Fairfax, Norman Pigott

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

Reference Number: 
SMC/3/4/1/4 2:3
Name of Practitioner (Surname): 
Fairfax
(Christian Names in Full): 
Norman Pigott
Qualifications: 
LRCP& S Ed LFP&SG
Address: 
Caddon View
City/Town: 
Innerleithen, Peebleshire
Present Work: 

Panel and otherwise doing part time military work

Age as at 1st January 1916: 
48
Group B (45 to 55) Part-time home military work: 
X in red by SMSEC
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: 
[No date]

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.