To the Rt: Worshipfull his Majestys Justices of the Peace
for the County of Middx Assembled in their Generall Session

The Humble Peticon and appeale of the Churchwardens
and Overseers of the Poor of the parish of Saint [..]
holborne above the barrs in the County of the [..]

Sheweth

That by a pass warrant or order under the hands and
Seales of John Milner< no role > and John Mercer< no role > Esqrs : two of
his Majestys Justices of the Peace for the said County of
Middx (Quor vuns) bearing date the ninth day of February
instant Ann Smith< no role > wido : with Ann < no role > her daughter were
removed and passed from the parish of Saint Giles's on the
Feilds in the said County of Middx to the said parish of
Saint Andrew-holborne above barrs as the place of them
last legall Settlement

Your Peticoners conceiving themselves aggreived
by the Judgment of the said two Justices
humbly appeal to this Court against the
and Pray that all Parties concerned herein
may be ordered to attend this Court some day
this Sessions to hear & abide the Judgement
& determinacon of this Court touching [..]
Appeale

And Your Petrs: shall pray Etc