| [Date] | 1877 May 7 |
| Day of the Week | Monday |
| Next Meal after Admission | S |
| Name | Hollis Julia |
| Calling, if any | Laundress |
| Religious Persuasion | Rom Cath |
| When Born | 1805 |
| Class for Diet | 6 |
| No. affixed to the Pauper's Clothes | |
| Parish from which admitted | Newington |
| By whose Order admitted | Bassett |
| Date of the Order of Admission | |
| If born in the House, Name of Parents | |
| Observations | Sick Widow |
Source: London Metropolitan Archives; Reference Number: SOBG/111/10
Source: Ancestry.com. London, England, Workhouse Admission and Discharge
Records, 1764-1930