de Souza, Hugh Clement Benjamin

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

Reference Number: 
SMC/3/4/1/3 5:6
Name of Practitioner (Surname): 
de Souza
(Christian Names in Full): 
Hugh Clement Benjamin
Qualifications: 
LRCP&SE, LRFP&S Glasgow
Address: 
Abosso
City/Town: 
Giffnock
Present Work: 

Medical Officer to gold producing mine in Gold Coast colony. At present on 3 months leave.

Age as at 1st January 1916: 
33

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: 

Moving on 3rd May to 13 Doune Terrace, North Kelvinside, Glasgow. Letter attached.

Date Form Signed: 
14/04/1916

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.