bodily health to be removed to an asylum, hospital, or licensed house (k).
5. I give this certificate having first read the section of the
Act of Parliament printed below.
Signed____________________________________
of (l)_____________________________
Dated this __________ day of ________ 19__
Lunacy 8.
53 Vict. c. 5, ss. 4, 11, 16, 28, 29.
Extract from section 317 of the Lunacy Act, 1890.
Any person who makes a wilful misstatement of any material
fact in any medical or other certificate or in any statement or
report of bodily or mental condition under this Act, shall be
guilty of a misdemeanour.