Butchart, Charles Alexander
To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916
Reference Number:
SMC/3/4/1/2 4:4
Name of Practitioner (Surname):
Butchart
(Christian Names in Full):
Charles Alexander
Qualifications:
MB, CM
Address:
52 Leith Walk
City/Town:
Leith
Present Work:
GP Panel
Age as at 1st January 1916:
52
Group B (45 to 55) Part-time home military work:
X
Group B (45 to 55) Part-time home civil 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.
Date Form Signed:
30/12/1915
To be returned to
The Secretary,
Scottish Medical Service Emergency Committee,
Royal College of Physicians,
Edinburgh.