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 |
245 | Fourth August 1909 39 York Street |
Susan Minnie | Girl | Richard Williams | Alice Maud Williams formerly Fiveash | Omnibus Conductor | A.M. Williams
Mother 39 York Street Walworth Road |
Sixth September 1909 | H Cripps Deputy Registrar |