Particulars to be filled up in respect to all Persons under fifteen years of age who slept or abode in this Dwelling on the night of Sunday, the fifth day of April, 1891.

	Name.	Sex.	Age (Last Birthday).	If receiving Education. (State " Yes " or " No," as the case may be.)	Where receiving Education. (Before filling up this column you are requested to read instructions on the other side.)
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