§

1778 177819

Name of the Child
If a Foundling mark F.
If a BastardB
If a CasualtyC
If the same Child is
taken a second time
mark the second Entry
of the Name2
If a third time3
Etc.

Age
Real or
reputed
Years Y
Months M.
Days D.

If Born
in the
Workhouse
when

If not
Born in
the Work
house when
Admitted

Name of the
Person by whom
sent.
If by an Officer
mark the Name O.
If by the Father F.
If by the Mother M.

If Money
be received
with any
Child
what Sum

When
Died in
the
Workhouse

When discharged
from the
Workhouse
If Nursed by the
Mother mark M.

If Removed or
Passed
to what Place

When delivered from
the Workhouse to
the Father Mother
or other Person.
If to the Father mark F.
If to the Mother. M.
If to any other Person
mention his or her
Name

Nurses Name to
whom delivered to
be nursed. If a wet
Nurse markW.
If a dry NurseD.
If the Nurse dies or
is changed write the
Name of the new Nurse
under the former

Place
where the
Nurse
lives

Price of Nursing each Week

Bounty
to
Nurse

If died
at Nurse
when

If taken from
Nurse when. If
brought to the
Workhouse mark
If delivered to the W.
Mother mark. M.
If to the Father. F.
If to any other
Person mention
his or her Name.

Y. M. D.
Sarah Belsom< no role > B.
3 - -
1778. 2d July
Mary Belsom< no role > D.
Brested Kent.
2s..6d

Chars. Robins< no role >
Thos. Palmer< no role > }
Church Wardens

Peter Pope< no role >
Thos: Hudson< no role >
William Arch< no role > This name instance is in set 1505.
Jos. Richardson< no role > }
Overseers

Nl. Andrews, Vestry Cl

Willm. Phillips< no role > Master of the Workhouse

2d. Feb: 1779 deled Cop at Nn Crippen's Nll