15
APPENDIX E.
(See Rule 25.)
[COUNTERFOIL.]
No.
Name.
Father's name.
Street
Village
Town
Taluk
District
Date
Initials of operator.
Plague Inoculation Certificate.
No CERTIFIED that , resident of , son of
, Street/Village
, Town/Taluk , District
, has been inoculated by me,
and that his thumb-mark was at the time
impressed before me.
Space for left thumb-mark.
(Signature and designation.)
Dated
NOTE.-Unless suffering or suspected to be suffering
from plague, the holder of the certificate is exempted
from segregation and from detention when travelling.
It does not, however, exempt him from liability to evacu-
ate an infected house, except in the case where all the
occupants of the house have been inoculated, or to have
his clothes and person disinfected when travelling. This
certificate is valid for a period of nine months.