Gordon, George Stevenson

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

INTIMATION FORM

Reference Number: 
SMC/3/4/1/5 2:4
Name of Practitioner (Surname): 
Gordon
Christian Names in Full: 
George Stevenson
Address: 
Anna Villa
City/Town: 
Kilwinning, Ayrshire
Rank in Army (or Navy): 
Lieut RAMC
The above-mentioned Practitioner is on Service as stated
Additional Information: 
Possibly the name of the medical practice Gage & Gordon written at the top. Signed by James Jack MD.

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.