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- Add Patient Details to Station Road Auxiliary Hospital, Blackpool -


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Add Patient Details to Station Road Auxiliary Hospital, Blackpool

This form is to be used to only to add Patient details to  Station Road Auxiliary Hospital, Blackpool  Please ensure this is the correct hospital as details of the patient will be registered as being in this hospital.


Please select the relevant date from the dropdowns below
Day:  Month:   Year:

Event:

Service Number: If not known, please leave this box blank

Rank:                 

First Name:          Middle Name(s):

Surname:            

Regiment, Squadron or Ship

Battalion & Company (if applicable):

Reason they are in Hospital

Brief Details:

eg. Gun shot wound left leg, wounded 1st July 1916, Battle of the Somme. (If transferring to or from another Hospital, Casualty Clearing Station or Hospital Ship, or being discharged to return to their unit, you can include details here. Please only include details relevant to a stay in this hospital, you can add other hospital stays afterwards.

Their home address leave blank if not known.

If this person is already listed in our main database, please enter the Unique ID number in this box. If UID is not know, please type 'NotKnown', if you have not entered their details on our site, please leave this box blank. You can add them to our main database after submitting this form.
Your Name:                

Your Email Address: @