No | When and where born | Name, if any | Sex | Name and surname of father | Name, surname and maiden surname of mother | Occupation of father | Signature, description and residence of informant | When registered | Signature of Registrar |
254 | Ninth January 1908 95 Bird in Bush Road |
Leonard | Boy | Richard Williams | Alice Maud Williams formerly Fiveash | Bus Conductor | A.M. Williams
Mother 95 Bird in Bush Road |
Nineteenth February 1908 | A. Lucas Registrar |