Case 342

13. At what address and with whom is the girl now living?

14. Give in full the names, addresses, ages, occupations and earnings of each living relative the child is known to possess either on the father's or mother's side such as grandparents, uncles, aunts, &c.

DEGREE OF RELATIONSHIP, NAMES, ADDRESS, AGE, OCCUPATION, WEEKLY EARNINGS

15. State whether any of her relatives are in your judgment in a position to maintain her, or to contribute in any degree to her support.

16. Has she ever been convicted? Is so, state the nature of her offence and term of imprisonment.

No.

17. Has she ever attended day school? If so, where and for how long?

Creaden Road board school

18. Has she ever attended Sunday School? Is so, where and for how long?

19. Has she ever been in the workhouse? If so, for how long and where?

Yes on remand ten days

20. Has she any affections of the limbs, joints, skin or eyes which may have the affect of preventing her from entering domestic services?

No.

21. Is she subject to fits or has she ever had one? If so, state its nature. Is this child subject to incontinence of urine?

No. No.

22. Is she at present affected with any infectious or contagious disease, or with scrofula requiring medical treatment?

No.

23. Has she had scarlet fever, or whooping cough or measles, or small pox? If not the latter, has she been vaccinated?

Has had whooping cough & he Vaccinated

24. Is her general health good?

Yes.

I certify that the foregoing questions have been correctly replied to.

Name

Address

Incumbent of

Date

Overwritten in pencil: J. MB