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<p n="168">Childrens Names Wher. Legitimate or Illegitimate.<lb></lb>
When Admitted or Born in the House<lb></lb>
Age when Admitted<lb></lb>
Mothers Name Settlemt. & Residence.<lb></lb>
Fathers Name Settlemt. Residence & Occupation.<lb></lb>
When Placed out to Nurse<lb></lb>
Nurse C:& Sir Name If with the Mor. or other Relation to be so Described.<lb></lb>
Nurses Residence be Ptlarised.<lb></lb>
Weekly Allowance<lb></lb>
Bounty<lb></lb>
When Paid<lb></lb>
When died at Nurse, Wher. Occasioned by the Nurses, Negligence or how.<lb></lb>
If Removed, When, where, with whom & how Placed.<lb></lb>
Remarks</p>
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