(1) Passed the night of Sunday, April 2nd, 1911, in this dwelling and was alive at midnight, or (2) Arrived on the Morning of Monday, April 3rd, not having been enumerated elsewhere.
No. of Schedule
Forename
Surname
Relationship
to Head of
Family
Age last Birthday
Status
Particulars as to Marriage
Personal Occupation
Industry or Service with which
worker is connected
Whether Employer,
Worker
or Working on,
Own Account