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<p n="22">§</p>
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<p n="23">Childrens Names Wher. Legitimate or Illegitimate <lb></lb>
When Admitted or Born in the House. If not Admitted, Note it <lb></lb>
Age when Admitted Y: M: D <lb></lb>
Mothers Name Settlemt. & Residence. <lb></lb>
Fathers Name Settlemt. Residence & Occupation <lb></lb>
When Placed out to Nurse <lb></lb>
Nurses Christn. & Sir Name If the Mor: or or. Relation to be so Described. <lb></lb>
Nurses Residence<obscured></obscured>
particularised <lb></lb>
Weekly Allowance S: D <lb></lb>
Bounty <lb></lb>
When Paid <lb></lb>
When Died at Nurse Wher. Supposed to be Occasioned by the Nurses Inattention or how <lb></lb>
If Removed, When, where with whom & in what Capacity Placed. <lb></lb>
Remarks</p>
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