Leask, Henry Leslie Graham

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

Reference Number: 
SMC/3/4/1/8 2:3
Name of Practitioner (Surname): 
Leask
(Christian Names in Full): 
Henry Leslie Graham
Qualifications: 
MD CM FRFP&S Glasgow
Address: 
70 Dixon Avenue
City/Town: 
Crosshill, Glasgow
Present Work: 

Ophthalmic Surgeon: Surgeon to Glasgow Eye Infirmary non-panel: at present taking share of work for one who is on military duty, I do not feel equal to any additonal duty.

Age as at 1st January 1916: 
50
Group B (45 to 55) Lieut., R.A.M.C. (home service): 
X in red circle

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: 
24/12/1915

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.