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Note The List to be made to the END of the Quarter, and sent to the Clerk of the Union within 7 days
COUNTY OF CORNWALL, UNION OF MYLOR, DISTRICT OF MYLOR
QUARTERLY LIST OF LUNATIC PAUPERS within the District of the Union of MYLOR, in the County of CORNWALL, not in any Asylem, Hospital, or Licensed House

Name sex age Illness duration resident in W.H. Date conditions restrained
Alice Beer F   Idiocy   From Birth No. Flushing With Mother 22nd Nov Satisfactory No

I declare that I have personally examined the several Persons whose names are specified in the above list on the days set opposite their names; I certify, firstly, with respect to those appearing by the above List to be in the Workhouse is sufficient for their reception, and that they are all proper patients to be kept in the Workhouse; and secondly, with respect to those appearing by the above List to be resident elsewhere than in the Workhouse, that they remain out of an asylum
I declare that the persons in the above List are, to the best of my knowledge, the only Pauper Lunatics in the MYLOR District of the Union of MYLOR who are not in an Asylum, Hospital, or Licensed House.
Dated 31st day of December 1894 Signed E Head Moore Medical Officer of the MYLOR District

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Contributed by Malcolm McCarthy, (Malc in Sunny Padstow), who has the original document.