| Age?? | 43 |
| Date | 1867 Jany. 21 |
| Day of the Week | Monday |
| Last Meal before Discharge | B[reakfast] |
| Name | Bray Pritchard Jesse |
| Class for Diet | 1 |
| Parish to which Charged | St. Mary |
| How Discharged | Dead |
| Observations |
Source: London Metropolitan Archives;Reference Number: P92/MRY/350
Source: Ancestry.com. London, England, Workhouse Admission and Discharge
Records, 1764-1930