Bianchi, Leo

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): 
Bianchi
(Christian Names in Full): 
Leo
Qualifications: 
FRCSEd, MRCPEd, DPH
Address: 
40 Brighton Place
City/Town: 
Portobello
Present Work: 

General Practitioner (Panel)

Age as at 1st January 1916: 
50
Group B (45 to 55) Lieut., R.A.M.C. (home service): 
X [in pencil, not clearly by SMSEC
Group B (45 to 55) Part-time home military work: 
X [in ink]
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: 
Next to Group B 'Part-time home military work' category:] If near residence. [Along edge of paper:] Applied for a Commission in April - rejected, medically unfit.
Date Form Signed: 
27/12/1917

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.