Adam, Thomas

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): 
Thomas
Qualifications: 
MA, MD, DPH, MRCS, LRCP
Address: 
County Buildings
City/Town: 
Stirling
Present Work: 

County Medical Officer of Health, County Tuberculosis Officer, County School Medical Officer

Age as at 1st January 1916: 
49
Group B (45 to 55) Part-time home military 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: 

[letter attached to form]

Date Form Signed: 
21/02/1916

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.