Section 7. [If that is the fact.] An application for an inquiry into the mental capacity of the said A. B. was

97. No suit, prosecution or other legal proceedings shall lie against any person for anything which is in good faith done or intended to be done under this Act. 7. [If that is the fact.] An application for an inquiry into the mental capacity of the said A. B. was made to the on the and a certified copy of the order made on the said petition is annexed hereto. [Or if that is the fact.] No application for an inquiry into the mental capacity of the said A. B. has been made previous to this application. The petitioner therefore prays that a reception order may be made in accordance with the foregoing statement. (Sd.) C. D. The statements contained or referred to in paragraphs are true to my knowledge; the other statements are true to my information and belief. (Sd.) C. D. Dated Statement of particulars. [If any of the particulars in this statement is not known, the fact to be so stated.] The following is a statement of particulars relating to the said A. B. - Name of patient at length. - Sex and age. - Married, single or widowed. - Previous occupation. - Caste and religious belief, as far as known. - Residence at or immediately previous to the date hereof. - Names of any near relatives to the patient who are alive. - Whether this is first attack of lunacy. - Age (if known) on first attack. - When and where previously under care and treatment as a lunatic. Duration [1] Here state whether either of the persons signing the medical certificates is a relative, partner or assistant of the lunatic or of the petitioner, and, if a relative of either, the exact relationship. 1912.] Lunacy. 71 (Schedule I.—Forms.) Duration of existing attack. Supposed cause. Whether the patient is subject to epilepsy. Whether suicidal. Whether the patient is known to be suffering from phthisis or any form of tubercular disease. Whether dangerous to others, and in what way. Whether any near relative (stating the relationship) has been afflicted with insanity. Whether the patient is addicted to alcohol, or the use of opium, ganja, charas, bhang, cocaine or other intoxicant. [The statements contained or referred to in paras. are true to my knowledge. The other statements are true to my information and belief.] [Signature by person making the statement.] --- FORM 2. Reception Order on Petition. (See sections 7, 10.) I, the undersigned E. F., being a Presidency Magistrate of [or the District Magistrate of or the Sub-divisional Magistrate of or a Magistrate of the first class specially empowered by Government to perform the functions of a Magistrate under Act IV of 1912] upon the petition of C. D. of [1] in the matter of A. B., [1] a lunatic, accompanied by the medical certificates of G. H., a medical officer, and of J. K., a medical practitioner [or medical officer], under the said Act, hereto annexed, hereby authorise you to receive the said A. B. into your asylum. And I declare that I have [or have not] personally seen the said A. B. before making this order. (Sd.) E. F. (Designation as above.) To [2] FORM 3. --- [1] Address and description. [2] To be addressed to the officer or person in charge of the asylum. Luracy. [ACT IV (Schedule I.—Forms.) FORM 3. Medical Certificate. (See sections 18, 19.) In the matter of A. B. of [¹] in the town of [or the sub-division of in the district of ] an alleged lunatic. I, the undersigned C. D., do hereby certify as follows: