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 Settlemt. & Residence.
Fathers Name Settlemt. Residence & Occupation
When Placed out to Nurse.
Nurse C:& Sir Name If the Mor. or other, Relation to be so Described.
Nurses Residence be Petlarised
Weekly Allowance s d
Bounty
When Paid
When Died at Nurse, & Wher. by the Nurses Negligence or not.
If Removed, When, where, with whom & how Placed
Remarks