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84                                                                                     APPENDIX.

                                                        No. 3.

                            Register of Admissions into Hospital.

1

2

3

4

5

6

7

8

Number on General Re-
gister.

Name.

Disease.

DATE OF

REMARKS.

Admission.

Discharge.

Death.

Cured.

Otherwise.*

                                * To be invariably noticed in the Remarks.

The names and numbers by which diseases are indicated in the nomenclature of 1868 should be
invariably given.

                                                        No. 4.

Register of Deaths in the                           Lunatic Asylum during the year 18

1

2

3

4

5

6

7

8

9

10

Number on General Re-
gister.

Name.

District from whence re-
ceived.

STATE ON ASMISSION.

Duration of confinement.

DEATHS.

REMARKS.

Mental disease.

Duration.

Bodily condition,
and disease, if
any.

Disease causing.

Duration of disease.

This is the only register whose submission is required. When two or more diseases have co-existed or
supervened, they should be severally noted in column 8.

                                                        No. 5.

Register of Solitary Confinement and Restraint in the                    Lunatic Asylum.

1

a

3

4

5

6

7

Number on General
Register.

Name.

Mental disease.

Kind of restraint
employed.

Reason for which
employed.

Duration of res-
traint in hours.

REMARKS.

                                                        No. 6.

                                           Register of Employment.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

DATE.

MALES.

FEMALES.

Daily Number.

Gardening.

Oil-making.

Soorkey-pounding.

Rice-husking.

Weaving.

&c.

&c.

&c.

Total employed.

Daily Number.

Soorkey-pounding.

Rice-husking.

Wheat-grinding.

&c.

&c.

Total employed.

1st Jauuary ... ... ... ... ...

2nd „ ... ... ... ...

31st December ... ... ... ...

Total ... ...

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