| Admitted to: --- |
Date of Injury: --- |
||
|---|---|---|---|
| D.O.B/Age when admitted: --- |
Cause of Incident: Crashed 17.1.1942. |
||
| Transferred to QVH: --- |
Injuries: --- |
||
| No. of Operations at East Grinstead: --- |
IDENTITY CARD
This is to certify that the patient mentioned below and whose description is stated hereon is the authorised holder of this Identity card.
| Forename: D. R. |
Surname: Scrivens |
||
|---|---|---|---|
| Service No: --- |
Nationality: --- |
||
| Awards/Honours: --- |
Patient Unit: --- |
||
|---|---|---|---|
| Profession: Volunteer Reserve, Observer. |
Patient Rank: Sq Ldr |
||
| Death: --- |
Age at Death: --- |
||
|---|---|---|---|
| Dr Rank: |
Dr Unit: |
||
Notes:
Glossary: