| Name | Age | Profession etc. | Same County |
|---|---|---|---|
| William Inkpen | 50 | Coach M | Y |
| Maria Inkpen | 47 | Y | |
| Statia Ford | 31 | Ind | Y |
| Sarah Smith | 17 | Ind | Y |
| Reference: | HO107/1078/6/3/9/11/10 |
| Registration District: | Croydon |
| Sub-Registration District: | Croydon |
| City or Borough of: | |
| Parish of: | Croydon |
| Place: | High St |