Adam, Robert

To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916

Reference Number: 
SMC/3/4/1/1 1:2
Name of Practitioner (Surname): 
Adam
(Christian Names in Full): 
Robert
Qualifications: 
MB, ChB
Address: 
21 Balmoral Cres., Queen's Park
City/Town: 
Glasgow
Present Work: 

General Practitioner (Panel), Hospital Appointment

Age as at 1st January 1916: 
34
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: 

At present am working panel of 2000 for two colleagues on active service

Date Form Signed: 
29/12/1915

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.