Literal question
<span class="h3">Householder's Schedule</span>
<br />Scotland
<br />(Prepared under the direction of one of Her Majesty's Principal Secretaries of State.)</p>
<p>____ Parish
<br />____ City, Burgh, Town or Village
<br />____ Street, Square, etc., or Road
<br />____ Name or No. of House