Campbell, Davidina Roberta F[_?] Davidson

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

Reference Number: 
SMC/3/4/1/15 1:2
Name of Practitioner (Surname): 
Campbell
(Christian Names in Full): 
Davidina Roberta F[_?] Davidson
Qualifications: 
MB ChB DPH
Address: 
Morven
City/Town: 
Kilmacolm
Present Work: 

At Home Married

Age as at 1st January 1916: 
33
Group B (45 to 55) Locum Tenens: 
X
Group B (45 to 55) Part-time home civil work: 
X in red circle
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: 
Annotation on form
Date Form Signed: 
03/01/1916

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.