White, Thomas Brown
To be filled in by a Practitioner not holding a Commission
REGISTRATION FORM
MEDICAL RECRUITING SCHEME - 1916
Reference Number:
SMC/3/4/1/14 3:4
Name of Practitioner (Surname):
White
(Christian Names in Full):
Thomas Brown
Qualifications:
MB & CM (Edin)
Address:
Dickson House
City/Town:
Moffat
Present Work:
General Practioner - Panel
Age as at 1st January 1916:
49
Group B (45 to 55) Lieut., R.A.M.C. (home service):
X in red circle
Group B (45 to 55) Locum Tenens:
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.
Date Form Signed:
23/12/1915
To be returned to
The Secretary,
Scottish Medical Service Emergency Committee,
Royal College of Physicians,
Edinburgh.