§

1787 1787

Name of the Child
If a Foundling mark F.
If a Bastard B
If a Casualty C.
If the same Child
is taken a second
time mark the second
Entry of the Name 2
If a third time 3
Etc

Age real
or reputed
Years Y
Months M
Days D

If Born
in the
Workhouse
when

If not
Born in the
Workhouse
when
admitted

Name of the
Person by whom
sent
If by an Officer
mark the Name C.
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 Work
house.
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 my other Person
mention his or her
Name.

Nurse's Name to
whom delivered to be
Nursed. If a Wet
Nurse markW
If a dry NurseD.
If the Nurse dies or
is charged write the
Name of the new
Nurse under the
former

Place
where the
Nurse
lives

Price of Nursing each Week

Bounty
to
Nurses

If died
at Nurse
when

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

Y M D
Maria Coomes< no role > C.
1 3 -
1786 Oct.}
Jan. 1787 Discharged from the Workhouse to her Mother}
No. 40 Wych Street St. Clements
2s

Martha Jones< no role > C.
2 - -
1787 14. Sept}
Oct. 1787 Removed on Appeal to Gillingham Rent.}
4s

Benjamin Smith< no role >
John Dcl< no role > }
Church Wardens

James Green< no role >
Jno. Hawkins< no role >
Edward Tutet< no role > }
Overseers

Nl: Andrews< no role >
Vestry Cl

Duplicate also sign'd by Willm. Phillips< no role > Master of the Workhouse

4th. Febry. 1780 deled Duplicate at Mr. Crippen's NA