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Registration

[[4 column table]]
| Names | Age | No of dependents | Remarks |

| Charles | 45 |   | Diseased - Kidneys affected |
| Alesy his wife | 44 |   |   |
| Nimrod | 17 | 1 |   |
| Octavia | 14 | 1 |   |
| Sarah | 10 | 1 |   |
| Andrew | 8 | 1 |   |
| Tryphina | 6 | 1 |   |
| Jarralt | 4 | 1 |   |
| Todd | 3 | 1 |   |
| Lucinda | 1 | 1 |   |
| Nancy | 52 |   | Stiff thumb. subject to colic |
| Alfred | 16 | 1 |   |
| Mary | 14 | 1 |   |
| John | 9 | 1 |   |
| Ann | 36 |   |   |
| Henry | 14 | 1 |   |
| Wiley | 8 | 1 |   |
| Isaac | 6 | 1 |   |
| Martha | 4 | 1 |   |
| Thompson | 1 | 1 |   |
| Sanford | 23 |   | Crippled from boyhood. occasioned by an old running sore, |
[[/4 column table]]

Executed in presence of,
Samuel A Agnew
Neal F. Hemby