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Census 1845 form

Name of village or place with specification of farms, houses, etc. ____

Number of families in each farm and every house ____

The names of every person in every farm, every house, and every family ____

The age of every person, the current year included ____

Married, unmarried, widower or widow ____

Place of birth ____

That is the name of the town and in the countryside, and name of the parish and county

Title, office, business, handicraft, occupation, position in the family or what they live by ____

Of these were the sanity taken away, were foolish or mad.

____ Number
____ Duration of illness