CERTIFICATE OF MEDICAL BOARD. The Candidate will fill up and sigh the following declaration before presenting herself for medical examination. I declare upon my honour that: 1st. I have never suffered from any serious illness or injury, except as stated below* 2nd. I am not, as far as I know, at present suffering from any mental or bodily infirmity, or physical imperfection or disability, except as stated below.* 3rd. I have never suffered from "fits" of any description, except as stated below.* 4th. I have fully revealed to the Examining Medical Officer all circumstances within my knowledge that concern my health. Signature Date The President of the Medical board will, after reading the above declaration, and examining the Candidate, complete the following certificate. I certify that I have examined and find that she is for service in the Women's Army Auxiliary Corps. (i.) At Home. (ii.) At Home and Overseas. Station Date Signature CERTIFICATE OF ENROLLING OFFICER The applicant was gazetted on the day of 19 , as and I hereby enrol her in the Women's Army Auxiliary Corps. Date Place Signature of Enrolling Office.

• The words in italics should be struck out in case there is no exception to record.

Insert "fit" or "unfit"