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Childrens Names Whether Legitimate or Illegitimate
When Admitted or Born in the House, If not Admitted, Note it
Age when Admitted Y: M: D
Mothers Name Settlement & Residence
Fathers Name Settlemt. residence & Occupation
When Placed out to Nurse
Nurses Christn. & Sir Name If the Mor. or or. Relations to be so Described,
Nurses residence be particularised
Weekly Allowance
Bounty
When Paid
When Died at Nurse, Wher. Supposed to be Occasioned by the Nurses Inattention, or how,
If removed, When, Where, & with Whom Placed
Remarks