Crowe, W C
To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916
Reference Number:
SMC/3/4/1/3 4:6
Name of Practitioner (Surname):
Crowe
(Christian Names in Full):
W C
Qualifications:
[left blank]
Address:
[left blank]
Present Work:
[left blank]
Age as at 1st January 1916:
64
Group C (56 and Upwards) Part-time home civil work:
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:
[letters attached to form]
Date Form Signed:
[not signed or dated]
To be returned to
The Secretary,
Scottish Medical Service Emergency Committee,
Royal College of Physicians,
Edinburgh.