Bennett, Simon Harry

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

Reference Number: 
SMC/3/4/1/2 2:4
Name of Practitioner (Surname): 
Bennett
(Christian Names in Full): 
Simon Harry
Qualifications: 
MB, ChB (Glasgow Univ)
Address: 
30 Windsor Terrace off St. George's Road
City/Town: 
Glasgow
Present Work: 

General Practitioner (Panel)

Age as at 1st January 1916: 
28*
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: 
[*modified category to be Age in 1917] [addendum to declaration at bottom of page:] 'This offer is subject to the condition that "I am found to be physically fit and that" in the event'...
Date Form Signed: 
28/04/1917

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.