Douglas, Donald

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): 
Douglas
(Christian Names in Full): 
Donald
Qualifications: 
MB, ChB
Address: 
Victoria Park
City/Town: 
Bellshill, Lanarkshire
Present Work: 

general practitioner, panel

Age as at 1st January 1916: 
45
Group B (45 to 55) Lieut., R.A.M.C. (home 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.

Date Form Signed: 
01/07/1916

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.