TITLE      *
SURNAME         *
FIRST NAME         *
SEX                     *	male female
DATE OF BIRTH       *
ADDRESS        *
POST CODE              *
NATIONALITY
NATIONAL INSURANCE NUMBER      *
TELEPHONE HOME
TELEPHONE WORK
TELEPHONE MOBILE
EMAIL ADDRESS     *
GDC REGISTRATION NUMBER *
PCT Number
MEDICAL INSURANCE NUMBER*
INSURANCE COMPANY    *
POSITION REQUIRED     *	Perm P/T Perm F/T Locum P/T Locum F/T
AVAILABLE FROM        *	TO
GEOGRAPHICAL AREAS    *
PRESENT POSITION:        *	PP NHS MIXED
AVERAGE GROSS  PER MONTH  *
HOW MANY PATIENTS ARE YOU ABLE TO SEE PER   DAY