Keay, Andrew Campbell

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

INTIMATION FORM

Reference Number: 
SMC/3/4/1/7 2:3
Name of Practitioner (Surname): 
Keay
Christian Names in Full: 
Andrew Campbell
Address: 
Rosskeen, Kelty
City/Town: 
Fife
Rank in Army (or Navy): 
Lieut RAMC
The above-mentioned Practitioner is on Service as stated
Additional Information: 
Signed by Isabella Keay

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.