| Name | Age | Profession etc. | Same County |
|---|---|---|---|
| Charles Smith | 36 | Ironmonger | Y |
| Lydia Smith | 32 | Y | |
| George Smith | 5 | Y | |
| Esther Wilks | 14 | F.S. | Y |
| Reference: | HO107/1078/5/1/9/9/4 |
| Registration District: | Croydon |
| Sub-Registration District: | Croydon |
| City or Borough of: | |
| Parish of: | Croydon |
| Place: | High Street |