| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 204/1 | Bannister, Albert G | Male | 25 Sep 1874 | Widowed | Retired | ||
| 204/2 | Beath, George H | Male | 15 Mar 1863 | Single | Jeweller | ||
| 204/3 | Blake, Evelyn M | Female | 6 Mar 1884 | Widowed | Housekeeper | ||
| 204/4 | Fisher, Edith E | Female | 10 Jun 1902 | Single | Waitress |
Source: findmypast - 1939 Register RG101/0576I/009/29