Kay, Adam
To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916
Reference Number:
SMC/3/4/1/7 2:3
Name of Practitioner (Surname):
Kay
(Christian Names in Full):
Adam
Qualifications:
MB CM
Address:
Clark[?] Cottage
City/Town:
Motherwell
Present Work:
General Practitioner Panel
Age as at 1st January 1916:
48
Group B (45 to 55) Lieut., R.A.M.C. (home service):
X in red circle
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.
Date Form Signed:
23/12/1915
To be returned to
The Secretary,
Scottish Medical Service Emergency Committee,
Royal College of Physicians,
Edinburgh.