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 |
356 | Twenty second April 1895 122 High Road Kilburn |
Mabel Alice | Girl | Frederick James Newland | Alice Newland formerly Chapman | Grocer's Manager | Frederick J. Newland
Father 122 High Road Kilburn NW |
Thirty first (24) May June | Fred S. Bridger Registrar |