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Childrens Names Wher. Legitimate or Illegitimate
When Admitted or Born in the House.
Age when Admitted Y M D
Mors. Name Settlemt. & Residence.
Fathers Name Settlemt. Residence & Occupation
When Placed out to Nurse
Nurse C: & Sir Name If the Mor. Etc to be so Described.
Nurses Residence to be particularised.
Weekly Allowance s d
Bounty
When Paid
When Died at Nurse, Wher. Etc by the Nurses Negligence
If Removed, When, Where, With whom, & how placed.
Remarks