amp doy 2 @ (9) that X charged and roe Mrs Air efilisn. TCATE 3 caRtt nq couse of + foe troatmy.t) (9 be completed in ateitted te hospite Lr that % charged and necived Bs conmilt (Gates to be “given at CeELNGe see eesenaah wei ons admtae 28 (c) that the patient is/was suffering’ from. and is/was under ny treatment from. sect e (Q that the pationt is/ias not given prenatal o7 post-natal treatmant» (g) that the x: texy test, ete. for vhich an expenditure 0: was incurred were necess: and were undn-caken on my advice at 1 labo: s(tame of hospital ox laboretomy) “(h) that I referred the paticnt to Ds aist consuitecion ond Ekot 3 required under tho mules (Administrative Medical, State) -. (Gi) that the pa it did not required hospital. voquired Signature & Designa:ion of the Medical Officer ana the hospital Aispensary to vhich ateecned. cates not applicable should be struck off. Certificate (a) is cor mast be filled SOUND RASEGUER, Medical suporintand teteeeeeveeescloapitah + certify that the patient hes boon under trontmat at che 5 peeeeee : spital and that ‘the facilitias provided were essential for the pstisnt's treatment. which were Place. atondent Date Hospital