Childrens Names Wher. Legitimate or Illegitimate
When Admitted or Born in the House. If not Admitted, Note it
Age when Admitted Y: M: D
Mothers Name Settlemt. & Residence.
Fathers Name Settlemt. Residence & Occupation
When Placed out to Nurse
Nurses Christn. & Sir Name If the Mor: or or. Relation to be so Described.
Nurses Residence [..] particularised
Weekly Allowance S: D
Bounty
When Paid
When Died at Nurse Wher. Supposed to be Occasioned by the Nurses Inattention or how
If Removed, When, where with whom & in what Capacity Placed.
Remarks