Stephen, John William
To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916
Reference Number:
SMC/3/4/1/12 4:5
Name of Practitioner (Surname):
Stephen
(Christian Names in Full):
John William
Qualifications:
MB ChB
City/Town:
[Beith, Ayrshire]
Present Work:
General Medical Practitioner, Civil Military Surgeon
Age as at 1st January 1916:
35
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:
Notes on form & letter attached
Date Form Signed:
01/01/1916
To be returned to
The Secretary,
Scottish Medical Service Emergency Committee,
Royal College of Physicians,
Edinburgh.