Banks, George

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

Reference Number: 
SMC/3/4/1/2 1:4
Name of Practitioner (Surname): 
Banks
(Christian Names in Full): 
George
Qualifications: 
LRCPE + LRCSE
Address: 
Hartfield, West Park
City/Town: 
Wick
Present Work: 

General Practitioner (Panel), Medical Off. Health Wick Burgh; Surgeon and Agent having present charge of Minesweeper Coast Troops (150) Naval Hospital and Parochial Med. Officer

Age as at 1st January 1916: 
77
Group C (56 and Upwards) Part-time home military work: 
X (SMSEC: Doing it now)

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: 

[Written in age category box:] "Surgeon and Agents are exempt" [Written next to service categories:] "I have enough to do without undertaking any other duty" [no serivce boxes ticked by practitioner -- instead marked by SMSEC]

Date Form Signed: 
11/07/1916

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.