| No. in Order of Admission | 3319 |
| Date of Admission | 1879 May 24 |
| Christian name and Surname | Susannah Guyett or Mayersbach |
| Sex | Female |
| Condition as to Marriage | Single |
| Age | 50 |
| Condition of Life and Previous Occupation | Housekeeper |
| Religious Persuasion | Protestant |
| Previous Place of Abode | Camberwell Workhouse |
| County, Union, or Parish to which chargeable | Camberwell |
| By whose Authority sent: |
M C ?. Sherman O.C.
E.M. Rolfe R.O. |
| Dates of Medical Certificates, and by whom Signed | H Chabot May 23 1879 |
| Form of Mental Disorder | Mania |
| Supposed Cause of Insanity | Excessive Drinking |
| Bodily Condition, and Name of Disease, if any | Fair |
| Age on First Attack | 50 |
| Date of Discharge, Removal, or Death | Died May 13 1880 |
| Observations |
Source: Surrey History Centre; Reference: SHC 3043/5/1/1/3