I have on the ................................. day of 191.... seen and examined ....................................... and hereby certify that she is apparently in good health, that she is not labouring under any deformity, and is, in my opinion, both physically and mentally competent to undertake duty in a Military Hospital, and is
[*]A. Fit for General Service.
B. Fit for Home Service only.
C. Unfit.

Date (Signed) Address

[*] Kindly delete categories which do not apply.

Reference No.: J.W. 19c.

JOINT WOMEN'S V.A.D. DEPARTMENT. Territorial Forces Association. British Red Cross Society. Order of St. John of Jerusalem. DEVONSHIRE HOUSE, PICCADILLY, LONDON. W1.

QUALIFICATIONS of Members of Women's Voluntary Aid Detachments for Nursing Service or General Service.