| Name | Relationship | Status | Age | Rank, Profession or Occupation | Where Born |
|---|---|---|---|---|---|
| Theresa Haywood | Head | W | 48 | Dress Maker | Stafford Burslem |
| Thomas Haywood | Son | U | 9 | Scholar | Stafford Burslem |
| Elizabeth Pickerl. | Relative | U | 21 | Wharehouse Potters | Stafford Burslem |
| Adam Bailey | Boarder | U | 24 | Teacher | Stafford Wolstanton |
| Fredk. Green | Boarder | U | 23 | Clerk | Stafford Burslem |
| Reference | RG11/2712/3/53/5/25 |
| Registration district: | Wolstanton |
| Sub-registration District: | Burslem |
| Civil Parish of: | Burslem |
| Municipal Borough of: | Burslem |
| Municipal Ward of: | North |
| Parliamentary Borough of: | Stoke on Trent |
| Town of: | Burslem |
| Urban Sanitary District of: | Burslem |
| Rural Sanitary District of: | |
| Ecclesiastical Parish or District of: | St Pauls |
| Address | 127 Newcastle St |