Burns, Charles
To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916
Reference Number:
SMC/3/4/1/2 4:4
Name of Practitioner (Surname):
Burns
(Christian Names in Full):
Charles
Qualifications:
MB, ChB
Address:
12 Ann Street
City/Town:
Stonehaven
Present Work:
General Practitioner (Panel)
Age as at 1st January 1916:
36
Group A (Under 45) Lieut., R.A.M.C. (general service):
X
At the call of the local War Committee for my area, as instructed by the
Scottish Medical Service Emergency Committee, I am prepared to render the service
or services marked above. This offer is subject to the condition that, in the event
of such service requiring me to leave my present work, I am enabled to make
arrangements for having it carried in during my absence.
Additional Information:
[letter attached to form] [numbers written and cross out by practitioner on bottom of page]
Date Form Signed:
17/06/1916
To be returned to
The Secretary,
Scottish Medical Service Emergency Committee,
Royal College of Physicians,
Edinburgh.