Application for Promotion in the Colonial Service.

23

form in be filled up by the Applicant himself, and returned to the Governor for transmission to the

Jame in full

Date of Application

Secretary of State for the Colonies.

Willed Vincent Miller Koch

January 7. 1913

Britant superintendent. Gram tere at Civil Hospital

Present Appointinent

Father's Name

D

Profession or Occupation

Address...

Hasking

Edwin Lawson Koch

Principal-leyte Medical Coly.

leylne.

C.O.

If dend, his Samo and Profession

4327

should nevertheless be given.

Day and year of Birth...

Delta 29. 1862.

29.1862.

Age last birthday

Rece IDEAL & PER 13

36

Place of Birth

Leyla

pcanied

Whether single, married, or a widower

Number of children...Sons in Age respectively

Education

402

***

Mention the Schools or Colleges at which you received your education, professional as well as general; and give in ench ense the date of entry and leaving.

Daughters

ben.

11

";

St Manor' CM - Columby

1871 - 1876

Royal High Schost - Edinburgh 1876-1875 Edaihugh Unitust - 1879 – 18814

St Bartholomew's Hospital, Smithfield, Linda.. [C. 1896–96 London Schost. of Tropical Medition 1910.

Golden Square Hospital po Alicam of the Duraft hen 1858 "City of London (hionpålds) Hospital pelep Drican, Bacheln of Medicine & Master of Simpoy 18846

Professional qualif. Dorth of Medicine (with 89ld undal & Frist (laus hermos)

cations (if any), and the date at which each was obtained.

Employment from completion of edu- cation to date of entering the public

service

Mention each position held by you, the dates between which you held it, and the cause of leaving.

1855

Dyce, compones by the university of linkupt Imenos tertificate of the London. Sthost of Tropied predstime

1910

Britant Medical Officer Hill Borough Myhun 18844 --1888 ( lyt to undertake private positièe)

Medical Open, Carlton Main & Hemektm main

CMana

New

Bannky 1888 1889 (left m

tuthing the Cynical

[TURN OVER.

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