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(Does applicant use intoxicating liquors?)

(To what extent?)

(Does applicant ever use them to excess?)

(Does applicant ever use opium, chloral or other narcotics?)

(To what extent?)

(Does applicant display any tendency to suicide? If so, give evidence)

(Has applicant ever been an inmate of any public institution? If so, give names)

(For what causes and how long?)

(Property of applicant-describe fully)

(Other means of support)

(Name and P.O. addresses of two responsible persons willing to become bound to municipality for maintenance of applicant)

(Name and P.O. address of nearest friend, relative or guardian)

Having carefully examined the applicant and having given due consideration to the facts before me, I am of the opinion that the said applicant is a fit and proper person for admission to the Old Folks' Home at in the Province of Manitoba.

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To the Minister of Public Works of the Province of Manitoba:

I, the undersigned, the head of the council of the (here state the municipality, rural or otherwise) hereby make application for and on behalf of said municipality for the admission of (here state the name of the person) into the Old Folks' Home, such person being as appears from the medical examination and certificate and report hereto annexed, a fit and proper person to be admitted and received in such institution.

I hereby agree that the said municipality of (here state the name) shall and will pay the Province of Manitoba as provided by "The Old Folks' Home Act" the expenses of conveying the said (here give name of person) to the Old Folks' Home, and the sum of fifty cents per diem from the time of admission of such person into the said institution to and during all the time such person shall remain therein.

Mayor or reeve, as the case may be,
Municipality of (here state name of
Municipality.)

CHAPTER 82.

An Act to amend "The Partnership Act."

[Assented to March 10th, 1916.]

IS MAJESTY, by and with the advice and consent of the
Legislative Assembly of Manitoba, enacts as follows:-

ship Act"

1. Section 51 of "The Partnership Act," being chapter 151 Section 51 of of the Revised Statutes of Manitoba, 1913, is hereby amended The Partnerby striking out the words "six months" from the first line of amended. said section and by substituting therefor the words "one month," and by adding after the word "manner" in the third line thereof the words "and within the same time."

HIS

CHAPTER 83.

An Act respecting the Village of Pilot Mound.

[Assented to March 10th, 1916.]

IS MAJESTY, by and with the advice and consent of the
Legislative Assembly of Manitoba, hereby enacts as

follows:

councillors and

validated.

1. Notwithstanding that the last annual municipal and Election of school trustees election in the Village of Pilot Mound, for the school trustees filling of certain vacancies in the council and board of school in Pilot Mound trustees of said village, were held at a time other than as required by law in that behalf, to wit; on the fourteenth instead of the twenty-first day of December, A.D. 1915, it is hereby declared that said election and the election of the persons thereat shall be deemed to be, and shall be, legal, valid and binding to all intents and purposes whatsoever.

2. This Act shall come into force on the day it is assented to.

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