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.
Father Name Settlemt. Residence & Occupation
When Placed out to Nurse
Nurses C: & Sir Name If the Mor. Etc. so to be Described.
Nurses Residence to be pticularised.
Weekly Allowance S D
Bounty
When Paid
When Died at Nurse, Wher Etc by the Nurses Negligence, or how.
If Removed, When, Where, With whom, & how Placed.
Remarks