Dale, Robert Wilson

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): 
Dale
(Christian Names in Full): 
Robert Wilson
Qualifications: 
MA, MB, ChB (1905)
Address: 
2 Greenlaw Terrace
City/Town: 
Paisley
Present Work: 

General Practitioner with large Panel and Private Practice

Age as at 1st January 1916: 
36
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: 
[note written along top of form]
Date Form Signed: 
27/12/1915

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.