1795 1795

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
It 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
where
admitted

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

If Money
be received
with any
Child
what Sum

When
died
in the
Work
house

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

If removed
or Passed to
what Place

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

Nurse is Name to
whom delivered to
be Nursed. If a wet
Nurse mark W. If
a dry Nurse D. 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
Nurses

If
died at
Nurse
when

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

Y M D
Robert Agate< no role > B
2 1 22
1794 8. Novr.
6. Ap [..]
St. Ann Levis< no role >
D. Wand Worth Survey
4s

Swift C.
1 3
1796 30. April
3d.
M
4

Margt. Jenks< no role > B.
15
25. Sept
10. Oct.
4

Wilkinson
Thos Brown< no role >
Wm Sampkin< no role > }
Church Wardens

J. Layton
Thos. Hunter< no role > }
Overseers

Robertson Simpson< no role > Man the Wor

Nel. Andrews< no role >
Vestry Cl

11th. Feb. 1797 deled Discharged at Mr. Clippen's NA