Cruickshank, Lewis Davie

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

Reference Number: 
SMC/3/4/1/3 4:6
Name of Practitioner (Surname): 
Cruickshank
(Christian Names in Full): 
Lewis Davie
Qualifications: 
MD, MRCPE, DPH (Camb)
Address: 
30 Queen's Crescent
City/Town: 
Edinburgh
Present Work: 

Medical Officer and Chief Inspector Phys. Training Scotch Education Department; Acting Medical Offier, Highland and Island Medical Services Board

Age as at 1st January 1916: 
40
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: 

[letter attached to form] [Written over service categories:] 'See attached copy of letter dated 20/11/15 from the Secretary of the Scotch Education Department, LDC 28/12/15'

Date Form Signed: 
[not signed or dated]

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.