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Full Name and Nationality of Woman to whom married , and Name of each Child ( if any ) ( 18 ) Place of Marriage , and of Birth of each Child ( 19 ) Date of Marriage , and of Birth of each Child ( 20 ) Campaigns , Wounds , Medals or Rewards of any kind ( 21 ) ( a ) Date ( b ) Place Discharge or becoming Non - Effective Cause 14. 5. 33 Para 91/441 ) Selly . Daftfort Top Rank and Character on Discharge ( 22 ) ( 23 ) 49-39 . Rejoined bolours . ( 24 ) 19. 5. 34 Para 91 / 2-1 ) Sthye TotE Sept ford 30.11 . 21 Jara 91 / 1x4 | Shhges Leptfordt Reduction & Stetfahrend Rate of pension awarded ( if any ) ( 25 ) Address on Discharge ( 26 ) Remarks ( 27 ) 158 T |
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