[Blank medical certificate to be completed by a medical practicioner in the event of a person being committed as a patient to St. Patrick's (also known as St. Patrick Dun's) Hospital or St. James Hospital].
Blank medical certificate to be completed by a medical practitioner following the examination of a person to be committed as a patient to St. Patrick Dun's Hospital or St. James Hospital, Dublin.
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[Dublin : s.n., n.d, pre-1910, ca. early 1900's]
This item is held in the Department of Ephemera.
Physical description: 1 sheet (4 p., folded) ; 38 x 25 cm.
Varying form of title: [Statement and request for the reception of an insane person].
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Reproduction rights owned by the National Library of Ireland.