WHEREAS [here insert the name of the lunatic] a lunatic, hath been this
day received as a patient into Bethlem Hospital, established for the
reception of lunatics, on our having jointly and severally agreed to
remove and take away the said lunatic in manner hereinafter mentioned:
now we do hereby jointly and severally undertake, promise, and agree,
that we, or one of us, will, within seven days next after we shall be
thereto required, by notice in writing, to be signed by the steward
for the time being of the said hospital, remove and take away the
said lunatic from the said hospital, at our, or one of our costs and
charges; and at the like costs and charges bury such lunatic, in the
event of death; and also that we, or one of us, will pay to the said
steward the costs and charges of clothing the said lunatic, during the
term of such lunatic’s continuance in the said hospital. And in case of
any default in the premises, we do hereby jointly undertake, promise,
and agree to pay to the treasurer of the said hospital for the time
being, the sum of ONE HUNDRED POUNDS, on demand, together with all
costs of suit to be incurred in respect thereof. As witness our hands
this ---- day of ---- 18
[Signed by the Bondsmen.]