Cheyne, Douglas Gordon

To be filled in by, or on behalf of, Practitioner on
Service.

INTIMATION FORM

Reference Number: 
SMC/3/4/1/3 1:6
Name of Practitioner (Surname): 
Cheyne
Christian Names in Full: 
Douglas Gordon
Address: 
1 Bonaccord Square
City/Town: 
Aberdeen
Rank in Army (or Navy): 
Captain RAMC, BEF 3rd Sanitary Section 4th Division
The above-mentioned Practitioner is on Service as stated

SPECIAL NOTE:

1. Where a Practitioner holds a Commission, but is still at home, this
Intimation Form should be filled in by the Practitioner himself.

2. Where a Practitioner is absent from home on Service, this Intimation Form
should be filled in by some person on his behalf.

 

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.