Literal question
<span class="h1">Householder's Schedule</span></p>
<p>Prepared under the direction of the Local Government Board, pursuant to the Act of 43 and 44 Vict. c. 37.</p>
<p>____Name of Occupier</p>
<p><span class="em">To the Occupier<br /><br />You are requested to insert the particulars specified on the other side, in compliance with an Act passed during the last Session of Parliament, and which received the Royal assent on the 7th September 1880<br /><br />List of the members of this family, of visitors, of boarders, and of servants, who slept or abode in this dwelling on the night of Sunday, April 3rd, 1881</span></p>
<p><svar a="all" v="GB81A402 GB81A403">Name and Surname<br /><br /><div class="i1">(No persons absent on the night of Sunday April 3rd, to be entered here; except those who may be traveling or out of work during that Night, and who return home on Monday, April 4th)<br /><br />State the Name of the:<br />____ Head of the Family<br />____ Wife<br />____ Children<br />____ Other Relatives<br />____ Visitors<br />____ Boarders<br />____ Servants</div><br /></svar></p>
<p><svar a="all" v="GB81A413 GB81A422">2. Relation to head of family:<br /><div class="i1">[] Head<br />[] Wife<br />[] Children<br />[] Other relatives<br />[] Visitors<br />[] Boarders<br />[] Servants</div><br /></svar></p>
<p><svar a="all" v="GB81A410">3. Condition as to Marriage<br /><div class="i1">(Write opposite the Names of all Persons except Young Children)<br /><br />[] Married<br />[] Widower<br />[] Widow<br />[] Unmarried</div><br /></svar>
