Case 9838

15. State whether any of the child's relatives are in your judgment in a position to maintain the child, or to contribute in any degree to its support.

From all enquiries I have made I found they are not able to.

16.Can any payment for the child be guaranteed from any source? If so, by whom?

None

17. Has the child ever been convicted? Is so, state the nature of the child's offence and term of imprisonment.

No

18. Has it ever attended day school? If so, where and for how long and in what Standard is it?

Board School. West Norwood. Now [Burlah] Road [?] Heath.

19. Ever attended Sunday School? Is so, where and for how long?

No

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

No

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

No

22. Is the child subject to fits or has it ever had one? If so, state its nature. Is the child subject to incontinence of urine?

No. No.

23. Is the child at present affected with any infectious or contagious disease, or with scrofula requiring medical treatment?

[pediculi] capitis.

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

whooping cough. measles. vaccinated. but is instructed to be done. Yes. Sep. 23. 03.

25. Is the child's general health good, and has it average mental capacity?

Yes. Yes. (parenthetical note on questions 20 through 24: B. [?] [muffate ?]

26. Are the child's parents, grandparents or next of kin, willing to sign an agreement to commit it wholly to the care of the Managers of the Home, to obey the rules in force, and to permit the said child when fully trained to be sent to any situation in the United Kingdom which may be obtained for it by the Committee?

Yes

I certify that the foregoing questions have been replied to, to the best on my belief.

Name - G. M.A.

Address - Parchmore Road. Thornton Heath.

Curate of - S. Paul's Thornton Heath.

Date - September. 9th 1903.

Overwritten in red: Left parish in 1906.