Stephen, John Hector

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

INTIMATION FORM

Reference Number: 
SMC/3/4/1/12 4:5
Name of Practitioner (Surname): 
Stephen
Christian Names in Full: 
John Hector
Address: 
Back Path
City/Town: 
Banff
Rank in Army (or Navy): 
Major RAMC Served with 89th Field Ambulance at Gallipoli
The above-mentioned Practitioner is on Service as stated
Additional Information: 
Signed by John Stephen MB BSC
Present Work: 
At present on sick leave

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.