336 



ACT 39 AND 40 VIC. C. 77 



Certificate A. 



* Here insert WHEREAS * 



name, address, 

 and profession of 

 person to whom 

 Certificate is to 



noflct.) (Sec ' has represented to us t 



t Here insert 

 name, address, 

 and statutory 



qualification of that he proposes, if duly authorized under the above-mentioned 



each person cer- * * ... . , . . , ,. 



tifying. (Sec. ii Act, to perform on living animals certain experiments described 

 below : We hereby certify that, in our opinion, insensibility 

 in the animal on which any such experiment may be per- 

 formed cannot be produced by anaesthetics without necessarily 

 frustrating the object of such experiment. 



I a Certificate t This Certificate is given for experiments. 



may be given for 

 such time, or for 



such series of ex- + This Certificate shall be in force until the day 



penments as the 1 J 



person signing Q f j q 



may think expe- ' ' 

 dient ; and it is 



such limitation This Certificate ceases to have effect on the expiration 



should be here j. . 7 T . 



inserted, if a of the Licence. 



Certificate is un- 

 limited, or limi- 

 ted by time only, 



Signature of Certifiers) 

 state usually to be attached here J 



imposes a limit 

 on the number of 

 experiments to D*** 

 be performed. -L/ace 



§ At the end of § Description of proposed experiments. 



the Description 

 the animals are 

 to be named, and 

 it is necessary to 

 submit, in addi- 

 tion, if dogs or 

 cats are used, 

 Certificate E, or 

 if horses, asses or 

 mules are used, 



Certificate F. M.B, — This Certificate is subject to any conditions that may be assigned in 

 the Licence, and it will be the duty of the holder to refer to his 

 Licence and ascertain whether any of the conditions attached to the 

 Licence limit the number of experiments authorized by this Certificate, 

 or in any other way place restrictions on what may be done under 

 this Certificate. 



