 | 1854 - 752 sider
...Sub-district (a» the Case may bej. SCHEDULE (D.) I, the undersigned, hereby certify, That I am of opiuion, That the child of of the parish of in the County of...(or other Medical Practitioner, as the Case may be}. MEDICAL AGENTS. Ми. BOWMEK, 50, Lincoln'8-Inn-FioldB. Мк. JACOBSON, 38, Walbrook, Clieapsidc. MESSRS.... | |
 | 1855 - 676 sider
...certify, that I am of opinion that , of , in the parish of , in the county of [or that , the child of . in the parish of , in the county of ], is insusceptible of the vaccine disease. Dated this day of ,16 . (Signed) AB [insert medical titles.'] SCHEDULE (c). I, the undersigned, hereby certify, that... | |
 | 1853 - 710 sider
...t 185 . JB Registrar of Births and Deaths for the sub district, (as the case may be). SCHEDULE (D). I, the undersigned, hereby certify, that I am of opinion, that , the child of ,_of the parish of , in the county of . is insusceptible of the Vaccine Disease. Dated this day of... | |
 | William Golden Lumley - 1859 - 628 sider
...AS Surgeon of the Union or Parish (or other medical practitioner, as the case may be). SCHEDULE (B.) I, the undersigned, hereby certify, that I am of opinion that , the cliild of , of the parish of , in the county «f , aged , is not now in a fit and proper state to be... | |
 | Canada - 1860 - 1118 sider
...do hereby postpone the vaccination until the day of (Signed,) AB Dated this day of , 186 . FORM C. I, the undersigned, hereby certify that I am of opinion that , the child of , of Ward, in the City of , is insusceptible of the vaccine disease. (Signed,) AB Dated thi« day of , 186'... | |
 | Canada - 1861 - 418 sider
...do hereby postpone the vaccination until the day of (Signed,) AB Dated this day of , 186 . FORM C. I, the undersigned, hereby certify that I am of opinion that , the child of , of Ward, in the City of , is insusceptible of the vaccine disease. (Signed,) AB Dated this day of , 186... | |
 | Prince Edward Island - 1862 - 658 sider
...and I do hereby postpone the vaccination until the day (Signed) AB Dated this day of 186 FORM (C.) I, the undersigned, hereby certify, that I am of opinion that the child of of is unsusceptible of the vaccine disease. (Signed) AB Dated this day of 186 CAP. XXIII. An Act for vesting... | |
 | Great Britain - 1863 - 1184 sider
...Officer of the Dispensary District (or other Medical Practitioner, as the Case may be). SCHEDULE (B.) I, the undersigned, hereby certify, That I am of opinion that the Child of of in the County of aged is not now in a fit and proper State to be successfully vaccinated, and I do... | |
 | Thomas Baker - 1865 - 714 sider
...AB Surgeon of the union or parish (or other Medical Practitioner, at the case may be). SCHEDULE (B.) I, the undersigned, hereby certify, that I am of opinion...that the child of of the parish of in the county of aged is not now in a fit and proper state to be successfully vacciLatfd, and I do hereby postpone the... | |
 | Charles Glackmeyer, Montreal, P.Q. City Council - 1865 - 544 sider
...the City of , has been successfully vaccinated by me. (Signed,) AB Dated this day of , 186 . FORM B. I, the undersigned, hereby certify that I am of opinion that , the child of , of Ward, in the City of , aged ' , is not now in a fit and proper state to be successfully vaccinated,... | |
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County of aged is not now in a fit and proper State to be successfully vaccinated, and I do hereby postpone the Vaccination until the Day of Dated... 
