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
Nurse C: & Sir Name If the Mor. Etc to be so Described.
Nurses Residence to be plarised.
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.