| Name | Relationship | Status | Age | Trade or Profession | Where Born |
|---|---|---|---|---|---|
| Sarah Henry? | Head | W | 62 | Annuitant | Surrey Croydon |
| Grace Smith | Dau | M | 26 | Surrey Croydon | |
| Robert Smith | Son in law | M | 27 | House Carpenter | Surrey Croydon |
| Selina G Dosonings? | Grandau | 11 | Surrey Croydon |
| Reference: | RG10/841/15/62/20/?? |
| Civil Parish [or Township] of: | Croydon |
| City or Municipal Borough of: | |
| Municipal Ward of: | |
| Parliamentary of: | County of East Surrey |
| Town of: | Croydon |
| Village or Hamlet, &c., of: | |
| Local Board of: | Croydon |
| Ecclesiastical District of: | St John’s |
| Address: | 73 Church St |