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Name. Address. No. of injections
of 2000 units each.
and that the above patient unable to pay for same.
Signature of Medical Practitioner
Address
Signature of Patient
(Or of Guardian if Patient is under 21 years of age).
Address
Unless this form is returned to the Medical Officer of Health at the Council
House, Hounslow, within 14 days from the date hereof, the Medical Practitioner
on whose requisition the supply is obtained will be debited with the cost of
supply and no payment will be made for injections.
It is not necessary that the Medical Practitioner should obtain the signatures
of the patients or patients' guardians. If this form is returned duly signed by
the Medical Practitioner within 14 days, the necessary signatures of patients or
patients' guardians will be obtained by the officers of this department.
Typhoid Fever. Six cases were notified, but five of these
occurred in institutions within the district and had no connection
with the district. The final diagnosis in the remaining shewed
that it was not a case of typhoid fever.
I am sure that the continual vigilance of the Sanitary
Authority as regards nuisances, exerts a powerful influence in