Childrens Names Wher. Legitimate or Illegitimate
When Admitted or Born in the House,
Age when Admitted Y: M: D
Mothers Name Settlemt. & Residence.
Fathers Name Settlemt. Residence & Occupation
When Placed out to Nurse
Nurses C: & Sir Name
Nurses Residence to be Ptlarised.
Weekly Allowance s:d
Bounty
When Paid
When Died at Nurse Wher Occasioned by the Nurses Negligence, or how.
If Removed, When, where, with whom & how Placed.
Remarks