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PROVISION RECEIPT AND CONSUMPTION ACCOUNT for the......Week of the Half-year ending the............day of............19...... FORM 26. (To be kept by the Master of the Workhouse.)

(ARTICLE 40.)

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NOTES.--A Sheet of this Form, and of the Provision Check Account (Form 25), may be printed alternately in the same book, this Form second; or the forms may be bound in separate books. (a) The Quantities consumed must correspond with the Total Quantities (Note (d)) shown in the Provision Check Account; and these Quantities, with the Stock in band, must equal the total on band and received. (b) Spirits if not reduced before delivery into the Workhouse Store should be reduced to a strength not lower than 17 under proof, and the number of ounces to be entered as received shall be 100 for each gallon of spirits at the strength to which the same shall have been so reduced. (e) See note (7) Vorm (35).

(ARTICLE 40.)

MEDICAL WEEKLY RETURN AND EXTRA BOOK. Week ending..

FORM 27.

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(This book to be kept according to instructions at (a) (b) (c)). [No Inmates but those actually under Medical or Surgical Treatment are to be entered in this Return.]

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Extras additional to the ordinary Diets for the Sick: Columns to be filled Daily by the Medical Officer, and the Total for each Patient weekly. (d)

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(c)

Friday.

Saturday.

Total.

Sunday.

Monday.

Wednesday. Thursday. Tuesday.

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Register Number.

(d) The entries in these columns given to the several Patients.

shall

represent

only

the

TOTAL

(e)

quantities over and above those prescribed in the ordinary Scale of Dietary for the Sick, which the Medical Officer considers should be

(e) These Totals are to be ascertained and filled in by the Master.

CERTIFICATE to be signed by Medical Officer at the end of the Return for each Week.

I hereby certify that the several items of Extra Dietary entered above were supplied according to the directions given by me: and that the several patients named therein were, on the day in each case specified, under my care in the Sick or Lunatic Wards, and that the Bed-head Cards (Form 28) have been regularly and accurately filled up ........day.

Dated this.

Examined and compared with the corresponding entries in the Daily Diet Book for the Sick, and in the Provision Check Account.

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FORM 28.
(ARTICLE 40.)

BED-HEAD CARD.

(To be kept by the Nurse under the supervision of the Medical Officer.)
Name of Union.....

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To be printed on Stout Card, with eyelets to admit of hanging up over bed; the continuation of the form to be printed on the back.

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FORM 29.

WEEKLY ABSTRACT OF PROVISIONS RECEIVED AND CONSUMED. (To be kept by the Master of the Workhouse, and forwarded for the Auditor with Clerk's Abstracts.)

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FORM 30.

(ARTICLE 40.)

I certify the foregoing Abstract to be correct. Dated this.......day of...

Master.

HALF-YEARLY SUMMARY OF WEEKLY ABSTRACT OF PROVISIONS RECEIVED AND CONSUMED. (To be kept by the Master of the Workhouse, and forwarded for the Auditor with the Clerk's Abstracts.)

I certify the foregoing Summary to be correct. Dated this...day of...

19......

Master

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