New Zealand Gazette – 1928 – No. 53

Page 2108

✨ Nurses and Midwives Registration Forms



2108
THE NEW ZEALAND GAZETTE.
[No. 53

Form No. 6.] [Reg. 13 (5).
The Nurses and Midwives Registration Act, 1925.
PARTICULARS OF REGISTRATION TO BE PUBLISHED IN THE GAZETTE.
Registered number : Qualifications :
Name : Hospital at which trained :
Date of registration : Residence :

Form No. 7.] [Reg. 16 (3).
The Nurses and Midwives Registration Act, 1925.
NOTICE OF APPEAL.
To the Registrar of Nurses and Midwives,
Health Department, Wellington.
TAKE notice that I, , of , do hereby appeal, under
section 22 of the Nurses and Midwives Registration Act, 1925, against
the decision of the Registration Board, conveyed to me by letter
dated the day of , 19 .
The following are the grounds upon which I make my appeal :
And I do hereby appoint , of , as one of the
assessors for the purposes of this appeal.
Dated at this day of , 19 .
Signature of appellant : . . . . . . . . . . .
I hereby consent to act as an assessor for the purposes of this
appeal.
Signature of assessor of appellant : . . . . . . . . . . .

Form No. 8.] [Reg. 21 (2).
The Nurses and Midwives Registration Act, 1925.
NOTICE TO BE SENT BY MIDWIFE REQUIRING ASSISTANCE OF
REGISTERED MEDICAL PRACTITIONER.
To Dr. , 19 .
YOUR help is immediately required at , owing to .
The patient’s condition is .
Time : [Signed] M.,
Registered Midwife.

Form No. 9.] [Reg. 22 (1).
The Nurses and Midwives Registration Act, 1925.
RECORD TO BE KEPT BY EVERY MIDWIFE OR MATERNITY NURSE OF
EACH PATIENT SHE HAS ATTENDED IN PRIVATE PRACTICE.
No.
Date of engagement to attend :
Name and address :
Number of previous labours and miscarriages :
Age :
Date and hour of nurse’s or midwife’s arrival :
Number of vaginal examinations made by nurse or midwife :
Presentation :
Duration of first, second, and third stage of labour :
Complications (if any) during or after labour :
Nature of any operation performed during or after labour or during
the lying-in period :
Sex of infant : . Born alive or dead :
Full time, or premature : If premature, number of months :
If doctor called : . Name of doctor :
A record of temperature taken twice daily :
Date of nurse’s or midwife’s final visit :
Condition of mother then :
Condition of child then :
Whether suckled :
Remarks :



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✨ LLM interpretation of page content

🏥 Form for Particulars of Registration for Nurses and Midwives

🏥 Health & Social Welfare
Registration, Nurses, Midwives, Form

🏥 Notice of Appeal Form for Nurses and Midwives Registration

🏥 Health & Social Welfare
Appeal, Nurses, Midwives, Registration, Form

🏥 Notice for Midwife Requiring Assistance of Registered Medical Practitioner

🏥 Health & Social Welfare
Midwife, Medical Practitioner, Assistance, Form

🏥 Record Keeping Form for Midwives and Maternity Nurses

🏥 Health & Social Welfare
Record, Midwife, Maternity Nurse, Patient, Form