| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 109/1 | Smith, George H | Male | 23 Aug 1898 | Married | Plumber Builders & Decorato[r] | ||
| 109/2 | Smith, Gladys L | Female | 16 Aug 1898 [sic] | Married | Unpaid domestic dutie[s] | ||
| 109/3 | Baillie, Herbert J | Male | 2 Feb 1882 | Single | General Labourer |
Source: findmypast - 1939 Register RG101/0931G/007/29