!
8. Mention any
Clinical appoint-
ments held—
Give
Non-resident: Out-Patient Offices.
Resident Clinical Assistant,
House Surgeon.
the date and
duration of each up- Resident Surgical Office
pointment.
9. State how you
have been en-
8
gaged since you obtained qualification Mention each position
held by you, the dates
between which you held it, and the cause of leaving.
(Information given.
under & should not
be repeated).
10. If
you apply for a particular appointment
state it...
If you do not apply for
a particular appoint- ment. state to what Colonies you would
go, giving the order of preference.
the
(Before filling in these particulars, you should read carefully papers headed Mis- cellaneous No. 99
and African (West) No. 678.)
11. Referees
Give the names and addresses of two re- sponsible persons who know you well in private life. The names of distinguished persons should not be
given unless they really know you well;
See above
Guy's Hosp. 3 months.
1908.
6 months. 1 year
-1907
1909-18
تاریخ
also six months havel study in Germany lik Private Practitioner at Hong Kong. 1912 - 1815 on. Visiting Surgeon. Civil Horf. Hong Kong. 1914-1 Ho Tung Proposon Clinical Surgery (university reached & anatomi Sugery stong Kong. Teacher of therative Surgery.
Enkinal Exammel in
д
1513
Hong Kong Affointment's given of on ceasing #feachre
He Tolong
Original afflication for post of Senior Gost. Surgeon at
Singapore.
Failing that any surgical post, preferably in connect
Lika teaching school.
1. Name Ancis Clack. M.D.
Address & Royal Societies Club. London.
Officer of thalt
Occupation Medical Wication Hong Kong
of Faculty of Medicine
and the names of rela- 2. Name
tives or of those from
whom you send testi-:
monials should not be given under any cir- cumstances.
Address
Rt. Hr.. Thre. R. Zereus
Holderness Road. Hall. Yorks
The As
me fo
・
gi
Has Nur he att
ረ.
Occupation Member of
Parliament. Prity
Councillor.
12. Testimonials.
Give the name, address, and occupation of the writer of each of your testimonials. Not more than six should be submitted. The originals must be sent for inspection, but they will be returned if their return is requested and if copies of them are sent for record in the Colonial Office. Copies may be in MS. or in print; and it preferred that they should be on foolscap paper not larger than this form.
It is desirable, but not essential, than one of your testimonials should be from the Dean of the Medical School at which you were educated.
Should the writer of a testimonial prefer to send it direct to the Private Secretary, there is no objection to his doing so.
112
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