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

Casualty Man