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09/11/1923: HOSPITAL - FORMS FOR ADMISSION
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No. 41,624—1923.
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To each County Board of Health ; and to all whom it may concern:
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WHEREAS under Articles 16 and 17 of every County Scheme certain orders relating to the examination and admission of persons eligible for relief to hospitals or other institutions provided under a County Scheme are required to be made in prescribed forms:
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And whereas the expression "prescribed" means prescribed by the Minister for Local Government.
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Now therefore, I, the Minister for Local Government in pursuance of the powers given to me by every County Scheme do hereby order and declare that the forms set out in the Schedule to this Order shall be the prescribed forms for the purposes of Articles 16 and 17 of every County Scheme.
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GIVEN under my Seal of Office, this Ninth day of November, in the Year of Our Lord, One Thousand Nine Hundred and Twenty-three.
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(Signed) SÉAMUS DE BÚRCA,
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Minister for Local Government.
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SCHEDULE.
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FORM 1.
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ORDER FOR EXAMINATION OF PERSON APPLYING FOR ADMISSION TO A HOSPITAL.
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To.....................................
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Dispensary or other Medical Officer of the............................................................ ..............................
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County Board of Health............................................................ ...............Dispensary District (if any).
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You are hereby requested to examine............................................................ ............a person eligible for relief and if in your opinion he requires treatment in a hospital, to sign an Order for his admission to such hospital under the control of the Board of Health as you may consider suitable.
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Date....................................
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Member of the.........................................County Board of Health or other authorised person.
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FORM 2.
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ORDER FOR ADMISSION TO A HOSPITAL.
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To the Matron of the..................................County (or District) Hospital.
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I hereby certify that I have this day examined............................................................ ............................................................ .....
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of.................................. a person eligible for relief and that in my opinion he is in need of treatment in a hospital and I hereby require you to admit him to the above-mentioned hospital for treatment therein.
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Dispensary or other Medical Officer of the
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..................County Board of Health.
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..................Dispensary District (if any).
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Date.....................
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FORM 3.
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ORDER FOR ADMISSION TO AN INSTITUTION OTHER THAN A HOSPITAL.
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.........................County.
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To the Matron or other Officer in Charge of the *............................................................ ...........................
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I hereby certify that, to the best of my belief,............................................................ ........................of
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......................is a person in the County eligible for relief who is................................................† and cannot be effectively relieved at less cost to the rates otherwise than in the above-mentioned institution and I hereby require you to admit the said person to the said institution.
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Member of the......................................County Board of Health
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or other authorised person.
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Date......................
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*Here insert name of institution, e.g., "County Home."
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† Here insert description of person in accordance with County Scheme, e.g., "Aged and infirm," "Chronic invalid," etc.
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