Leiper, J A

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

INTIMATION FORM

Reference Number: 
SMC/3/4/1/8 2:3
Name of Practitioner (Surname): 
Leiper
Christian Names in Full: 
J A
Address: 
78 Field Ambulance 28th Division, Salonica Expeditionary Force C/O GPO London
Rank in Army (or Navy): 
Lieut
The above-mentioned Practitioner is on Service as stated
Additional Information: 
Signed by Alexander Leiper Father
Qualifications: 
MC MB ChB

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.