Rust, Montague

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

Reference Number: 
SMC/3/4/1/11 4:4
Name of Practitioner (Surname): 
Rust
(Christian Names in Full): 
Montague
Qualifications: 
LRCPS&SE 1898
Address: 
Boyndie
City/Town: 
West Newport
Present Work: 

General Practitioner & Panel have been medical officer to troops at Wormit since Feb 1/15 under SCO No.498 500 men stationed at above camp. My appointment is under article 364 of Pay Warrant.

Age as at 1st January 1916: 
42
Group A (Under 45) Lieut., R.A.M.C. (general 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.
Additional Information: 
August 22 birthday
Date Form Signed: 
20/12/1915

To be returned to

The Secretary,

Scottish Medical Service Emergency Committee,

Royal College of Physicians,

Edinburgh.