Mental Health Care Act, 2002 (Act No. 17 of 2002)RegulationsGeneral RegulationsAnnexuresForm MHCA 33 |
ANNEXURE
FORM MHCA 33
DEPARTMENT OF HEALTH
UNCONDITIONAL DISCHARGE BY HEAD OF HEALTH ESTABLISHMENT OF STATE PATIENT PREVIOUSLY DISCHARGED CONDTIONALLY
(Section 48(4)(a) of the Act)
Surname of state patient...........................................................................................
First name(s) of state patient ....................................................................................
File No. (if known) .......................................
Date of birth ..........................................or estimated age ....................
Gender:
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Male |
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Female |
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Occupation ..................................................................................................... |
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Marital status: |
S |
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M |
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D |
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W |
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Address: ....................................................................................................................
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Date of conditional discharge: ....................................................................................
Date of expiry of conditional discharge: .....................................................................
I hereby state that the period of the above state patient's conditional discharge has expired, that he / she has complied with the terms and conditions applicable to his / her mental health status and that his / her mental health status and that his / her mental health status has not deteriorated.
The above state patient is hereby unconditionally discharged.
Print initials and surname: .........................................
Signature: ....................................................................
(head of health establishment)
Date: ....................................
Place: ............................................
(Copy to be forwarded to the state patient, registrar of the court concerned, the official curator ad litem and national department)