Smith, John

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

Reference Number: 
SMC/3/4/1/12 3:5
Name of Practitioner (Surname): 
Smith
(Christian Names in Full): 
John
Qualifications: 
MD CM Edin MRCS Eng LRCP Lond
Address: 
Brycehall, Kirkwynd
City/Town: 
Kirkcaldy
Present Work: 

General Practitioner - Panel PO Medical Officer Referee - Workmen's Compensation Act: Joint Recruting (Civilian) MO - Kirkcaldy District (with partner).

Age as at 1st January 1916: 
60
Group C (56 and Upwards) Part-time home military work: 
X
Group C (56 and Upwards) Part-time home civil work: 
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.