the-ordinances-of-the-legislative-counci-1890v3 — Page 507

1790 ORDINANCE No. 6 OF 1884.


Medical Registration.


Form B.

I, A.B., residing at
do hereby
declare, that I am a member (or as the case may be) of (here state the college, faculty ,
or society) and was authorised by such (here state the college, faculty, or society which
gave the authority) on the day of 18 , to practise
medicine and surgery, and that I am by the name of A. B. , duly registered in the
United Kingdom under the provisions of the Act 21 and 22 Victoria, chapter 99, as
qualified to practise medicine and surgery.

Signed A. B.

Declared before me this day of 18


C.D. , Justice of the Peace ,




Form C.

I , A.B. , Colonial Secretary, do hereby certify that C.D. has satisfied me that he is
a medical practitioner, registered as such, and entitled to practise medicine and surgery
in (name of Colony) , and I give this certificate accordingly under section 12 of the
Medical Ordinance , 1884.

Dated this day of 18

A. B.,
Colonial Secretary.




Form D.

We, the medical board, do hereby certify that A.B. has satisfied us that he is a
medical practitioner, holding a diploma (or as the case may be) (granted to him by as
the case may be) in consequence of his having passed through a course of study and
examinations as thorough and sufficient as is the minimum course in such a case
approved by Her Majesty's Most Honourable Privy Council under section 21 ofthe
Act of Parliament 21 and 22 Victoria, chapter 90, and we give this certificate accord
ingly under section 13 of the Medical Ordinance , 1884.

Dated this day of 18

(To be signed by a majority of the Board) .