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 |
46 | Eighteenth November 1921 102 Brookmill Road |
Denis Raymond | boy | Thomas Bushby Olliver | Mabel Alice Olliver formerly Newland | Motor Fitter | M. A. Olliver
Mother 102 Brookmill Road |
Thirty first December 1921 | J. E. wates Registrar |