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 C: & Sir Name
Nurses Residence to be Ptlarised.
Weekly Allowance s d
Bounty
When Paid
When Died at Nurse,
If Removed When, Where with whom & how placed.
Remarks