Application for Admission of Mentally ill Person under s. 19 of the Mental Health Act 1987
To
The Medical Officer-in-Charge
Psychiatric Hospital
Sir
I submit that Sree............................, aged...............years, my nephew has been suffering from mental illness for the last two months and, I have been looking after him as both of his parents are dead. On his behalf, therefore, I request you to admit him as an in-patient in your hospital for his necessary treatment. Medical Certificates from two medical practitioners including one from a medical practitioners in Government service regarding the condition of the patient are enclosed.

    Yours faithfully