Date of application (if given): 13 February 1875
Age of applicant: 36
Address: Bedern
Occupation (if given): Field Labourer
Dependents: Margaret (wife, 38); Children Mary (13), William (12), Francis (9), Catherine (8), Margaret (4), Elizabeth (2)
Relief given (if documented): Medical aid cost
Ward name or number: Minster Yard, Bedern