Broadforth, John

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

Reference Number: 
SMC/3/4/1/2 3:4
Name of Practitioner (Surname): 
Broadforth
(Christian Names in Full): 
John
Qualifications: 
MB, ChB
Address: 
Castle Street
City/Town: 
Dingwall
Present Work: 

General Practitioner (Panel)

Age as at 1st January 1916: 
29
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: 

[Submitted two forms, earlier one dated 27 Dec 1915 with Group B 'Part-time home military work' marked and selected] [note written directly on earlier form, letter attached to later form]

Date Form Signed: 
23/06/1916

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.