| Name and Surname | Relationship | Age - Years & Months | Marriage or Orphanhood | Birthplace | Nationality | Education | Occupation | Employment | Place of Work | Number & Ages of Living Children under 16 |
| Robert Shepherd | Patient | 59 - 3 | Married | London Lambeth | Commission Agents Clerk | (last Employer - Waylands | Kingly? St Regents ??? W.1. | none |
| Institution | Bolingbroke Hospital Bolingbroke Grove Battersea |
| Place | Battersea, London |
| Registration District | Wandsworth |
| Registration Sub-district | South West Battersea |
| Enumeration District | 33 |
| Schedule Type | lii |
Source: Ancestry - 1921 Census