Clark, Robert

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

Reference Number: 
SMC/3/4/1/3 1:6
Name of Practitioner (Surname): 
Clark
(Christian Names in Full): 
Robert
Qualifications: 
MB, ChB (Glasgow Univ)
Address: 
Viewmount
City/Town: 
Lossiemouth
Present Work: 

General Medical Practitioner (Panel)

Age as at 1st January 1916: 
46
Group B (45 to 55) Lieut., R.A.M.C. (home service): 
X
Group B (45 to 55) Locum Tenens: 
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: 
[letters attached to form] [Written next to Group B 'Lieut. RAMC (home service)':] Hospital preferred
Date Form Signed: 
14/01/1916

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.