 Ed.

[Subsidiary]

L.N. 171/70. L.N. 81/71.

FORM 3

[reg. 6.]

MEDICAL REGISTRATION ORDINANCE

(Chapter 161)

MEDICAL PRACTITIONERS (REGISTRATION AND DISCIPLINARY PROCEDURE) REGULATIONS

APPLICATION FOR REGISTRATION AS A REGISTERED

MEDICAL PRACTITIONER

L.N. 330/82.

of

I,

apply for registration as a registered medical practitioners in accordance with section 14 of the Medical Registration Ordinance.

2. I have not been convicted in Hong Kong or elsewhere of any offence punishable with imprisonment, nor have I ever been found guilty of misconduct in a professional respect.

I hold the following qualifications--

L.N. 42 71. L.N. 81 71.

and have had the experience prescribed in the Medical Registration Ordinance. Declared at Hong Kong

this

day

of

19

Before me.

Barrister-at-law, Commissioner for Oaths, Justice of the Peace, Minister of Religion, Registered Medical Practitioner or Solicitor. Hong Kong.

Photograph

FORM 3A

MEDICAL REGISTRATION ORDINANCE

(Chapter 161)

[reg. 6.]

MEDICAL PRACTITIONERS (REGISTRATION AND DISCIPLINARY PROCEDURE)

REGULATIONS

APPLICATION FOR REGISTRATION AS A REGISTERED MEDICAL PRACTITIONER BY A RESIDENT OUTSIDE

I.

HỒNG KONG

of

apply for registration as a registered medical practitioner in accordance with section 14 of the Medical Registration Ordinance.

2. I have not been convicted in Hong Kong or elsewhere of any offence punishable with imprisonment, nor have I ever been found guilty of misconduct in a professional respect.

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