Childrens Names Wher. Legitimate or Illegitimate
When Admitted or Born in the house
Age when Admitted Y M D
Mothers Name Settlemt. & Residence
Fathers Name Settlemt. Residence & Occupation
When Placed out to Nurse
Nurses C: & Sir Name
Nurses Residence be ptlarised
Weekly Allowance S D
Bounty
When Paid
When Died at Nurse
If Removed, When, Where, With whom & how Placed
Remarks