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[接上页] (Chapter 136) (Section 39(4)) CERTIFICATE THAT A PATIENT WHO IS ABSENT ON TRIAL NEED NOT BE FURTHER DETAINED I, .............................................................................................................. , Medical Superintendent of the .......................................................................................... Hospital, certify in accordance with the provisions of section 39(4) of the Mental Health Ordinance that it is not necessary that [name of patient, and, if known, identity card number] ................ ........................................................................................................................................ ........................................................................................................................................ who was detained in that hospital as a *certified patient/patient under observation and who is now absent on trial from that hospital, be detained under the Mental Health Ordinance. Signed .............................................Medical Superintendent Date ............................................... * Delete as appropriate. FORM 10 MENTAL HEALTH ORDINANCE (Chapter 136) (Section 42) APPLICATION FOR DISCHARGE OF A PATIENT BEFORE RECOVERY To: The Medical Superintendent, ..................................................................................... ........................................................................................... Hospital. I, [name and address of *relative/friend] .................................................................... ........................................................................................................................................ ........................................................................................................................................ make application in accordance with the provisions of section 42(1) of the Mental Health Ordinance for the discharge of [name of patient, and, if known, identity card number] ................................................................. from the above-named Mental Hospital. My relationship or connection with the said patient is that of a ................................... I request that the said patient may be delivered over to me. I undertake that the said patient will receive proper care and will be prevented from doing injury to *himself/herself or to others. *I am the person upon whose application the said patient was admitted to a mental hospital. OR *I have given notice of this application to .................................................................. the person upon whose application the said patient was admitted to a mental hospital. Signed ......................................... Date ............................................ * Delete as appropriate. Note: The patient must be discharged within 48 hours unless the Medical Superintendent completes Form 11. FORM 11 MENTAL HEALTH ORDINANCE (Chapter 136) (Section 42) CERTIFICATE OF REFUSAL TO DISCHARGE A PATIENT I, .........................................................................................., Medical Superintendent of ............................................................................................................. Hospital, in pursuance of section 42(1) of the Mental Health Ordinance certify that I refuse to discharge [name of patient, and, if known, identity card number] ...................................... ........................................................................................................................................ a *voluntary patient/certified patient/patient under observation on the grounds that- *I am satisfied that the said patient is dangerous or otherwise unfit to be at large. OR*I am not satisfied that the said patient will receive proper care. Signed ....................................................Medical Superintendent Date ...................................................... * Delete as appropriate. FORM 12 MENTAL HEALTH ORDINANCE (Chapter 136) (Section 42B(3)) NOTICE OF RECALL OF A CONDITIONALLY DISCHARGED PATIENT To: [name of patient, and, if known, identity card number and address] ...................................................................................................... In pursuance of section 42B(3) of the Mental Health Ordinance I, .............................. ......................................, *Medical Superintendent of ...................................................... Hospital/medical officer authorized by the Secretary for Health, Welfare and Food, *recall/call you to ............................................................................................................. Hospital *forthwith/within ...................... days of the date of service of this notice (See Note 1). (a) It appears to me that you have failed to comply with the following conditions to which your discharge on [date] ...................... was subject- |