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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
Mothers Name Settlemt. & Residence.
Fathers Name Settlement Residence & Occupation
When Placed out to Nurse
Nurses C: & Sir Name
Nurses Residence to be plarised.
Weekly Allowance
Bounty
When Paid
When Died at Nurse, Wher. Etc by the Nurses Negligence, or how
If Removed, When, Where, With whom, & how Placed
Remarks