411
P
1. Med.
Application for a Colonial Medical Appointment.
Form to be filled up by the Applicant himself, and returned to the Assistant Private Secretary (Appointments) to the Secretary of State, Colonial Office, London.
1. Name in full (Surname first in block capitals.) State whether British- born or naturalised; if latter, give parti- culars.
Day and year of birth
CLIFT
Henry Lechmere.
British born
April 6th 1870. Age last birthday.
(A birth certificate must be enclosed; it will be returned.)
Place of birth Chickmaglur, India
48
Present address 5 Lefunter Mansions, Horf hong
2. Whether single, married, or a widower....
Wife's maiden name
""
Ina rried
Winifred Ashby
nationality at birth and place of birth...
Number of children.. none Sons
English, stained
Aged respectively
Daughters
""
3. Father's Name.. Henry Wilking Clift
Curl infiniment Service
Profession or occupation, Cuil infinies
lian
Indi
nationality at birth and place of birth English
Bristol
(If dead the above questions should be answered nevertheless; living his address should be given below.)
Address
Lead
4. Mother's maiden name.
""
Eleanor Lech
nationality at birth and place of birth..
...
5. Education (general)
Mention the Schools, Col- leges, and Universities at which you received your general education; and give in each case the date of entry and leaving.
6. Education
(Professional)...
Mention the Schools, Col- leges, and Universities at which you received your professional education; and give in each case the date of entry and leaving.
}
mese.
English, Lindon
Bishop Cotton's School, Shillong-1883–1889 Preparatory School, Croydon - 1884-1886 Eastboume High School Jan-Dec. 1888 Bishop Cotton's School, Bangalore aptsy-&ce/90 Mysore foot Central College set- Aug. 1893
Edinburgh un iversity
1893-1901
absent Two Winters from Edinburgh=
1898-99ûssisting several practitioner in Yorkshire. 1900-1901- Clinical Clerk, St. Northern Hosp, London
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