I (the applicant) am the [state relationship] (13) of the mentally incapacitated person/ a social worker/a registered medical practitioner/ a public officer in the Social Welfare Department*.

• 本人(申请人)是该精神上无行为能力的人的[述明与该人的关系](13)/社会工作者/注册医生/社会福利署的公职人员*。