1964_TERMINATION_OF_PREGNANCY_REGULATIONS — Page 11

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1982 Ed.] Termination of Pregnancy Regulations

[CAP. 212

15.

Was sterilization performed?

Yes

Complications or death prior to notification-

16.

(a) None

(b) Sepsis

(d) Death

(e) Other (specify)

17.

In the case of death, specify the cause-

Now: This form is to be completed by the operating medical practitioner and sent in a sealed and confidential envelope not later than 3 days after the termination of the pregnancy to the Director of Medical and Health Department, Hysan Avenue, Hong Kong.

機

表格三

(中斷妊娠規例第四條)

侵害人身罪條例

(香港法例第二一二章)

根據條例第四十七A條施行中斷妊娠手術後向醫務衛生署署長申報之通知書

本人……

地址為

茲申報:本人已替孕婦

(用楷書填寫醫生姓名及學歷)

(醫生之詳細地址)

(用楷書填寫孕婦全名)

地址為……

(用楷書填寫孕婦通常居住之地址)

……

.施行中斷妊娠手術。

手術日期,

.時間……

必須施行中斷妊娠手術之理由業經證明如下

該孕婦如繼續懷孕,對性命所造成之危險較中斷妊娠爲大;

該孕婦如繼續懷孕,身體或精神所受之損害較中斷妊娠爲大;

如讓嬰兒誕生,則該嬰兒大有可能身體或精神不健全而致嚴重傷殘。

All

[Subsidiary]

(Ring appropriate answer)

(Ring appropriate letter)

甲,(此欄必須填寫)

乙、(此欄必須填寫 )

( 圈出一項適當者)

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1982 Ed.] Termination of Pregnancy Regulations [CAP. 212 15. Was sterilization performed? Yes Complications or death prior to notification- 16. (a) None (b) Sepsis (c) Haemorrhage (d) Death (e) Other (specify) 17. In the case of death, specify the cause- No Now: This form is to be completed by the operating medical practitioner and sent in a sealed and confidential envelope not later than 3 days after the termination of the pregnancy to the Director of Medical and Health Department, Hysan Avenue, Hong Kong. 機表格三 (中斷妊娠規例第四條) 侵害人身罪條例 (香港法例第二一二章) 根據條例第四十七A條施行中斷妊娠手術後向醫務衛生署署長申報之通知書本人…… 地址為茲申報:本人已替孕婦 (用楷書填寫醫生姓名及學歷) (醫生之詳細地址) (用楷書填寫孕婦全名) 地址為…… (用楷書填寫孕婦通常居住之地址) …… .施行中斷妊娠手術。手術日期, .時間…… 必須施行中斷妊娠手術之理由業經證明如下該孕婦如繼續懷孕,對性命所造成之危險較中斷妊娠爲大; 該孕婦如繼續懷孕,身體或精神所受之損害較中斷妊娠爲大; 如讓嬰兒誕生,則該嬰兒大有可能身體或精神不健全而致嚴重傷殘。 All [Subsidiary] (Ring appropriate answer) (Ring appropriate letter) 甲,(此欄必須填寫) 乙、(此欄必須填寫 ) ( 圈出一項適當者)

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1982 Ed.] Termination of Pregnancy Regulations [CAP. 212 15. Was sterilization performed? Yes Complications or death prior to notification- 16. (a) None (b) Sepsis (c) Haemorrhage (d) Death (e) Other (specify) 17. In the case of death, specify the cause- No Now: This form is to be completed by the operating medical practitioner and sent in a sealed and confidential envelope not later than 3 days after the termination of the pregnancy to the Director ofodieal-und- Heshir Servimen edical-and-Health-Department, Hysan Avenue, Hong Kong. 機表格三 (中斷妊娠規例第四條) 侵害人身罪條例 (香港法例第二一二章) 根據條例第四十七A條施行中斷妊娠手術後向警衛生署署長申報之通知書本人....... 地址為茲申報:本人已替孕婦 (用楷書填寫醫生姓名及學歷) (醫生之詳細地址) (用楷書填寫孕婦全名) 地址為.. (用楷書填寫孕婦通常居住之地址) #... .施行中斷妊娠手術。手術日期, .時間.... 必須施行中斷妊娠手術之理由業經證明如下該孕婦如繼續懷孕,對性命所造成之危險較中斷妊娠爲大; 該孕婦如繼續懷孕,身體或精神所受之損害較中斷妊娠爲大; 如讓嬰兒誕生,則該嬰兒大有可能身體或精神不健全而致嚴重傷殘。 All [Subsidiary] (Ring appropriate answer) (Ring appropriate letter) 甲,(此欄必須填寫) 乙、(此欄必須填寫 ) ( 圈出一項適當者)

2026-05-05 14:23:06 · Baseline

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