Literal question
<span class="em"> Name and surname</span>
<br />No person absent on the night of Sunday, April 7th to be entered here; except those who may be travelling or out at work during that night, and who return home on Monday, April 8th.
<br />Write after the name of the head of the family, the names of his wife, children, and other relatives; then visitors, etc., and servants.
<br />____Name
<br />____Surname</p>
<p><span class="em">2. Relation to head of family</span>
<br />State whether wife, son, daughter, or other relative, visitor, boarder, etc., or servant
<br />____ Relation to head of family