Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Wandsworth, Metropolitan Borough]
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Report of the Medical Officer of Health. 140
| Number and age of patients. | Patient's relatives living and dead :—(i.) Father and Mother ; (ii.) Brothers and Sisters ; (iii.) Uncles and Aunts. | Patient's wife if remarried give particulars for deceased wife or wives. | Patient's children. | Number of patients childless. | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Whether affected or not. | I. | II. | III. | ||||||||||
| Age. | No. | Iiving. | Dead. | Living. | Dead. | Living. | Dead. | Living. | Dead. | Living. | Dead. | ||
| ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ||
| ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | |||
| ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | |||
| 2 | ... | ... | ... | ... | ... | ... | ... | ... | ... | ||||
| 1 | 1 | ... | ... | ... | ... | ... | ... | ||||||
| ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | |||
| 11 | ... | 1 | ... | ... | ... | ... | |||||||
| 1 | 1 | ... | ... | ... | ... | ... | |||||||
| ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | ||||
| ... | ... | ... | ... | ... | |||||||||
| ... | ... | ... | 1 | ... | 29 | ... | |||||||
| 50 | ... | ... | ... | ... | ... | ... | ... | ... | ... | ... | |||
| 7 | ... | 2 | ... | 3 | ... | ... | ... | 1 | ... | ... | |||
| ... | ... | ... | ... | ... | ... | ||||||||
| ... | 10 | ... | ... | ... | ... | ... | ... | ... | ... | ... | |||