Valentine, Leslie

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

INTIMATION FORM

Reference Number: 
SMC/3/4/1/14 1:4
Name of Practitioner (Surname): 
Valentine
Christian Names in Full: 
Leslie
Address: 
18 Whitehill Street, Dennistoun
City/Town: 
Glasgow
Rank in Army (or Navy): 
Captain RAMC, Military Hospital Ghain Tuffeha, Malta
The above-mentioned Practitioner is on Service as stated
Additional Information: 
Signed by Annie S Valentine

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.