Thom, John Allan
To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916
Reference Number:
SMC/3/4/1/13 2:3
Name of Practitioner (Surname):
Thom
(Christian Names in Full):
John Allan
Qualifications:
MB ChB (Glasgow University 1903)
Address:
19 Dalblair Road
City/Town:
Ayr
Present Work:
General practioner panel. At present attending 750 panel patients of doctor on military service besides 950 of my own. Married.
Age as at 1st January 1916:
34
Group A (Under 45) Lieut., R.A.M.C. (general 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.
Additional Information:
Note on form
Date Form Signed:
01/03/1916
To be returned to
The Secretary,
Scottish Medical Service Emergency Committee,
Royal College of Physicians,
Edinburgh.