Registration of Births and Deaths Act 1874 (SA)

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ANNO TRICESIMO SEPTIMO ET TRICESIMO OCTAVO

A.

D. 1874.

No. 10.

An Act to amend the Law relating to the Reyistration of Births

aud Deaths in the Province of Hoouth Australia.

[Assented to, 6th November, 1874.1

HEREAS it is expedient to amend the Law relating to the Preamble.

W Registration of Births and Deaths in the Province of South Australia-Be it therefore Enacted by the Governor of the Yro- vince of South Australia, with the advice and consent of the Lcgis- lative Council and House of Assembly of the said Province, in this present Parliament assembled, as follows:

1. From and after the passing of

this Act, (' An A ct to amend Repeal of A ~ E ~ O.

3.

the law relating to Registering of

Births, Deaths, and Marriages in of 1865-6.

the Province of South Australia," being No. 3 of l85 5-6, so fhr as the same has not already been repealed, shall be and the same is hereby repealed: Provided always, that all acts done, proceedings taken, births and deaths registered, rights acquired, and liabilities incurred under, by virtue, or pursuant to the said Act, shall not be impeached, invalidated, or destroyed by virtue of this repeal, in any wise howsoever.

2. Every birth and death whereof the registration or an entry Validation of pte~ioua

re~i"ration. be deemed to be, for all purposes whatsoever, a legal and valid registration of the birth or death, as the case may be, whereof any such entry purports to be a registration, and shall he and Fe deemed to have been, for all purposes ahatsoever, legally and duly made: Provided always, that no fraudulent registration or entry of any

appears in the books of registry in the custody of the Renistrar-

Q

such

\

37" & 38"ICTDRIB,

No. 10.

The Registration of Births and Deaths Act.-1874.

such birth or death shall be or be deemed to be hereby vali-

dated.

Regietrar-General of

Births, &C., and

3. The present Registrar-General of Birtbs and Deaths, and the

Deputy Registrar to

present Deputy Registrar of Births and Deaths, shall respcctiveIy

be Registrar-General

and Deputy Re&trar

be Registrar-General and Deputy Registrar respectively of Births

under this Act.

and Deaths under this Act, and the present office in the City of Adelaide for keeping the General Register of Births and Deaths shall be the General ~ e ~ i s ~ ~ ~ c e of Births and Deaths under this Act: Provided always that the Governor, from time to time as he shall think fit, may appoint persons to and remove persons from such offices of Registrar-General and Deputy Registrar respectively, and may declare any building to be the General Registry Office of Births and Deaths.

into districts and

Division of Province

4. The Governor shall, within three months after the passing he shall think fit, and from time to time thereafter may alter the boundaries of any such district, or reduce the size thereof, or create new districts, and every such district shall have a distinct name: Provided always that until such division of the said Province into districts under this Act, all the Regimars' Districts duly created under the Act hereby repealed shall be and be deemed to be Registrars' Districts under this Act, and the District Registrars of such districts, duly appointed under the said Act, shall be and be deemed to be District Regietrars for such last-mentioned districts under this Act, and shall exercise the funckions and perform the duties by this Act prescribed: Provided always, that the Governor may from time to time remove such Registrars.

appointment of Die.

of this Act, by Proclamation to be published in the Gocernment

trict Registrars.

Gazette, divide the said Province into such and so many districts as

District Registrare

5. The Governor may from time to time appoint a District Registrar for any Registrar's District, and may remove any such Registrar from his ofice, and appoint some other person as District Registrar in his stead, and such appointment or removal shall be

may be appointed.

duly notified in the Governmefit Gazette.

Auaiatant Registrars

6. The Registrar-General may appoint Assifitant Registrars of Births and Deaths in the several Registrars' Districts of the said Province, who shall register the births and deaths which take place in their said several districts, and shall forward every such registra- tion within seven days from the date thewof to the District Rcgie- trar of the district within which such tirths aud deatha may have occurred as aforesaid.

.

may be appointed,

In oaae of illness or

'7.

In case of the illness or unavoidable absence of the Registrar-

unavoidable abaence

General, or of the Deputy Registrar, or of any District Registrar

of

Registrar- General,

Deputy Registrar,

District Begistrar, or

or Assistant Registrar, the Governor may appoint, by writing under

Assistant Registrar,

his hand, a fit person to act in the place and stead of such Regis-

a fit person to be ap-

pointed in place or

trar-General, Deputy Registrar, District Registrar, or Assistant

stead of.

Registrar, and such person while so acting shall exercise and per-

form

37" & $8" VICTO'ItIA3, No, 10.

The Registration of Births ad Deaths Act--1874.

form all the powers and duties, and be sabject to ail1 the liabilities hereby imposed upon the Registrar-General, Deputy Registrar, Dis- trict Registrars, or Assistant Registrars.

Thc Registrar-General shall be, and he is hereby charged with, the due administration of all and singular the powers, duties, and

Registrar-General

may make regula-

tion~.

authorities conferred by this Act, and may make rules and regu-

lations-

8.

For the management of the General Registry Office and of the

offices of District Registrars and Assistant Registrars:

For prescribing, subject to this Act, the duties of District Regis- trars and assistant Registrars, and the manner of perform-

ing and fulfilling the same:

For the departmental working of this Act:

And generally for carrying out and enforcing the provisions of

this Act in an effectual manner; and such rules and regu- lations, when approved by the Governor, shall be binding and obligatory upon the Registrar-General, the Deputy Registrar, and upon all District Registrars and Assistant Registrars.

9. The Registrar-General, the Deputy Registrar, District Registrars, and Assistant Registrars, for the time being acting

Regiatrarrr under this

Fees to he levied by

Act.

under this Act, shall levy and receive the several fees authorized to be collected by them under and by virtue thereof, and the same shall be applied in ma8nner hereinaft& provided.

10. The Registrar-General and Deputy Registrar are hereby authorized to register births and deaths that may have occurred in

Registrar-General and Deputy-Registrar

to register births and

ally district of the said Province.

deaths.

11. Every District Registrar and Assistant Registrar of every district shall, and he is hereby authorized and requ~red

Birtha to be registered

according to the form

to, inform

in First Schedule to

himself carefully of every birth that shall happen within the district

the Act.

for which he is appointed, and to ascertain and register, so soon

after the event as can conveniently be done, without fee or reward,

save as herein~fter mentioned, the particulars required to be regis-

tered concerning every such birth according to the form in the

First Schedule to this Act.

12. Every District Registrar and Assistant Registrar of every district shall, and he is hereby authorized to, inform himself care-

according to the form

Deaths tobe registered

in Second Schedule.

fully of every death which shall happen within the district for which

he is appointed, and to ascertain and register so soon after the event

as conveniently can be done, without fee or reward, save as herein- after mentioned, the particulars required to be registered concerning every such death, according to the form in the Secoud Schedule to this Act.

13. The father or mother of any child born, or the occupier of

Parente or oocupiere

every

of houaee in whiah

L

82 37" & 38" VICTOIRIB, No. 10.

The Registration of Births and Deaths Act.-1 874.

4

birth happen, or

petaon finding new-

every house or tenement in the said Province or its dependencies, in

bomSchild exposed,

which any birth shall happen, or any person authorized by such

requlredtogivenohce father, mother, or occupier, shall, in case of the birth of a child,

to Begrstrar.

within forty-two days next after the day of such birth, give notice thereof to the Registrar-General, Deputy Registrar, or to the District Registrar, or to any Assistant Registrar of the district wherein such birth occurs, and shall state, to-the best of his or her knowledge and belief, the several particulars required by the said First Schedule touching such birth; and in case any new-born child shall be found exposed, the constable of or resident within the district where such child shall be found, or the person bv whom such child shall be found, shall forthwith give notice and information thereof, and of the place where such child was found, to the District Registrar of the district wherein such child was found; and for the purposes of this Act the master or keeper, or officer in charge, of every gaol, prison, or house of correction, iiospital, lunatic asylum, or public or charitable institution, shall be deemed to be the occupier thereof; and every such father, mother, occupier, or person neglecting to give notice, and every such constable or person so finding a new- born child exposed, neglecting to give notice and information shall, upon conviction, forfeit and pay a pexalty of not more than Ten Pounds for every such offence.

Parents or accupiera

14. The father or mother of every child which shall die, or the occupier of every house or tenement in the said Province, or its depen.clencies, in which any death shall happen, or any person authorized by such father, mother, or occ~apier shall, within ten days after the day of such death, give notice thereof to the Registrar- General, Deputy Registrar, or to the District Registrar, or to any Assi~tant Registrar of the district wherein sucl: death takes place, and shall state, to the best of his knowledge and belief, the several particulars required by the Second Schedule to this Act touching such death; and in case any dead body shall be fo~md exposed, the

to

deaths.

give notice of

Conatable or Coroner

constable or Coroner, who may institute inquiries with reference to,

to give notice of dead

bodies which may be

and the Coroner who ma,y hold an inquest upon such body, s h d

found.

forthwith give notice and information thereof, and ot the place

cause of death, to the District Registrar of the district wherein such where suCbody was found, together with a certificate of supposed

body happens to be found; and for the purposes of this Act, the

master, or keeper, or officer in charge of every gaol, prison, or house of correction, hospitsl, lunatic asylum, or public charitable iustitu- tion, shall be deemed tso be the occupier thercof. and every such father, mother, occupier, or person or constable, neglecting to give notice, and the Coroner, in the case of the finding of a dead body, neglecting to give such notice and certificate as aforesaid, shall,

upon conviction, forfeit and pay a penalty of not more than Ten

Pounds for cvery such offence.

In default of registry

15. In case any birth or death shall not have been registered

within ten or forty-

within such periods of forty-two days or ten days, as the case may

,

,

,

,,,

to c& on parties.

be, it shall be lawful for the Registrar-General, Deputy Registrar,

37" & 38" VICTORIB, No. 10.

The Registration of Births and Deaths Act.-1874.

or for any District Registrar, or Assistant Registrar to call upon

and require such parent, occupier, constable, Coroner, officer, or

any person present at or cognizant of such birth or,death, to makc a solemn declaration of' the particulars required to be known touching slxh birtli or death, according to the best of his or her knowledge and belief, and it s l d l be lawful for the Registrar- General, Deputy Registrar, or District Registrar, or Assistant Registrar thereupon to register such birth or death according to the particulars so ascertained; and the parent, occupier, district constable, Coroner, officer, or other person so called upon as aforesaid, shall pay to the Registrar-General, Deputy Registrar, or District Registrar, or Assistant Registrar, Two Shillings and Sixpcncc; Penalty for negleotmg

and every parent, occupier, constable, Coroucr, officer, or other person E $ ~ ~; ~ $ ~ ~ h t,

who, when so called upon by the Registrar-General, or District

Registrar, shall neglect to state such particulars, or shall knowingly malre a false statemerit thereof, shall, for every such offence, fbrfeit and pay a sum not exceeding Fifty Pounds.

16. In the case of any child born at sea, or in m y part of Registration of birth

Australasia, other than the said Province or its depeudencies, of at"a. rewired to be civen. then and there to rerister the birth of such

.,

1 1

parents whose ordinary place of abode is within the said Province,

it sliall be lawfir1 for the Registrar-Gcnerd, Deputy Registrar, or

for a District Rcgistrar, or any Assistant Registrar, upon a solemn

declaration made hy the father, mother, or guardian of such child,

or by such other person as shall be approved of by the Registrar-

General, Deputy Registrar, or District Registrar, or Assistant

ehfid according to su& information; and that nothing in the pre - Nothing in the pre-

ceding sections relative to the registration of births contained, shall $ b ", ~ ~ ~ ~ ~ $ ~ ~

be taken to exclude from registration the birth of any child born tion of the bwth of

within the said Province or its dependencies, or in any part of Aus- ,,id I'rolince, or at

any child born in the

tralasia othcr than the said Province, or at sea, within six months sea, six months pro-

previously to the commencement OF this Act; but it shall and may ,,n,,,,,f,~i,

vious to the corn-

be lawful for the parent or guardian of any such child to cause its Act.

birth to be rcgisteied under &e same prov&ions as by this Act are

attached to the registration of the birth of children born witliin the

said Province subsequently to the commencement of this Act.

17. If any child born ia the said Province or its delxndencies, whose birth shall have been registered as aforesaid, shall, within six months tration of

Name given may be

registered after regis-

after it shall have been so registered, have any name or additional narne given to it iu the presence of the Registrar-General, Deputy Registrar, or of any District Itegistrar, then the Registrar-Gencral, Deputy Registrar, or District Registrar, in whose custod~ the register of the birth of the child may then happcn to be, shall furnish a certificate, according to the fbrm of the Third Schedule to

this Act, which certificate such Registrar is hereby required to deliver

irnniediatcly after the name or additional narne has been given, on payment of the fee of Ten Shilling!, which he shall be therefore entitled to receive; and the District Registrar, upon the giving of

such

84 32" & $8" VXCTORIB, No. 10.

The Registration of Births and Deaths Act.-1874.

such certificate, shall, without any erasure of the original entry, forthwith register therein that the child had such name or additional name given to it in his presence, and the District Registrar shall thereupon notify to the Rgistrar-General the additioual entry so made.

Birthsnotto beregia-

18. After the expiration of six calendar months from the

teredaftersixmoiths birth of any child, b l e s s such child shall have been born at

unless the child has

been born at sea, &C.

sea, or in any part of Australasia othet than the said Province. it shall not 6e lawful for any Registrar to register the birth of such child, and no register or certified copy of a register of births shall be given in evidence to prove the birth of any child except as nfbresaid, wherein it shall appear that six calendar months have intervened between the day of the birth and the day of the registra- tion of the birth of such child; and every person who shall knowingly register or cause to be registered the birth of any child, except as hereinbefore provided for, after the expiration of six calendar months following the day of the birth of such child, shall forfeit and pay for every such offence a sum not exceeding Fifty Pounds.

Registrars to give

19. The ltegistrar-General, the D e p t y Registrar, and over7 registering any death, or as soon thereafter as he shall be required so to do, shall, without fee or reward, deliver to the

of death to under-

registq District Registrar, or Assistant Rckistrar, immediately upon

taker, who shall

deliverthes""e

the pcrson having

charge ofplace of

undertaker, or other person having chwge of the funeral, s certifi-

burial.

Coroner may

cate under his hand, according to the form of

the Fourth Schedule

order

to be

buried, and give cer- to this Act, that such dcath has been duly registered, and such

tificate thereof.

No

certificate shall be delivered by such undertt~ker,

or other person,

dead boas to be

b~"edwith?t~ertifi-

to the person legally having c h a r ~ e

of the place of burial; and if any

cate of registry or of

inquest. PenaltpTen dead body shall be buried for whlch no certificate shall have been so

P O U ~ ~ E. delivered; the person who shall bury, or who shall in any other way

dispose of the body, sball forthwith give notice thereof to the Regis- trar-General, Deputy Registrar, or District Registrar, or Assistant Registrar respectively, as the case may be: Provided always, that the Coroner, upon holding any inquest, may order the body to be buried, if he shall think fit, before the registry of the death, and shall, in such case, give a certificate of his order, in writing under

his hand, according to the form of the Fifth Schedule to this Act,

to such undartakc; or other person having rhmge of the funeral;

which shall be delivered as aforesaid; and every person who shall bury any dead body, for which no certificate sball have been duly made and delivered as aforesaid, either by the Registrar-General, Deputy Registrar, District Registrar, or Assistant Registrar, or Coroner, arid who shall not within ten days give notice thereof to the Registrar-General, Deputy Registrar, District Registrar, or Assistant Registrar, shall forfeit and pay for every such offence a penalty or sum not exceeding Ten Pounds.

Medicalprnctitionerto

20. Every medical practitioner who shall have been in attend-

aO*ifr

came ordeath* ance upon any person deceased, or who shall have examined the

body shall, OQ such decease or examination, immediately forward to

the

37" & 38" VICYTORIB, No, 10.

--

The Registration Q f Births and Deaths Act.-1874.

the Registrar-General, Deputy Registrar, or District Registrar, or Assistant Registrar, a certificate under his hand, according to the form in the Sixth Schedule to this Act, setting forth to the best of his knowledge and belief the cause of death; and any such medical practitioner refusing or neglecting to qive such certificate shall be liable to a penalty of not more than F& Pounds nor less than Two Pounds,

Every person by whom the information required for registering any birth or death under this Act shall have been given, shall sign ,ioll,

Informant to sign

certificate o f regiatra-

2 1.

or attest his or her name and place of abode in the certificate of registration, which shall in all cases be made in duplicate by the Registrar-General, Deputy Registrar, District Registrar, or Assis- tant Registrar, according to the First or Second Schedules to this Act, as the case may be, and the Assistant Begistrar shall forward to the District Registrar all certificates of registration in dupli- cate within seven days from the dste thereof, and the District Registrar shall certify therein that such has been duly entered at the office of the District Registrar, and shall thereupon file oue original of such certificates in his office, and forward the other to the Registrar-General in Adelaide, to be there filed by him; and ~egistrar-Generaland

District Registrars o f

the Registrar-General and District 'Itegistrars shall carefully pre- B.

I C ~ ~ S

and Deaths to

serve all such certificates, and classify the registrations of births arrange and preserve

such certificates.

together and the registrations of deaths together, and shall number them in consecutive series according to their dates, and shall from time to time cause them to be so arranged and to be bound in con- venient volumes to constitute respectively the General and District Registers of Births and Deaths.

22. After the expiration of six calendar months from the death Regietrationsof death

of any person, unless such person shall have died at sea, or B~xmunfh8hsre!apsed

not to be made after

in. some pnrt of Australasia othr;r than the said Province, it sincedeath-

shall not be lawful for any Registrar to register the death of such person, and no register or certified copy of a register of deaths shall be given in evidence to prove the death of any person except as aforesaid, wherein it shall appear that six calendar months have

intervened between the day of the death and the day of the registra-

tion of the death of such person; and every person who shall

knowingly register or cause to be registered the death of any person, except as hereinbefore provided for, after the expiration of six calendar months followirig the day of the death of such person, shall forfeit and pay for every such offence a sum not exceeding Fifty Pounds.

The Registrar-General and every District Registrar shall cause indexes of the register books in his office to be made and kept with ,,

Indexcs to be made. and peraons entitled

23.

amb.

the other records of his office, and everv person shall be entitled at

all reasonable hours to requiri search to*bi made in the said indexes,

and to have a certified copy of any entry or entries in the said regis- ter books under the hand and seal of the Registrar-General, Deputy Registrar, or District Registrar on payment of the fees hereinafter

mentioned,

' .,

37" & 380 VICTORIB, No. 10.

The Registration of Births and Deaths Act.-l 874.

mentioned, that is to sap-for any search the sum of One Shilling, and for every such certified copy the sum of Two Shillings and Sixpence; but no person other tlkn the Registrar-General, Deputy Registrar, District Kegistrar, clerk in or officer of the General or some District Registry Office, shall 1~ entitled to personally search the indexes, books, or entries of any register office.

Certiiea copiee sealed

24.

All certified copies of eritries purporting to be under the hand and seal of the Registrar-General or Deputy Registrar as aforesaid,

Or

seal of the Registrar-

with the

General or Deputy-

shall be received as evidence in any Court of Justice within the

evidence.

said Province or its dependencies of the birth or death to which the same relates, without any further or other proof of such entry; and upon a certificate being made by the Registrar-Geueral that the register of births or deaths for any specified period, or for any particular district, is lost or destroyed, then and in all such cases the certificate of such Registrar-General ander his hand and seal of office shall be received as evidence in any Court of' Justice within the said Province of the fact or matter to which the same

relates,

without f ~ ~ r t h e r

proof being req~=ired.

Penalty for wilfully

giving falee informa-

25. Every person who shall wilfuliy make, or cause to be made, for the purpose of being inserred in m y register of births or deaths, any false statement touching any df the particulars hercin required

tion.

to be known and registered, shall, upon conviction, be guilty of a

ruisdemeanor, and be punished with the same pains and penalties

as are attached to the crime cf perjury.

Penalty for des tro~ iw

or faleifying regiater

26. Every person who shall wilfully destroy, or injure, or cause to be destroyed or inju~ed, any such register book, or any part thereof, or shall falsely xake or counterfeit, or cause to be falsely made or counterfeited, any part of any such register book or any certified copy thereof' respectively, or shall wilfully insert or cause to be inserted in any register book or certified copy thereof ally false entry of any birth or death, or shall wilfully give any false certificate, or s11a:l certify any writing to be a copy or extract of any register book, lmowine the same to be false in a n y part thereof,

books.

of any District Registrar or Assistant Registrar shall be guilty of

or shall forge or counterfeit the seal of the ~e~ist&4eneral or

a felony.

Acoidentalerrora may

27. No person charged with the duty of registering any birth or death, who shall discover any error to have been comhitted, or who has committed any error in the form or slibstr~ncc of any such entry, shall be tberefor liable to any of the penalties aforesaid, if within one calendar month next after the discovery of such error, in the pTesence of the parent of the child whose birth may have been so registered, or of the inmate of the house or tenement where the death regis- tered may have occurred, or in case of the death or absence of the respective parties aforesaid, then in the presence of the District Registrar and of two credible witnesses (who ahall respectively attest the same), he shall correct the erroneous entry according to the

be corrected.

Registrar made

, truth

37" & 31)" VICTORIB, No. 10.

-

--

The Registration o f Births and Deaths Act.-1874.

truth of the case by entry in the margin, without any alteration of the original entry, and shall sign the marginal entry and add there- unto the day of thc month and year when such correctiou shall be made, and such District Registrar shall thereupon notifjr the Par-

ticulnxs of such correction to the Kegistrar-Gcneral, who shall

make a marg.in1 entry of such correction in the General Register,

affixing l& slgnaturc, with thc date of such correction.

otherwise directed, shall bc recovered before m y two Justices of the &c.

28. All fines, penalties, and forfeitures by this Act imposed, unless Recovery of penaltiee

Peace in a summary may in the manner provided by the laws of the said Province for regdnting summary proceedings before Justices of the Peace, and any persou feeling aggrieved by any summary judgment or conviction under this Act may appeal therefrom to the Local Court of rldelaide ill its Full Jurisdiction, pursuant to the provisions of the Act No. G of 1850.

29. All fines, penalties, and forfeitures levied and recovered under Applioation of fees,

this Act shall he paid to the Treasurer, to be applied to tllc pub1.i~

uses of the said Province and support of the Governmeat thereof.

30. This Act may be cited for a11 purposes as " The lslegistratiom Short title.

of Births and Deaths Act, 1874."

In thc name and on bchnlf of Her Majcsty, 1 hcrcby assent

to this Bill.

A. MUSGRAVE, Governor.

THE

88

3'7" & 38" VICTORIB, No. 10.

-

The Registration of Births and Deaths Act.-1874.

THE FIRST SCHEDULE.

I

1s

.

District of

l

Entered at

Rcgistry Office, this

2ay of

18

..

, Registrar.

THE SECOND SCHEDULE.

Certtjicate of Death.

I

18 .

District of

l

-

Signature,

Rank

or

1

Sigr$ture

Cause of

fiescriptlon,

'L2

IeX.

*ge.

profeaalon.

e

.

dcatli.

P

l

a

and redence

~

~

~

lecur.ed.

of informant.

---

--

_ _ - - - _ _ - -

----l

\

Entered at

Registry Office, this

day of

.l8

,

, Registrar.

THE THIRD SCHEDULE.

1, A.B., Registrar of

, do hereby ceriifj~

that thc name of (Thornas] hath

this day been given to a male child produced to me by [Will lam Green], as the son of [ TViZliam Green] and &becca Greev*], and declared by thc said [ TViliiam Green)

to have bccn born at

on tht;

day of

18

.

Witness my hand this

day of

18

.

(Signed)

A. B., ltegistrar.

THE FOURTH SCHEDULE.

I, A.B., District (or Assistant) Registrar of Births and Deaths in the District of

,

do heraby ccrtify that the death of [Henry Hastings] was duly

registered by me on the

day of

18

.

Witness mv hand this

dav o f

18

.

(Signed)

A. B., District Registrar.

THE

37" & 380 VICTOkrCTB, No. 10.

The Registration of

Births and Deaths Act.-1874.

THE FIFTH SCHEDULE.

I, LJohn

T J a ~ n e r

Nicholls~, Coroner for the District of

d o

hereby order the burial of the body now shown to the inquest-jury as t he body of [Thornas Jones], and do hereby certify the causc of death was declared to be [say fracture, o r contusion, or burn o r otherzoise].

Witness my hand this

day of

18

.

1 JOHN WARNER

NICHOLLS],

Coroner.

THE SIXTII SCHEDULE.

Hedical CertiJicate qf the Cause of Death.

-%ZedL_

last Birthday, was attended by me.

Length of Residence in the Australian Colonies

-

Died on the-

.

day of

, 18.

--

n ~ ~ r a t ~ o n

of

Cause of Death.

Diseabe.

---

--

Rave t h ~

goodness

to state the primary,

Primary disease.

.

(a). .

and only the important

Secondary iliseases(b)..

secondttry diseases.

if any...

.

.

., . (d. .

(d..

--

Signed -

Professional titles (if any).

--

-

-----p-

-

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Adelaide: By authority, W. C. Cox, Government Printer,

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