[Medical Association Application: Robert Estes Blount, MD] Page: 1 of 4

                                
TEXAS MEDICAL ASSOCIATION
MILITARY
Application forjIembership-Date          5 May 1959
(To be made in duplicate, original to be retained by County Society Secretary, duplicate to be mailed to Texas Medical Association, 1801 N. Lamar, Austin,
Texas, as soon as applicant has been elected and his dues have been collected by County Society Secretary.)
To the                                            Berar                                          County Medical Society
Gentlemen: I hereby make application for membership in the above Society, and, if elected, agree to abide by its constitution and by-laws, as they now exist
or may hereafter be amended.                                                                      Internal
Full Name             Robert              Estes        B1 ount            SexilML     Specialty   Medicine
Please Print         First              Middle            Last                                    One Only for Directory
Address: Permanent-Office Brooke Army Hospital, Brooke Army Mr. Ctr., Ft Sam Honst on; Txa
Street and No. or P. O. Box                         City               State
Residence       177 Artillery      Post,    Fort Sam Houston, Texas                                   (),j
Present (if different)                                                         IU
Not lieensed Si
License to Practice Medicine in Texas: Dated            Texas                Serial Number
Members must have permanent license               Month Day Year
Birth: Date        July    21, 1908                    Parentage: Father's Name       E. N, Blount, M. ,
Month  Day  Year
Place    Bassfield, Miss.                             Mother's Maiden Name        Mary Leola Blount
City                State
Brothers and Sisters     Lt Col .1 R    . B1lount,    USAF
Name                                    Address
Mrs. Floyd P. Smith                                              Bassfield. Miss

Marriage: Spouse  Alice Boy  Ridgway                1/05 Robinson
Former Name
Date of Marriage _ 29 Oct 1930              Place of Marriage
Month  Day  Year
If Spouse Has Died, Date of Death
Children
Name
R. E. Blount, Jr.                                 Sr. Med. Stuiden
R. B. R.  lount                                 Sr Pre-m d, Mil
Jane E. Blount                                   177 Artillery P
Education: Preliminary
City
Academic   Millsaps C& 1eae, Jackson, Miss,
Name of College       Location             Years

St, Jasckson, Miss.
'ormer Address
No Orleans, Ta.

Address
t, Duke Univ , Durh a  N,
lsaps College, J ck on,. Mi ,
ost, Fort, Sam Houston, Texas
State
4          BS  1 Jun 1928
Attended  Degree  Date Degree Received

Mo.  Day  Yr.
Medical Tulane Univ Sch of Medicine New Orleans, La -4                MD 2 Jun 1932
Name of College      Location           Years Attended  Degree  Date Degree Received
Mo.  Day  Yr.
Internship      U. S. Marine Hospital, New Orleans, La.
Name of Hospital          Location                 Dates
Residency (Preceptorship) Col W . L. Starnes, Sta, Hopp., Fort Slocum, N.Y. 193,19%,1937
Name of Hospital          Location                 Dates
Concurrently served as Assistant in syphilology & Dermatology, Vanderbilt Clinic,
Columbia University College of   & S., NYC, 1935, 1936, 193/
Postgraduate Walter Reed Army Institute of Research, Wash., D.C.  2 months, 19/5
Name of Institution   _   Location                 Years Attended
Oliver Gen. Hosp., Augusta, Ga.  6 months -Oct 1945 1946  (Internal Medicine)
Certification by Specialty Board  Internal Medi ci ne               1946
Specialty                    Date Certified
(OVER)

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