rooms: Bath? Rent:
| information.|No. depending on |Location on floor:
| | family income: | front, rear, right, left.
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| | | | | MARITAL | | |EDUCATION AND INDUSTRIAL
| | | | |CONDITION| | | TRAINING.[*]
| | | | +---------+ | +----------------------------
Family |Age|Place of|Time |Reason|M|S|W|D|S|Chr|Pol|R|W|M S|M C|M I S|M T|T |W F
Members. | | Birth. |in | for |a|i|i|i|e| + | X |e|r|o c|o o|o n c|o r|r |h o
| | |N.Y. |coming|r|n|d|v|p| | |a|i|s h|s l|s d h|s a|a |e l
| | | |to |.|g|.|.|.| | |d|t| o|. l|. u o|. d|d |r l
| | | |N.Y. | |.| | | | | |.|e|i o| e| s o| e|e |e o
| | | | | | | | | | | | |.|n l|i g|i t l|a .| | w
| | | | | | | | | | | | | | .|n e|n r .|t | | e
| | | | | | | | | | | | | | | .| i | | | d
| | | | | | | | | | | | | | | | a | | | .
| | | | | | | | | | | | | | | | l | | |
------------+---+--------+-----+------+-+-+-+-+-+---+---+-+-+---+---+-----+---+--+---
1. Man | | | | | | | | | | | | | | | | | | |
2. Woman | | | | | | | | | | | | | | | | | | |
(Sex.) | | | | | | | | | | | | | | | | | | |
3. | | | | | | | | | | | | | | | | | | |
4. | | | | | | | | | | | | | | | | | | |
5. | | | | | | | | | | | | | | | | | | |
6. (Lodgers)| | | | | | | | | | | | | | | | | | |
7. | | | | | | | | | | | | | | | | | | |
8. | | | | | | | | | | | | | | | | | | |
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| [*] OCCUPATION. (State exact kind of work done and weekly pay.)
|-------+------+-----+------+------+-------+-------+----------------------
Family | At |